Title : Global Nursing collaboration for safer psychiatry: An ongoing international project on violence and aggression prevention

Background: Violence and aggression in psychiatric settings pose significant risks to staff wellbeing, patient dignity, and organisational stability. Romania’s mental health system is undergoing reform, yet persistent gaps remain in training, protocols, and the implementation of least restrictive, trauma informed practice. This ongoing project aims to strengthen prevention and management of violence and aggression at Spitalul Clinic de Psihiatrie “Prof. Dr. Alexandru Obregia” from Romania through the adaptation of UK aligned, evidence based approach
hes tailored to local cultural and systemic realities.

Methods: A mixed methods assessment was conducted with over 200 multidisciplinary professionals, examining exposure to aggression, confidence levels, procedural consistency, and access to protective equipment. Findings informed the development of a structured training programme integrating crisis cycle understanding, therapeutic communication, self regulation, team based de escalation, Safewards aligned interventions, and medical risk aware physical skills. Training delivery prioritised scenario based learning, cultural adaptation, and psychological safety, supported by clear protocols and leadership engagement. Implementation continues as part of a multi phase improvement plan.

Results: Initial findings revealed high rates of aggression, inconsistent application of protocols, and limited protective resources. Early training outcomes indicate increased staff confidence, improved team coordination, clearer team responsibilities, and stronger alignment with least?restrictive principles. As the project is still in progress, final outcomes cannot yet be measured, but early indicators suggest potential improvements in safety culture, consistency of practice, and staff wellbeing.

Conclusions: This ongoing international collaboration demonstrates that structured, culturally adapted training has the potential to enhance competence, reduce restrictive practices, and promote dignity?centred psychiatric care. As implementation continues, final outcomes cannot yet be fully measured; however, early indicators suggest meaningful improvements in safety culture, consistency of practice, and staff confidence.
Importantly, the project highlights the power of cross?border nursing collaboration. International nurses bring diverse clinical experience, shared professional values, and a capacity to translate global evidence into local solutions. Their involvement strengthens knowledge exchange, accelerates system improvement, and supports countries in adapting modern, least?restrictive approaches to their own cultural and organisational contexts.

Continued evaluation will determine the long?term impact and scalability of this model, but the early phases already demonstrate that international nursing partnerships can act as a catalyst for sustainable change in mental health services worldwide.
 

Mr. Morosteș Gabriel has over 12 years of experience in the UK in the field of mental health for both adults and children. Mr. Morosteș started his career working directly with patients in private psychiatric hospitals, progressing to senior management positions including ward manager and director of clinical services.

Currently, Mr. Morosteș is responsible for quality improvement in the South East Region for the largest private mental health organization in the UK, coordinating quality improvement activities in several hospitals. Experienced in Quality Improvement, Mr. Morosteș is also a Quality Improvement coach, supporting the continuous development of quality standards in the teams he works with.

Patient safety is another of Mr. Morosteș’ areas of expertise, complementing his efforts to bring constant improvements in the healthcare services provided.

With a strong desire to contribute to the development of the field in Romania as well, Mr. Morosteș is dedicated to sharing the knowledge and experience gained in the UK, supporting his Romanian colleagues in adopting best practices to increase quality and safety in healthcare.