Page 34 - Reduction of coercive measures

Chapter 2
on which day to day components of care are described. Professionals were ultimately responsible for the registration of coercive measures in the system and therefore they decided if a coercive measure was registered in the registration system or not. In most cases, the researchers considered measures as a coercive measure according to the list of coercive measures, but the staff members and professionals thought it was not in that specific case.
The electronic personal file consisted of all information of a resident, including treatment plans, challenging behavior management plans, records of professionals, and forms on which information is included concisely. Conform policy of the organization, the use of coercive measures is described and supported by professionals in these plans. The first author and a research assistant checked plans of 30 residents on coercive measures which were not registered in the registration system nor in the section of electronic personal file where coercive measures could be described in case no consensus was obtained.
Instruments
In order to validate the results of the first part of the study, the panel of stakeholders discussed its results within a set structure. Results were presented and the panel was asked to generate explanations why support staff would or would not register a measure as a coercive measure. Also, they discussed consequences of results for routine registration of coercive measures by support staff and professionals. The reflections of the panel were recorded and minutes were made.
To register coercive measures, a mandatory registration system of the health care organization was used, which was developed by the health care organization in order to provide data and reduce the use of coercive measures, and was implemented after the first part of this study. The registration system included the 57 listed coercive measures used in the first part of the present study and additional coercive measures. Registration could be done at any given moment and, depending on the type of coercive measure, evaluations took place at least every three or six months, but updates could be made more frequently when necessary. The registration system was part of the
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