Safety Incidents in Psychiatric Inpatient Care: A Qualitative Content Analysis of Safety Incident Reports

Abstract

Introduction. Safety is an essential factor in patient recovery, occupational well-being, and a well-functioning care environment. To identify and understand potential safety risks, information from safety incidents is needed. Aim. To describe safety incidents that occurred on psychiatric inpatient wards. Method. A retrospective register study. The data were collected from a web-based incident reporting database (HaiPro) from six Finnish psychiatric inpatient wards. The incident reports (N = 76) were analysed with descriptive statistics and inductive content analyses. Results. The incidents were verbally or physically aggressive situations, rule violations, or challenges in the ward’s basic activities. The incidents resulted in consequences for patients, personnel, and the wards with varying severity. Some of the incidents could have possibly been prevented with simple, practical measures, such as sharing information, being prepared for safety practices, and having comprehensively planned care. Discussion. Safety incidents cause fear and challenges and could partly be prevented with multiprofessional and multilevel cooperation. Implications for Practice. Preventative actions include multidisciplinary and ward-specific education for safety practices, ensuring resources and not having too many patients on the ward. Multiprofessional communication and mutual understanding, including patient participation, are central. Wards should be designed or renovated so that safe environments can be guaranteed.