Safewards model

Safewards is a model that was developed from extensive research in the United Kingdom by Professor Len Bowers and colleagues. Some of the key aims of the Safewards model include explaining the relationship between conflict and containment, identifying opportunities for intervening, as well as generating ideas for change that have the potential to reduce conflict and containment.

The model consists of six originating domains, which are the patient community, patient characteristics, regulatory framework, staff team, physical environment and influences outside the hospital.

The six domains can give rise to specific flashpoints, which are situations that arise out of features of the originating domains that signal and proceed imminent conflict behaviours.

Flashpoints can then lead to conflict events such as self-harm, suicide, aggression and absconding.

Conflict may then lead to staff interventions, also known as containment, such as increased observation, use of extra medication, through to use of restrictive interventions such as restraint and seclusion.

Containment is in a dynamic reciprocal relationship with conflict, as sometimes the use of containment can also give rise to conflict, rather than preventing it.

Staff can intervene at any time of the model to assist in originating factors, flashpoints and conflict and containment.

Patients also have a role in modifying behaviour in the ward environment.

No single intervention will solve all of the issues, as these issues are inherently complex, rather a variety of interventions are needed.

It’s really important that you’re able to gain a good understanding of the Safewards model and the associated interventions.

The Safewards website contains more detailed information about the model to enhance your learning.