What is Safewards?

Safewards is a program that encourages staff and clients (including carers, family, and support people) to work together to make the ward safer for everyone. Safer means a calmer and more positive place.

Safewards is effective in reducing conflict and containment (restrictive practices) and gives a call to action to nurses and other clinical and supporting staff. Examples of conflict and containment include the following:

Conflict Containment
Aggression PRN medication
Rule-breaking Coerced intramuscular medication
Substance abuse Special observations 
Absconding/missing Seclusion
Medication declining Manual restraint
Self/harm/suicide  

Use of the Safewards program in other Australian states and territories has been associated with reduced events involving conflict, with the most improvements seen in adults and youth mental health wards.

It has also been shown to have an impact on staff and consumers feeling safer and more positive in inpatient environments.

The Safewards model

The Safewards model and interventions is an adaptable program of evidence-based nursing interventions that were tested over a 20-year period led by the Institute of Psychiatry at Kings College London.

While these interventions were originally developed for use in the mental health setting, they have much broader applicability. In many ways, they strengthen existing principles of good nursing practice such as those espoused by the Royal College of Nursing:

  • treating everyone in one’s care with dignity and humanity
  • promoting care that puts people at the centre by involving patients service users, their families and their carers
  • taking responsibility for the care we provide

ACT Safewards Trial

Safewards was introduced as a trial in four wards across the ACT public health service as part of the Nurses and Midwives: Towards a Safer Culture Strategy

Safewards is a strong fit with strategies that aim to limit the occurrence and impacts of occupational violence (OV), as well as broader culture change strategies that seek to embed respect, inclusion, and collaboration across organisations.

ACT Health has led the trial of the Safewards model and interventions into ACT public health services from November 2020 - June 2021.

The trial ran from January to June 2021 in four inpatient wards:

  • Canberra Hospital Ward 7B General Medical ward
  • Canberra Hospital Adult Acute Mental Health Unit
  • Calvary Public Hospital Ward 4W General Medical Ward
  • Calvary Public Hospital Older Person Mental Health Inpatient unit

What are the Safewards actions in the ACT trial?

Safewards outlines 10 actions staff and clients can do to reduce conflict and restrictive practices.

Click the image below to learn about each action.

Safewards 10 Simple Actions

Review of the Safewards Model of Care Trial in the ACT

The Safewards Review considered the impact it has had in supporting staff and patients to work together to achieve the best health outcomes.

It looked at training, acceptability, implementation, and outcomes.

The review was based on a survey of more than 290 nurses and midwives and data from training workshops, participant focus groups, and stakeholder interviews.

Next steps

Findings from the Safewards trial review will now be used to consider broad implementation across the ACT public health system.

Research opportunities

There are many aspects of Safewards that can be explored in greater detail, for example how nurses, midwives, and consumers perceive Safewards, which factors in the work environment provide the strongest support, and what are the best educational and training models. 

For anyone interested in undertaking research into Safewards in their service or more broadly, contact Professor Michael Roche via the SYNERGY Nursing and Midwifery Research Centre.

Resources and information

For more information

If you are interested in more information about the Safewards trial, contact the project implementation team: NM.SaferCulture@act.gov.au.

Page last updated on: 15 Feb 2022