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Journal Article

Citation

Bowers L, Whittington R, Nolan P, Parkin D, Curtis S, Bhui K, Hackney D, Allan T, Simpson A. Br. J. Psychiatry 2008; 193(5): 395-401.

Affiliation

Psychiatric Nursing, City University, Philpot Street, London E1 2EA, UK. L.Bowers@city.ac.uk

Copyright

(Copyright © 2008, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.107.037721

PMID

18978321

Abstract

BACKGROUND: Special observation (the allocation of nurses to watch over nominated patients) is one means by which psychiatric services endeavour to keep in-patients safe from harm. The practice is both contentious and of unknown efficacy. AIMS: To assess the relationship between special observation and self-harm rates, by ward, while controlling for potential confounding variables. METHOD: A multivariate cross-sectional study collecting data on self-harm, special observation, other conflict and containment, physical environment, patient and staff factors for a 6-month period on 136 acute-admission psychiatric wards. RESULTS: Constant special observation was not associated with self-harm rates, but intermittent observation was associated with reduced self-harm, as were levels of qualified nursing staff and more intense programmes of patient activities. CONCLUSIONS: Certain features of nursing deployment and activity may serve to protect patients. The efficacy of constant special observation remains open to question.


Language: en

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