Page 28 - Reduction of coercive measures

Chapter 2
In sum, further research on registrations is needed to improve policy and practice around the use of coercive measures. One of the subjects to be studied is whether recording of the use of coercive measures can be standardized and sufficiently robust while incorporating the context and the purpose of the potential coercive measure. Firstly, this study aims at establishing reliability of registrations of coercive measures, and secondly it determines whether registration of coercive measures by support staff and professionals in a routine registration system is comprehensive and feasible. The study followed a flexible design (Dellinger & Leech, 2007) in which intermediate research outcomes on psychometric properties of the initial instrument were validated by reflections by stakeholders in order to arrive at a registration that was both reliable and meaningful, and thus would have the highest chance of successful implementation. The first part of the study focused on the reliability of each of the measures that were identified based on a broad definition of coercive measures, as these measures are taken by support staff over the course of a 24 hours period of providing residential care for residents. Reliability was tested by comparing recordings by different members of the care staff team and by comparing recordings between care staff members and observations made by trained, independent observers. The second part of the study focused on the implications of the findings regarding the reliability with which coercive measures could be recorded in two ways. First, findings concerning reliability were discussed in a stakeholder panel of which results were used for the implementation of a mandatory routine registration system. Testing the success of the implementation of the registration system was the next step in the second part of the study. The question was to what extent the new routine recording of coercive measures yielded data that corresponded with the coercive measures as described and approved in the residents’ electronic personal plan.
26