Page 43 - Reduction of coercive measures
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                                complete, according to a list of standardized coercive measures, and reliable registration of coercive measures in day to day care appears therefore to be only partly feasible. Considering the several goals of registration on improvement and justification of the use of coercive measures, it should not be assumed that routine registrations are a reliable and valid reflection of actual care practice. Which coercive measures are included in the registration system is an outcome of the process of consideration by support staff and professionals whether a measure is restrictive in a specific context or not. Implications for policies on improvement of registration and reduction of the use of coercive measures therefore focus on this process in two ways. First, as indication and registration of coercive measures is an outcome of a group process, interventions on improvement should focus on this process. Outcomes will be improved when information obtained from the registration system is used to support caregivers (Huckshorn, 2004). A registration system should serve and challenge support staff members to provide the best care and therefore use as few as possible coercive measures. Also, independent observers can be used to test these registrations and contribute to the development of a reliable and full registration of coercive measures. Second, it should be clearer how contextual factors affect the identification of coercive measures. In the current Psychiatric Hospitals (Compulsory Admissions) Act (Wet Bopz) and also the Care and Coercion Act (Staatsblad, 2018, 36) the reason or aim of the use of coercive measures is very clear: to reduce harm for a resident. The context in which coercive measures are used, however, is not taken into account. Therefore, aims of further research should focus on addressing important context factors in using coercive measures. Also, focus has to be on how registration can serve multiple goals, such as support for staff members, professionals and management to improve quality of care. Finally, it should be clear how registration contributes to the explanation and justification of the use of coercive measures, especially in designing and adapting (new) legal frameworks about coercive measures. Preventing violation of rights of people with intellectual disabilities by the use of coercive measures should be the basis of registration of coercive measures and therefore developments in policies and legal frameworks.
Measurement of coercive measures
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