TY  - JOUR
PY  - 2008//
TI  - Relationship between service ecology, special observation and self-harm during acute in-patient care: City-128 study
JO  - British journal of psychiatry
A1  - Bowers, Len
A1  - Whittington, R.
A1  - Nolan, Peter
A1  - Parkin, D.
A1  - Curtis, Sarah
A1  - Bhui, Kamaldeep
A1  - Hackney, Diane
A1  - Allan, Teresa
A1  - Simpson, A.
SP  - 395
EP  - 401
VL  - 193
IS  - 5
N2  - 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>
LA  - en
SN  - 0007-1250
UR  - http://dx.doi.org/10.1192/bjp.bp.107.037721
ID  - ref1
ER  -