Maria Ameel, Tiina Talja, Jaakko Varpula, Tessa Maguire, Michael Daffern, Sanna Blomqvist, Tella Lantta
{"title":"A Mixed Methods Feasibility Study of a Clinical Decision Support System Designed to Assess Risk for Aggression and Prevent Aggressive Behaviour","authors":"Maria Ameel, Tiina Talja, Jaakko Varpula, Tessa Maguire, Michael Daffern, Sanna Blomqvist, Tella Lantta","doi":"10.1111/inm.70281","DOIUrl":"10.1111/inm.70281","url":null,"abstract":"<p>The electronic Dynamic Appraisal of Situational Aggression combined with the Aggression Prevention Protocol (eDASA+APP) is a clinical decision support system designed to prevent aggression, reduce coercive practices and promote proactive nursing interventions. It has previously been tested in forensic psychiatry in Australia. Adaptation and feasibility testing are required before implementation in new clinical and linguistic contexts. The aim of this study was to examine the feasibility of the Finnish version of the eDASA+APP using a mixed methods approach. The study took place in four Finnish mental health inpatient units. Nurses completed an online learning module and used the eDASA+APP for 2 weeks. Quantitative and qualitative data were collected on nursing documentation and feasibility. As a result, the eDASA+APP was perceived as easy to use and helpful in establishing a shared process and terminology for aggression prevention. Documentation of risk assessments and preventive interventions increased. The e-learning module was considered adequate. One unit caring for older adults found the risk assessment component less practical. The Finnish eDASA+APP appears feasible and beneficial, supporting a larger implementation in units with adult patients. However, the feasibility testing in older adult services is recommended. The Mixed Methods Reporting in Rehabilitation & Health Sciences checklist was followed in reporting this study.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramiro Manzano-Nunez, Diego A. Gomez, Elvira M. Triana, Rebeca Alcalá, Laura Repiso, Marcel Camino-i-Gibernau, Teresa Logroño, Monica Sanchez-Autet
{"title":"Venous Thromboembolism as a Forgotten Complication of Physical Restraint: A Scoping Review and Implications for Practice","authors":"Ramiro Manzano-Nunez, Diego A. Gomez, Elvira M. Triana, Rebeca Alcalá, Laura Repiso, Marcel Camino-i-Gibernau, Teresa Logroño, Monica Sanchez-Autet","doi":"10.1111/inm.70280","DOIUrl":"10.1111/inm.70280","url":null,"abstract":"<div>\u0000 \u0000 <p>This scoping review explores and synthesizes the literature on thromboembolic events in physically restrained patients in mental healthcare settings, focusing on patient characteristics, associated risk factors, and treatment strategies. Following PRISMA-ScR guidelines, PubMed and Scopus were searched through September 2025 for studies reporting thromboembolic events in patients subjected to physical restraint in psychiatric settings. Two reviewers independently performed study selection and data extraction regarding patient profiles, restraint configurations, and preventive strategies. Evidence was synthesized descriptively without formal risk-of-bias assessment. Of 142 records identified, 20 studies (2001–2025) were included: 7 case reports, 3 case series, 6 case–control, and 4 cohort studies. Populations ranged from adolescents to older adults, primarily with schizophrenia or mood disorders. The incidence of thromboembolic events in cohort studies was 9% to 11%. Technical documentation was heterogeneous; 50% of studies did not report on the management of hydration, nutrition, or elimination. Six studies found an association between restraint and thromboembolic events, with prolonged duration most consistently implicated. Thromboprophylaxis was inconsistently described: 4 studies reported its use, 4 reported its absence, and 12 provided no information. Thromboembolic events are a preventable complication of physical restraint. Current evidence is limited by retrospective designs and fragmented reporting. Improving clinical safety requires standardized risk assessment and nursing-led somatic monitoring integrated with interdisciplinary support. Protocols tailored to these immobilization episodes are required to ensure behavioural stabilization does not compromise physiological safety.</p>\u0000 </div>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abstract","authors":"","doi":"10.1111/inm.70264","DOIUrl":"https://doi.org/10.1111/inm.70264","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 S1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Björkdahl, L. Berring, G. Brennan, M. Fogelkvist, L. Kjellin, V. Pelto-Piri, A. Simpson, B. Hamilton
{"title":"Active Ingredients Across the 10 Safewards Interventions: Expert Consensus Towards Fidelity Measurement","authors":"A. Björkdahl, L. Berring, G. Brennan, M. Fogelkvist, L. Kjellin, V. Pelto-Piri, A. Simpson, B. Hamilton","doi":"10.1111/inm.70276","DOIUrl":"10.1111/inm.70276","url":null,"abstract":"<p>Safewards is implemented internationally to prevent conflict and containment in psychiatric settings. Although evaluations generally show a reduction in such incidents, effects vary across studies. A key limitation is the absence of a valid and robust measure of implementation fidelity to indicate how closely Safewards is implemented as originally intended. Without this knowledge, replication, refinement, and effective implementation is difficult, jeopardizing both clinical quality assurance and scientific evaluation rigour. This study reports the first steps in developing a new implementation fidelity tool for Safewards. The objective was to identify important active ingredients and corresponding measurement levels for the 10 Safewards interventions. A Delphi survey design with an international expert panel was used to reach consensus on active ingredients and measurement levels. The preliminary survey list was derived from the Safewards.net website and informed by implementation fidelity theory, incorporating both direct and indirect measurement levels. The resulting set of ingredients and measurements was pilot tested for comprehensibility by likely end-users in an acute psychiatric clinic. Their experiences were explored in a group interview, analyzed with thematic content analysis, and informed adjustments. The final output comprises 48 active ingredients and 122 measurements across the 10 interventions, each represented by three to seven statements and up to four measurement levels. The findings provide a conceptual and content-valid foundation for the development of a new Safewards fidelity tool. In addition, the active ingredients have intrinsic value, offering guidance for the clinical implementation of Safewards.</p>","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/inm.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148094379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148085560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148085559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148085561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":14007,"journal":{"name":"International Journal of Mental Health Nursing","volume":"35 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148079673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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