TY - JOUR

T1 - Positive risk management

T2 - staff perspectives in acute mental health inpatient settings

AU - Just, Daniela

AU - Palmier-Claus, Jasper E.

AU - Tai, Sara

PY - 2021/1/25

Y1 - 2021/1/25

N2 - Aims To explore inpatient staff's understanding and implementation of positive risk management. Background Risk management is an essential skill for staff working in acute mental health inpatient settings. National policies advocate the use of positive risk management as a form of collaborative, recovery-focused risk management. However, little is known about how staff understand, operationalize, and use positive risk management in practice. Design Qualitative reflexive thematic analysis study. Methods The authors recruited a purposive sample of healthcare professionals working in acute inpatient settings (N = 16) in 2019 across three National Health Service Trusts in the North-West of England. Participants completed semi-structured interviews which were analysed using reflexive thematic analysis. Results The analysis generated three themes: (a) within staff barriers; (b) within service user barriers; and (c) delivery in practice. Conclusion Understanding and implementation of positive risk management was dependant on multiple factors, including staffs’ beliefs about mental health, levels of worry and anxiety, and amount of experience and seniority. Staff were more likely to use positive risk management with service users that they perceived as being trustworthy and less risky. Use of positive risk management was reliant on the support practitioners received, how able they were to view situations from multiple perspectives, and the degree to which they felt able to prioritize positive risk management. Impact Although staff expressed the desire and intention to practice positive risk management, the current study highlights challenges around operationalization and implementation. The authors discuss the clinical implications of the findings.

AB - Aims To explore inpatient staff's understanding and implementation of positive risk management. Background Risk management is an essential skill for staff working in acute mental health inpatient settings. National policies advocate the use of positive risk management as a form of collaborative, recovery-focused risk management. However, little is known about how staff understand, operationalize, and use positive risk management in practice. Design Qualitative reflexive thematic analysis study. Methods The authors recruited a purposive sample of healthcare professionals working in acute inpatient settings (N = 16) in 2019 across three National Health Service Trusts in the North-West of England. Participants completed semi-structured interviews which were analysed using reflexive thematic analysis. Results The analysis generated three themes: (a) within staff barriers; (b) within service user barriers; and (c) delivery in practice. Conclusion Understanding and implementation of positive risk management was dependant on multiple factors, including staffs’ beliefs about mental health, levels of worry and anxiety, and amount of experience and seniority. Staff were more likely to use positive risk management with service users that they perceived as being trustworthy and less risky. Use of positive risk management was reliant on the support practitioners received, how able they were to view situations from multiple perspectives, and the degree to which they felt able to prioritize positive risk management. Impact Although staff expressed the desire and intention to practice positive risk management, the current study highlights challenges around operationalization and implementation. The authors discuss the clinical implications of the findings.

KW - inpatient

KW - nurses

KW - nursing

KW - positive risk management

KW - qualitative

KW - risk management

KW - thematic analysis

U2 - 10.1111/jan.14752

DO - 10.1111/jan.14752

M3 - Journal article

VL - 77

SP - 1899

EP - 1910

JO - Journal of Advanced Nursing

JF - Journal of Advanced Nursing

SN - 0309-2402

IS - 4

ER -