Exploration of nurses' experiences of the assessment and management of patients at risk of absconding from an acute psychiatric ward in the Western Cape

Abstract

Unlawful absence of patients from the acute psychiatric ward increases concern on the part of the professionals responsible for their care. Patients who abscond from psychiatric hospitals represent a risk of potential harm to patients or the general public. Consequences of absconding may include physical harm and prolonged treatment time, as well as considerable economic cost to the family and government. The aim of the study was to explore and describe the nurse's experiences of assessment and management for patients at risk of absconding from an acute psychiatric ward in the Western Cape. A qualitative approach using an exploratory descriptive design was applied to conduct this study. The target population was mental health nurses working in acute psychiatric wards where patients were at risk of absconding. A sample of ten (n=10) mental health nurses was purposively selected to participate in the study. Semistructured interviews were used to collect the data from participants. Data collection continued until data saturation was reached (until no further new information emerged). Data was analysed manually by coding, categorizing and identifying similar patterns. Trustworthiness of the study was ensured through addressing the confirmability, transferability; credibility and dependability. Ethics approval was obtained from the University Research Ethics Committee and Ethics Committee of the Department of Health and the selected psychiatric hospital. The ethical principles of the right to self-determination, withdrawal from the research study, privacy, autonomy and confidentiality, fair treatment, protection from discomfort and harm, and obtaining informed written consent were adhered to. Three themes emerged from the data: risk assessment, risk management, and increased observations. The results of the study was discussed with relevant recent literature evidence. The qualitative research is limited to few study sample size, and the results cannot be generalized to other similar population.