Constant special observation and self-harm on acute psychiatric wards: a longitudinal analysis

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Abstract

Objective: Special observation (the allocation of nurses to watch over nominated patients) is a method of preventing patients harming themselves. This study assessed the relationship between constant special observation (keeping a patient within eyesight or reach) and rates of self-harm on acute psychiatric wards. Method: A longitudinal analysis of officially collected data covering a period of 2 1/2 years froth 16 acute wards at three Hospitals in London. Results: There was no statistically significant association between constant special observation and self-harm outcomes. Use of observation varied markedly between hospitals and wards, but overall, there was a significant decline over time. Self-harm incidents were rare (recorded in only 7% of ward weeks) and did not decline over time, but were correlated over consecutive weeks. Conclusion: The lack of association with self-harm suggests that the use of constant special observation could be reduced without compromising patient safety. (C) 2009 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)523 - 530
Number of pages8
JournalGENERAL HOSPITAL PSYCHIATRY
Volume31
Issue number6
DOIs
Publication statusPublished - Nov 2009

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