Page 109 - Reduction of coercive measures

Multidisciplinary reduction of coercive measures
of the expert team themselves and from professionals working in the organization. These elements often focused on the reduction of coercive measures applied as physical support for a resident, reorganizing spaces within the unit and reorganizing daily routines. Also, expertise on the operation and developments and best practice experiences on surveillance technology was employed.
Prioritization of treatment plans was done by weighing the severity of the coercive measure and the preferences of care staff. Risk analyses informed the prioritization of treatment plans as well as the implementation of preemptive measures to prevent or management adverse responses to the reduction of coercive measures.
The multidisciplinary expert team coordinator and the first author were regularly briefed by the members of the team in order to maintain adherence to the design of the intervention. The intervention stopped when the consultation plan had been implemented.
Care as usual
Care as usual consists of a team of support staff members who provide daily care to residents. Treatment professionals such as physicians and psychologists are responsible for supporting the support staff and carrying out the treatment. They work together with management who can set up the organisation in such a way that treatment and supervision can be carried out. Management, professionals and support team together form the regular team that is involved in the unit. Part of the work of this team is to reduce the use of coercive measures. If they fail to make progress in this respect, they can request advice from the coercive measure committee of the organisation which, among other things, supervises the careful use of coercive measures and supports their phasing out. Additional expertise may also be requested, for example specialists working within the same organisation or with another organisation. Care as usual is also subjected to organisation-wide efforts to raise employee awareness of the use of coercive measures and the need to reduce these. The implementation of a mandatory registration system was part of this organisation-wide program.
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