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A study of agitation, conflict and containment in association with change in ward physical environment

Published online by Cambridge University Press:  16 May 2014

Oliver Jenkins ,
Stephen Dye Open the ORCID record for Stephen Dye [Opens in a new window]  and
Chris Foy
Oliver Jenkins*
Affiliation:
ST5, General Adult Psychiatry, Ipswich, Norfolk and Suffolk NHS Foundation Trust, UK
Stephen Dye
Affiliation:
Consultant, Inpatient Adult Psychiatry, Ipswich, Norfolk and Suffolk NHS Foundation Trust, UK
Chris Foy
Affiliation:
Medical Statistician, Gloucestershire NHS Foundation Trust, UK
*
Correspondence to: Dr Oliver Jenkins, Lark Ward, Woodlands Hospital, Ipswich IP4 5PD. Email: oliver.jenkins@nsft.nhs.uk
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Abstract

Aims

To assess the impact of a changed ward environment upon levels of inpatient arousal and aggression on a National Health Service psychiatric intensive care unit.

Method

A retrospective service evaluation comparing seclusion episodes, duration of close observation, recorded aggressive incidents and data from the Nursing Observed Illness Intensity Scale (NOIIS) on a psychiatric intensive care unit for two three-month periods either side of a move from an old, temporary building to a new, purpose-built ward. The ward environments were also objectively assessed and compared using the Environment Assessment Inventory (EAI).

Results

A statistically significant reduction in episodes of seclusion, total seclusion hours and aggressive incidents, as well as a reduction in levels of agitation from the NOIIS data on the new ward compared to the old ward. The EAI scores showed important qualitative improvements on the new ward.

Conclusions

This study supports the hypothesis that the physical environment of a psychiatric intensive care unit has a significant impact on levels of arousal and aggression. Established measures of ward environment should be applied to the development and improvement of psychiatric wards.

Keywords

PICUenvironmentdisturbanceseclusion
Type
Original Research Articles
Information
Journal of Psychiatric Intensive Care , Volume 11 , Issue 1 , April 2015 , pp. 27 - 35
Copyright
Copyright © NAPICU 2014 

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