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Table 2 Safewards interventionsa

From: Quality of intervention delivery in a cluster randomised controlled trial: a qualitative observational study with lessons for fidelity

Clear Mutual Expectations A set of mutual expectations identified by ward staff in partnership with the patient community, for staff, patients and ward visitors, based around values, respect and mutual support, which are displayed on posters around the ward
Soft Words Short statements outlining potential strategies to use when handling flashpoints (e.g. responding to requests, setting limits, etc.), printed on postcards and a poster hung in the nursing office which is changed every few days
Talk Down A poster summarising basic to advanced de-escalation techniques placed in the nursing office. One member of staff who is expert in de-escalation spends about 10–15 minutes with members of staff explaining the poster and what it means
Positive Words When giving handover staff say something positive about what each patient has been doing during the shift, or draw attention to some positive quality they have, or something positive about the way in which staff supported them
Bad News Mitigation Staff maintain an awareness of occasions and events that might cause people to feel upset or angry (e.g. phone calls or family, unwelcome news from the treatment team). The staff work with the team to express the bad news sympathetically, or support the person after it has happened
Know Each Other Staff and patients produce a profile of who they are as a person (e.g. hobbies, interests, likes and dislikes, etc.) which is made available to everyone via either a notice board or a folder on the ward
Mutual Help Meeting A voluntary meeting of all patients and staff on duty, to be held preferably in the morning, about how everyone can help everyone else during the rest of the day. The meeting follows a structured agenda (rounds of thanks, news, suggestions, requests and offers) stressing mutual support agreements. The meeting does not have to be chaired by a staff member
Calm Down Methods A box of distraction, sensory modulation and relaxation tools to offer to people when they appear to be upset, tense or agitated (e.g. stress toys, mp3 players with soothing music, light displays, textured blankets, etc.)
Reassurance Explanations and reassurance offered to all patients following potentially frightening incidents
Discharge Messages A display of positive messages about the ward from people who have been discharged, covering what they liked about the wards and a helpful piece of advice for new patients
  1. aFull descriptions of these interventions coupled with training videos are freely available online at