@article{ref1,
title="Relationship between service ecology, special observation and self-harm during acute in-patient care: City-128 study",
journal="British journal of psychiatry",
year="2008",
author="Bowers, Len and Whittington, R. and Nolan, Peter and Parkin, D. and Curtis, Sarah and Bhui, Kamaldeep and Hackney, Diane and Allan, Teresa and Simpson, A.",
volume="193",
number="5",
pages="395-401",
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.<p /> <p>Language: en</p>",
language="en",
issn="0007-1250",
doi="10.1192/bjp.bp.107.037721",
url="http://dx.doi.org/10.1192/bjp.bp.107.037721"
}