King's College London

Research portal

Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)1412-1422
Number of pages11
JournalInternational Journal of Nursing Studies
Issue number9
Early online date9 Jul 2015
Accepted/In press3 May 2015
E-pub ahead of print9 Jul 2015
PublishedSep 2015


King's Authors


BACKGROUND: Acute psychiatric wards manage patients whose actions may threaten safety (conflict). Staff act to avert or minimise harm (containment). The Safe wards model enabled the identification of ten interventions to reduce the frequency of both. 

OBJECTIVE: To test the efficacy of these interventions. DESIGN: A pragmatic cluster randomised controlled trial with psychiatric hospitals and wards as the units of randomisation. The main outcomes were rates of conflict and containment. 

PARTICIPANTS: Staff and patients in 31 randomly chosen wards at 15 randomly chosen hospitals. 

RESULTS: For shifts with conflict or containment incidents, the experimental condition reduced the rate of conflict events by 15% (95% CI 5.6-23.7%) relative to the control intervention. The rate of containment events for the experimental intervention was reduced by 26.4% (95% CI 9.9-34.3%). 

CONCLUSIONS: Simple interventions aiming to improve staff relationships with patients can reduce the frequency of conflict and containment. 

TRIAL REGISTRATION: IRSCTN38001825. Crown Copyright.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454