Page 19 - Reduction of coercive measures
P. 19

                                coercive measures. Implementing a structural change in professional care requires breaking through ingrained patterns (May, Johnson, & Finch, 2016). Such patterns may involve interrelated practices of how people work together, such as support staff, residents and professionals. Patterns of action, which include the use of coercive measures, are formed, are reinforced, and thus continue to exist through these interactions. A multi-component approach (Williams & Grosset, 2011;Schreiner et al., 2004) may influence the various facets of professional care simultaneously, maximizing the chance that coercive measures may be discontinued. It is as yet unclear to what extent effects of interventions focused on single interactions or problems can be extended to a complex of interactions involving multiple residents and units. In line with Schreiner et al (2004) and Williams and Grosset (2011) Chapter five reports on the effects of a multi- component approach on the reduction of coercive measures. Chapter five demonstrates the effects of a multi-component approach on the number of coercive measures employed. A program was developed aimed at awareness and registration at the organizational level, multidisciplinary consulting at the residential care team level, and multidisciplinary intervention at the resident level. The main objective was to test the effect of this program on the use of coercive measures. Effects were determined using a clustered randomized controlled trial. For the coercive measures subjected to the experimental condition, a multidisciplinary expert team was deployed. The expert team worked in systematic and close cooperation with the team of support staff and professionals associated with each residential unit. Central to this systematic work was the registration of coercive measures in the mandatory registration system and the consultation plan. This made it possible to monitor the effects on the use of coercive measures and, if necessary, to adjust the consultation plan. Within the control group, apart from the implementation of registration, care as usual was provided. Findings showed that coercive measures in units in the experimental group had a higher rate of reduction than coercive measures in units in the care as usual group. Also, during the intervention period, more coercive measures were recorded in the experimental group than in the control group. An alternative
Summary and general discussion
 17
































































































   17   18   19   20   21