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The rate of reporting adverse events on mental health care staff

Analysing previously reported incidents to examine how it can help to monitor and predict where staff safety may be at risk.

A healthcare professional advising a patient


Research background

Evidence highlights the intrinsic link between nurse staffing and expertise and outcomes for service users of healthcare, and that workforce retention is linked to the clinical and organisational experience of employees. There has been some qualitative work that highlights the concept of the absence of threat of harm to staff as being essential for nurses to be able to work effectively in the inpatient psychiatric setting, but there is little published research quantifying staff harm and exploring its relationship with staffing in mental health.

Research aims

This study utilises existing data from a large English mental healthcare provider of both acute and community services, focusing on the analysis of reported incidents to examine how such data can be used to monitor and predict where staff safety may be at risk. We examine the extent to which the perceived demand for RNs and unregistered nurses, as well as the variations from the ‘clinically required’ levels, is correlated with increases in staff adverse event reporting.

How was the research carried out?

Two databases were extracted from a large English mental healthcare provider in England providing both acute and community services – one containing safety incidents and one containing nurse staffing data. The data were analysed via a selection of count-based models including Poisson, zero-inflated Poisson, negative binomial, and hurdle regressions.


The analysis reveals a strong dependence of the rate of adverse events on the location and perceived clinical demand of the wards, and a reduction in adverse events where registered nurses exceed ‘clinically required levels’. In the first study of its kind, these findings present significant implications for nursing workforce policy and present an opportunity to not only improve safety but potentially impact nurse retention.