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Key Components of Safety

This collection of resources, created by experts from the APNA Council for Safe Environments, is designed to empower psychiatric-mental health nurses in creating and sustaining safe environments across all practice settings.

Research shows that achieving safety in mental health settings requires a multifaceted, integrated approach. While each component in this toolbox stands on its own, they are deeply interconnected, reinforcing the reality that safety is a dynamic balance of systems, relationships, leadership, and culture.

These 8 components were identified by PMH nurse subject matter experts as the key elements of a safe environment. With each element you’ll discover a synthesis of current and foundational evidence to inform your practice, followed by a compilation of the most current research alongside foundational articles that continue to shape our profession. Each component incorporates contemporary terminology and aligns with today’s best practices, while honoring the enduring principles that define our area of practice.

Psychiatric-mental health nurses must often navigate competing priorities, for example, maintaining robust safety protocols without compromising therapeutic engagement. Addressing these tensions requires both practical tools and thoughtful reflection, both of which this toolbox is designed to support.

This toolkit aims to help you translate evidence into action—to build safer environments that foster healing, support positive outcomes, and uphold the dignity of every individual in your care.

Last updated October 2025 by the APNA Council for Safe Environments

Culture and Philosophy

To foster a treatment environment conducive to recovery, it is essential to cultivate a culture in which staff and patients alike feel secure and respected.

Culture and Philosophy

Patient Engagement

Engagement is a fundamental aspect of person-centered care that promotes a culture of safety, impacts patient recovery, and influences patient and staff satisfaction.

Patient Engagement

Patient Assessment & Monitoring

Identifying and preventing patient self-ham or harm to others is a core focus of psychiatric-mental health nursing. Ongoing assessment and monitoring are critical to ensuring safety.

Patient Assessment and Monitoring

Environment of Care

The design and overall environment of care in psychiatric inpatient units play a critical role in influencing both patient outcomes and staff well-being

Environment of Care

Staff Resources, Education, & Training

Education and training are essential for reducing workplace violence in psychiatric settings, as they empower nursing teams to manage violent situations in high-risk environments effectively.

Staff Resources, Education, and Training

Milieu Process

In the broadest context, the manner in which patients experience the milieu or inpatient environment is dependent on the cumulative actions and practices of the nursing staff.

Milieu Process

Crisis Prevention

Psychiatric-mental health nurses often serve on the front lines in identifying, de-escalating, and managing behavioral health emergencies by responding with strategies that prioritize patient dignity and safety.

Crisis Prevention

Quality Improvement

Ongoing quality improvement efforts have meaningfully advanced our understanding of patient safety and strategies to reduce harm and prevent errors.

Quality Improvement

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