The British Journal of Psychiatry (2008) 193: 395-401. doi: 10.1192/bjp.bp.107.037721
© 2008 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data supplement
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Bowers, L.
Right arrow Articles by Simpson, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bowers, L.
Right arrow Articles by Simpson, A.

Relationship between service ecology, special observation and self-harm during acute in-patient care: City-128 study

Len Bowers, RMN, PhD

City University, London

Richard Whittington, PhD, CPsychol, AFBPsS, BA, PGCert

University of Liverpool

Peter Nolan, RMN, PhD

Staffordshire University, Stoke-on-Trent

David Parkin, BA, DPhil

City University, London

Sarah Curtis, BA (Hons) (Oxon), DPhil

Queen Mary Westfield College, University of London

Kamaldeep Bhui, BSc (Hons), MB BS, MRCPsych, MD

Queen Mary Westfield College, University of London

Diane Hackney

Independent service user consultant, London

Teresa Allan, MSc

City University, London

Alan Simpson, RMN, BA (Hons), PhD

City University, London, UK

Correspondence: Len Bowers, Professor of Psychiatric Nursing, City University, Philpot Street, London E1 2EA, UK. Email: L.Bowers{at}city.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

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.


Related articles in BJP:

Highlights of this issue
Sukhwinder S. Shergill
BJP 2008 193: A18. [Full Text]