Safewards implementation in residential aged care: a pilot and feasibility study.

• Safewards offers a feasible restraint reduction program for RAC. • Fewer restrictive practice incidents were observed in the care home which implemented five Safewards interventions. • Future implementation should capitalise on aged care staff interest in learning strategies and approaches to supp...

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Publicado en:Geriatric Nursing Vol. 68
Autores principales: Dawson, Suzanne, George, Stacey, Schofield, Merridy, Rickards, Sharon, Gulyani, Aarti, Ng, Lorraine, Aikman, Jenie, Hamilton, Bridget, Oster, Candice
Formato: research Journal Article
Publicado: Elsevier B.V. Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 68
      pid: 467
      pub: Elsevier B.V.
      place: New York, New York
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        191602131
        191602131
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        10.1016/j.gerinurse.2025.103767
        191602131
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        atl: Safewards implementation in residential aged care: a pilot and feasibility study.
      aug:
        au:
          Dawson, Suzanne
          George, Stacey
          Schofield, Merridy
          Rickards, Sharon
          Gulyani, Aarti
          Ng, Lorraine
          Aikman, Jenie
          Hamilton, Bridget
          Oster, Candice
        affil: Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
      sug:
        subj:
          Residential Care
          Mental Health Services
          Program Implementation
          Nursing Models, Theoretical
          Geropsychiatric Nursing
          Restraint, Physical
          Program Evaluation
          Conflict (Psychology)
          Human
          Australia
          Male
          Female
          Aged
          Pilot Studies
          Conceptual Framework
          Multimethod Studies
          Outcome Assessment
          Implementation Science
          Aged: 65+ years
          Male
          Female
      ab: • Safewards offers a feasible restraint reduction program for RAC. • Fewer restrictive practice incidents were observed in the care home which implemented five Safewards interventions. • Future implementation should capitalise on aged care staff interest in learning strategies and approaches to support their interactions with residents. • Contextual barriers need to be addressed to scale up and sustain Safewards in aged care settings. The prevalence of restrictive practices in residential aged care (RAC) remains unacceptably high. To address this, feasible, evidence-informed interventions that can be integrated into routine practice are needed. Safewards, a model and set of ten interventions that explains and reduces conflict and restrictive practice use in mental health care settings, presents a promising approach for application within RAC. This study evaluated the feasibility of implementing Safewards to reduce restrictive practice use in RAC. This pilot and feasibility study used a mixed methods process and outcomes evaluation. Safewards was implemented in two Australian care homes. Implementation outcomes were assessed using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) and the Consolidated Framework for Implementation Research (CFIR) guided qualitative data collection to identify the contextual factors that facilitated or hindered implementation. Eight Safewards interventions were suggested for implementation in RAC. Three Safewards interventions were implemented at site 1 and five interventions at site 2 with between 28–52 % staff attending training across sites. Physical restraint use decreased at site 2 but not at site 1. Most implementation enablers and barriers were identified within the CFIR domains of inner setting and implementation process. Safewards was feasible to implement in RAC, with 5/8 interventions contributing to reduced physical restraint use. The variation in findings across sites, including greater reach and adoption and stable and engaged leadership at site 2, emphasises the importance of contextual factors for successful implementation. Findings from this study can inform future implementation of Safewards into RAC. A person with lived experience as a caregiver for a family member with dementia was employed as a Safewards facilitator and as a member of the project steering committee and had input into all stages of the project.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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