Page 24 - Reduction of coercive measures

Summary and general discussion
they may apply as a matter of routine. It may also contribute to norm setting, meaning that the right to self-determination becomes more appreciated and translated into concrete terms of coercive measures. However, change in norms was not assessed in this study and therefore awaits further research.
In addition, reliable information about coercive measures contributes to the identification of units that may require extra attention and to evaluation of effects of interventions in care practice. Registering the daily application of coercive measures thus contributes to the changes in coercive care practices that are pursued through policy, legislation, and programs to improve quality of care. It is therefore recommended to develop and implement registration systems for residential care. In the course of implementation, attention must be paid to training support staff members and professionals in the identification of coercive measures, which should lead to a more reliable and complete registration. Training in the registration of coercive measures is essential in order to achieve a complete and accurate registration. Without proper training, it is likely that the benefits of registration will not be realized. The importance of training in registration and also the development of unequivocal guidelines for registration are emphasized by the finding that the criteria for registration set by the Dutch legislator are partly unclear. Although the legislator formulates starting points, these do not appear to give sufficient direction for a uniform registration. A comprehensive an accurate registration of coercive measures gives professional care the opportunity to analyze and monitor the use of coercive measures. It gives the possibility to map certain resident and context related factors and to adapt interventions to these factors. Effects of interventions can also be monitored by means of the registration system.
The intervention study shows that accelerating the phasing out of coercive measures is possible. The multi-component approach aims at several interrelated facets of care that are bound to lock each other in place. These patterns were purposefully disrupted by deploying a multidisciplinary expertise team. While also in the control group coercive measures were reduced, the results of the experimental group showed reduction at a more rapid pace. It is therefore recommended
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