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Journal Article

Citation

Richardson Velmans S, Joseph C, Wood L, Billings J. J. Psychiatr. Ment. Health Nurs. 2024; 31(3): 325-339.

Copyright

(Copyright © 2024, John Wiley and Sons)

DOI

10.1111/jpm.12987

PMID

37874310

Abstract

INTRODUCTION: Nursing staff are frequently exposed to high-risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours.

AIM: The aim of the study was to examine nursing staff experiences of high-risk behaviours in inpatient mental health settings.

METHODS: Four electronic databases (CINAHL, Medline, PsycINFO, EMBASE) were searched. The protocol for this review was prospectively registered in PROSPERO (Ref: CRD42022334739). A meta-synthesis of nursing staff's experiences of high-risk behaviours in inpatient mental health settings was conducted.

RESULTS: We identified 30 eligible studies. Six themes were constructed from the meta-synthesis: the social contract of care; the function of risk behaviours; the expectation of risk; risk as a relational concept; navigating contradictions in care; the aftermath.

DISCUSSION: Nursing staff conceptualize risk as a meaningful behaviour shaped by patient, staff and environmental factors. Managing risk is an ethical dilemma for nursing staff and they require more training and support in ethical risk decision-making.
IMPLICATIONS FOR PRACTICE: Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours.

RELEVANCE STATEMENT: Nursing staff are frequently exposed to high-risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. This systematic review offers insights into how high-risk behaviours are experienced by nursing staff and makes recommendations about how to improve the understanding and management of them. Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours.


Language: en

Keywords

aggression; Humans; Inpatients; Mental Disorders; Nursing Staff, Hospital; psychiatric inpatient staff; Psychiatric Nursing; Risk-Taking; self‐harm; suicide; Systematic Literature Reviews

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