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How do staff and team characteristics relate to ward safety incidents in adult inpatient mental health settings? A protocol for a systematic integrative review

How do staff and team characteristics relate to ward safety incidents in adult inpatient mental health settings? A protocol for a systematic integrative review
How do staff and team characteristics relate to ward safety incidents in adult inpatient mental health settings? A protocol for a systematic integrative review
Introduction: a neglected area of patient safety research is how the characteristics of mental health staff and teams may influence incidents, specifically, through unintended and harmful consequences of clinical care. While the research literature into patient safety has increased, there is still a need to further consider safety on mental health wards, for example, the role of the staff team in containment and conflict. This review aims to explore the question, ‘How do staff and team characteristics relate to safety incidents in adult inpatient mental health settings?’.

Methods and analysis: the review will follow Whittemore and Knafl’s integrative review framework. CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, Web of Science will be searched. Literature published after 1999, that includes extractable quantitative, qualitative and mixed methods data exploring the relationship between staff and team characteristics on incidents in adult inpatient mental health settings, will be suitable for inclusion. The Mixed Methods Appraisal Tool will be used for quality appraisal and data analysis and will comprise data reduction, display and comparison.

Ethics and dissemination: no new data or access to participants will be involved in this review. As such, ethical review will not be required. Dissemination will include publication in peer-reviewed journals and presentations at national and international conferences.

PROSPERO registration number: this review has been registered on PROSPERO (ref. CRD420251119981; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251119981).
2044-6055
Greenfield, Katy
Griffin, Bethany
Kendal, Sarah
Woodnutt, Samuel
dbb6678a-2b2b-4e7c-9a12-f9d838555116
Hallett, Nutmeg
Johnson, Judith
8fb195ae-89df-4bca-99b3-6d0a0e4268ef
Berzins, Kathryn
304182ce-720d-458d-8925-ffcfa5ba2c0a
Bojke, Chris
3e0d3496-1e3b-4daa-b3a1-d6fb693ac492
Henderson, Max
Lomani, Jo
Wadey, Emma
80c1373e-4f7b-40e8-8143-73fc1e525957
Baker, John
Greenfield, Katy
Griffin, Bethany
Kendal, Sarah
Woodnutt, Samuel
dbb6678a-2b2b-4e7c-9a12-f9d838555116
Hallett, Nutmeg
Johnson, Judith
8fb195ae-89df-4bca-99b3-6d0a0e4268ef
Berzins, Kathryn
304182ce-720d-458d-8925-ffcfa5ba2c0a
Bojke, Chris
3e0d3496-1e3b-4daa-b3a1-d6fb693ac492
Henderson, Max
Lomani, Jo
Wadey, Emma
80c1373e-4f7b-40e8-8143-73fc1e525957
Baker, John

Greenfield, Katy, Griffin, Bethany, Kendal, Sarah, Woodnutt, Samuel, Hallett, Nutmeg, Johnson, Judith, Berzins, Kathryn, Bojke, Chris, Henderson, Max, Lomani, Jo, Wadey, Emma and Baker, John (2026) How do staff and team characteristics relate to ward safety incidents in adult inpatient mental health settings? A protocol for a systematic integrative review. BMJ Open, 16 (3), [e110675]. (doi:10.1136/bmjopen-2025-110675).

Record type: Article

Abstract

Introduction: a neglected area of patient safety research is how the characteristics of mental health staff and teams may influence incidents, specifically, through unintended and harmful consequences of clinical care. While the research literature into patient safety has increased, there is still a need to further consider safety on mental health wards, for example, the role of the staff team in containment and conflict. This review aims to explore the question, ‘How do staff and team characteristics relate to safety incidents in adult inpatient mental health settings?’.

Methods and analysis: the review will follow Whittemore and Knafl’s integrative review framework. CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, Web of Science will be searched. Literature published after 1999, that includes extractable quantitative, qualitative and mixed methods data exploring the relationship between staff and team characteristics on incidents in adult inpatient mental health settings, will be suitable for inclusion. The Mixed Methods Appraisal Tool will be used for quality appraisal and data analysis and will comprise data reduction, display and comparison.

Ethics and dissemination: no new data or access to participants will be involved in this review. As such, ethical review will not be required. Dissemination will include publication in peer-reviewed journals and presentations at national and international conferences.

PROSPERO registration number: this review has been registered on PROSPERO (ref. CRD420251119981; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251119981).

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More information

Accepted/In Press date: 20 February 2026
e-pub ahead of print date: 11 March 2026
Published date: 11 March 2026

Identifiers

Local EPrints ID: 510924
URI: http://eprints.soton.ac.uk/id/eprint/510924
ISSN: 2044-6055
PURE UUID: 8ac9dbc4-dd59-4810-89aa-c4d803941a0a
ORCID for Samuel Woodnutt: ORCID iD orcid.org/0000-0001-6821-3158

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Date deposited: 27 Apr 2026 16:37
Last modified: 28 Apr 2026 02:07

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Contributors

Author: Katy Greenfield
Author: Bethany Griffin
Author: Sarah Kendal
Author: Samuel Woodnutt ORCID iD
Author: Nutmeg Hallett
Author: Judith Johnson
Author: Kathryn Berzins
Author: Chris Bojke
Author: Max Henderson
Author: Jo Lomani
Author: Emma Wadey
Author: John Baker

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