Page 33 - Reduction of coercive measures

to professionals of the care organization and the committee of representatives of residents. Because the response rate of this invitation was low a reminder was sent fours week later. Nevertheless, response rate stayed low and five professionals were individually approached and asked to participate. Eventually, the panel consisted of thirteen people, including the first three authors of this article. One meeting of four hours was organized.
For the purpose of the implementation of a mandatory routine registration system senior support staff members, managers, psychologists, and physicians of fifty units were informed by email about this step of the study and invited for training in registration of coercive measures. The online system was developed to register and justify the use of coercive measures within the health care organization; it had to meet extant standards which were set by law, health care inspectorate and organizational policy. The system is part of the electronic personal file of a resident. Therefore, training focused as well as on the identification of coercive measures as on laws and regulations and policies and how the system could be used. Outcomes originating from reflections by stakeholders on results of the first part of the study contributed to the training. This meant increasing awareness and thereby the identification of coercive measures. Training was given by the first author of this paper, by a research assistant, and by several master students. At the end of the training, coercive measures were registered in the system and caregivers were able to maintain the registration. Training contained one or more visits to units to support registration of coercive measures. The number of visits depended on the number of coercive measures which had to be registered, and time needed for identification and registration of all coercive measures. Whenever a psychologist or physician was not able to come to training, the inventory of coercive measures and an explanation of the system were talked through by phone. Senior support staff members were always present at training.
When researchers and support staff, professionals, or management did not agree whether a measure was a coercive measure or not, they were registered in a different section of the electronic personal file of a resident. This section had the structure of a form
Measurement of coercive measures
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