Factors Influencing Staff Perceptions of Inpatient Psychiatric Hospitals: A Meta-Review of the Literature.

Staff perceptions of inpatient psychiatric hospitals ultimately impact a range of organisational and care-related variables, including staff retention and quality of care for inpatients. The aim of this study was to conduct a meta-review to synthesise themes reported by staff to influence their perceptions of inpatient psychiatric hospitals. The review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for systematic reviews. PsycINFO, CINAHL, MEDLINE and EMBASE were systematically searched. Reviews were eligible for inclusion if they examined the perception/experience of paid staff involved in caring for adults with mental illnesses admitted to an inpatient psychiatric hospital. Eligible reviews were assessed for methodological quality and bias. Thematic synthesis was used to merge thematically similar findings into an aggregate summary. Fifteen reviews were included, from which seven themes were reliably extracted: staff and patient safety, views on inpatients' experiences, relationships on the ward, ward rules, knowledge and experience, service delivery issues and coercive measures. Confidence in the evidence underlying each theme was analysed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) criteria. Results indicate that staff perceptions of inpatient psychiatric hospitals overlap with inpatients' perspectives, particularly regarding the therapeutic relationship, coercive measures and ward safety, in addition to unique experiences. Factors identified can help guide ways to improve staff retention, satisfaction and quality of treatment.