Creating Safety – the role of senior psychiatric nurses reducing restrictive interventions on an adult acute psychiatric inpatient unit

Mrs Elyse Riverson1, Ms Emer Keaveney1
1Northwestern Mental Health – Melbourne Health, Parkville , Australia

Psychiatric inpatient units are often staffed by novice nurses, who are expected to care for high risk presentations with minimal role modelling or experience. The Creating Safety Nurse (CSN) functions as a role model for nurses to learn from and improve confidence and overall sense of safety on the inpatient unit.
The CSN is a senior psychiatric nurse that specialises in the acute mental health setting. The position has a primary role to reduce restrictive interventions and the incidence of aggression and violence. By encompassing principles of trauma informed care and a recovery-oriented approach, the CSN’s role model best-practice in the management of clinical aggression, gender sensitive care, sensory modulation, and Safewards.
The CSN role models a range of interventions and communication techniques to assist consumers to manage their agitation in the inpatient setting. Specific inpatient enhanced treatment plans are also generated for consumers who have had repeated restrictive interventions or who have complex care needs. They are also responsible for updating and delivering the Safety Huddle at each clinical handover and supporting the admission process for high risk consumers.
The CSN appears to have contributed to a reduction in seclusion episodes on the inpatient unit. It has also contributed to improved staff satisfaction and sense of safety. This presentation will explore the role and function of the CSN, including an overview of implementation processes and the associated barriers, as well as preliminary data collection related to seclusion rates and staff satisfaction.


Elyse and Emer are both mental health nurses working in the adult acute inpatient setting. Their careers have spanned mostly acute mental health, and both have a passion for good quality inpatient care and reducing restrictive practice. Elyse has worked on several inpatient units within Melbourne, and also as an Emergency Mental Health Clinician. She is currently working as the Clinical Nurse Educator and supports the Creating Safety Nurse on a regular basis. Emer has worked in many senior roles across inpatient units in both Australia and Ireland, and is currently the acting Nurse Unit Manager. Emer has frequently practised in the Creating Safety Nurse role that is being presented today.


TERP focuses on identifying, avoiding and reducing harm across all environments in which the care of people with mental ill health is provided. TERP inforces Australia’s commitment to reduce the use of, and eliminate restrictive practices as a priority for action. Each jurisdiction, in conjunction with the Safety and Quality Partnership Standing Committee and the Commonwealth Government, works towards this vision by holding a series of forums providing an opportunity to learn and grow from local and national initiatives to eliminate restrictive practices and create a dialogue for future care.

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