Implementation of safety agreements in an acute psychiatric facility.

BACKGROUND Registered nurses (RNs) frequently contract for safety with patients who are at risk for self-harm. It is important to determine if contracting for safety is an effective intervention. OBJECTIVE This study explores results of implementing a safety agreement tool, a form of contracting, in an acute psychiatric facility. STUDY DESIGN Two surveys were given to RNs after implementation of the safety agreement tool. The rate of self-harming incidents pre- and postimplementation was compared. RESULTS RNs were evenly divided in reporting if nurse-patient interactions were enhanced with safety agreements. However, RNs perceived increased patient responsibility, nurse contact, safety guidance, safety discussions, and time guidelines with the safety agreement use. The mean rate of self-harming incidents before was not significantly different from the mean rate after implementation of safety agreements. CONCLUSION Although implementation of the safety agreement tool did not result in statistically significant decreased levels of self-harm, RNs perceived numerous positive effects. [ABSTRACT FROM AUTHOR]