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Junior staffing changes and the temporal ecology of adverse incidents in acute psychiatric wards
Author(s) -
Bowers Len,
Jeffery Debra,
Simpson Alan,
Daly Christina,
Warren Jonathan,
Nijman Henk
Publication year - 2007
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/j.1365-2648.2006.04101.x
Subject(s) - staffing , medicine , poisson regression , incident report , adverse effect , emergency medicine , medical emergency , psychiatry , nursing , environmental health , population , forensic engineering , engineering
Title. Junior staffing changes and the temporal ecology of adverse incidents in acute psychiatric wards.Aim. This paper reports an examination of the relationship between adverse incident rates, the arrival of new junior staff on wards, and days of the week on acute psychiatric wards. Background. Incidents of violence, absconding and self‐harm in acute inpatient services pose risks to patients and staff. Previous research suggests that the arrival of inexperienced new staff may trigger more adverse incidents. Findings on the relationship between incidents and the weekly routine are inconsistent. Method. A retrospective analysis was conducted of formally reported incident rates, records of nursing student allocations and junior doctor rotation patterns, using Poisson Regression. Variance between days of the week was explored using contingency table analysis. The data covered 30 months on 17 psychiatric wards, and were collected in 2002–2004. Findings. The arrival of new and inexperienced staff on the wards was not associated with increases in adverse incident rates. Most types of incidents were less frequent at weekends and midweek. Incident rates were unchanged on ward‐round days, but increased rates were found on the days before and after ward rounds. Conclusion. Increased patient tension is associated with raised incident rates. It may be possible to reduce incident rates by moderating stimulation in the environment and by mobilizing support for patients during critical periods.