4.1 IntroductionThe use of coercive measures generally has negative effects on patients. To help prevent its use, professionals need insight into what nurses believe about coercion and which staff determinants may influence its application. There is need for an integrated review on both attitude and influence of nurses on the use of coercion.4.2 AimTo summarize literature concerning attitude of nurses towards coercive measures and the influence of staff characteristics on the use of coercive measures.4.3 MethodSystematic review.4.4 ResultsThe attitude of nurses changed during the last two decades from a therapeutic to a safety paradigm. Nurses currently view coercive measures as undesirable, but necessary to deal with aggression. Nurses express the need for less intrusive interventions, although familiarity probably influences its perceived intrusiveness. Literature on the relation between staff characteristics and coercive measures is inconclusive.4.5 DiscussionNurses perceive coercive measures as unwanted but still necessary to maintain safety on psychiatric wards. Focussing on the determinants of perception of safety might be a promising direction for future research.4.6 Implications for practiceMental health care could improve the focus on the constructs of perceived safety and familiarity with alternative interventions to protect patients from unnecessary use of coercive interventions.
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Various tools for safety performance measurement have been introduced in order to fulfil the need for safety monitoring in organisations, which is tightly related to their overall performance and achievement of their business goals. Such tools include accident rates, benchmarking, safety culture and climate assessments, cost-effectiveness studies, etc. The current work reviews the most representative methods for safety performance evaluation that have been suggested and applied by a variety of organisations, safety authorities and agencies. This paper discusses several viewpoints of the applicability, feasibility and appropriateness of such tools, based on the viewpoints of managers and safety experts involved in a relevant research that was conducted in a large aviation organisation. The extensive literature cited, the discussion topics, along with the conclusions and recommendations derived, might be considered by any organisation that seeks a realistic safety performance assessment and establishment of effective measurement tools.
Although reengineering is strategically advantageous fororganisations in order to keep functional and sustainable, safety must remain apriority and respective efforts need to be maintained. This paper suggeststhe combination of soft system methodology (SSM) and Pareto analysison the scope of safety management performance evaluation, and presents theresults of a survey, which was conducted in order to assess the effectiveness,efficacy and ethicality of the individual components of an organisation’s safetyprogram. The research employed quantitative and qualitative data and ensureda broad representation of functional managers and safety professionals, whocollectively hold the responsibility for planning, implementing and monitoringsafety practices. The results showed that SSM can support the assessment ofsafety management performance by revealing weaknesses of safety initiatives,and Pareto analysis can underwrite the prioritisation of the remedies required.The specific methodology might be adapted by any organisation that requires adeep evaluation of its safety management performance, seeks to uncover themechanisms that affect such performance, and, under limited resources, needsto focus on the most influential deficiencies.
