General Hospital Psychiatry
Volume 31, Issue 6 , Pages 523-530 , November 2009

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

Received 24 February 2009 ,Accepted 12 May 2009.

References 

  1. Bowers L, Gournay K, Duffy D. Suicide and self-harm in inpatient psychiatric units: a national survey of observation policies. J Adv Nurs. 2000;32:437–444
  2. Bowers L, Simpson A, Alexander J. Patient-staff conflict: results of a survey on acute psychiatric wards. Soc Psychiatry Psychiatr Epidemiol. 2003;38:402–408
  3. Shugar G, Rehaluk R. Continuous observation for psychiatric inpatients: a critical evaluation. Compr Psychiatry. 1990;1:48–55
  4. Dennis S. Close observation: how to improve assessments. Nurs Times. 1997;93:54–56
  5. Langenbach M, Junaid O, Hodgson-Nwaefulu CM, et al. Observation levels in acute psychiatric admissions. Eur Arch Psychiatry Clin Neurosci. 1999;249:28–33
  6. Neilson P, Brennan W. The use of special observations: an audit within a psychiatric unit. J Psychiatr Ment Health Nurs. 2001;8:147–155
  7. Lehane M, Rees C. Alternatives to seclusion in psychiatric care. Br J Nurs. 1996;5:974–979
  8. Department of Health . Mental Health Nursing: Addressing Acute Concerns. London: Standing Nursing and Midwifery Advisory Committee, Department of Health; 1999;
  9. Bowers L, Park A. Special observation in the care of psychiatric inpatients: a literature review. Issues Ment Health Nurs. 2001;22:769–786
  10. Porter S, McCann I, McGregor A. Auditing suicide observation procedures. Psychiatr Care. 1989;5:17–21
  11. Aidroos N. Nurses' responses to doctors' orders for close observation. Can J Psychiatry. 1986;31:831–833
  12. Duffy D. Out of the shadows: a study of the special observation of suicidal psychiatric in-patients. J Adv Nurs. 1995;21:944–950
  13. Goldberg RJ. Use of special observation with potentially suicidal patients in general hospitals. Hosp Com Psychiatry. 1987;3:303–305
  14. Green S, Grindel C. Supervision of suicidal patients in adult inpatient psychiatric units in general hospitals. Psychiatr Serv. 1996;47:859–863
  15. Meehan J, Kapur N, Hunt I, et al. Suicide in mental health in-patients and within 3 months of discharge: national clinical survey. Br J Psychiatry. 2006;188:129–134
  16. Bowers L, Whittington R, Nolan P, et al. The relationship between service ecology, special observation and self-harm during acute in-patient care: the City-128 study. Br J Psychiatry. 2008;193:395–401
  17. Janofsky JS. Reducing inpatient suicide risk: using human factors analysis to improve observation practices. J Am Acad Psychiatry Law. 2009;27:15–24
  18. Kapur N, Hunt IM, Webb R, et al. Suicide in psychiatric in-patients in England, 1997–2003. Psychol Med. 2006;36:1485–1492
  19. National Patient Safety Agency . With Safety in Mind: Mental Health Services and Patient Safety. London: National Patient Safety Agency; 2006;
  20. Appleby L, Dennehy J, Thomas C, Faragher E, Lewis G. Aftercare and clinical characteristics of people with mental illness who commit suicide: a case-control study. Lancet. 1999;353:1397–1400
  21. Hunt I, Kapur N, Webb R, et al. Suicide in current psychiatric in-patients: a case-control study. Psychol Med. 2007;37:831–837
  22. Powell J, Geddes J, Deeks J, Goldacre HK. Suicide in psychiatric hospital in-patients: risk factors and their predictive power. Br J Psychiatry. 2000;176:266–272
  23. Sansone RA, Songer DA, Sellbom M. The relationship between suicide attempts and low-lethal self-harm behavior among psychiatric inpatients. J Psychiatr Pract. 2006;12:148–152
  24. Rissmiller D, Rissmiller F. Inpatient suicide epidemics and suggestions for prevention. Hosp Com Psychiatry. 1990;41:922–924
  25. Taiminen T, Salmenpera T, Lehtinen K. A suicide epidemic in a psychiatric hospital. Suicide Life Threat Behav. 1992;22:350–363
  26. Shah A, Ganesvaran T. Inpatient suicides in an Australian mental hospital. Aust N Z J Psychiatry. 1997;31:291–298
  27. Haw C, Hawton K, Casey D, Bale E, Shepherd A. Alcohol dependence, excessive drinking and deliberate self-harm: trends and patterns in Oxford, 1989-2002. Soc Psychiatry Psychiatr Epidemiol. 2005;40:964–971
  28. Sansone RA, Songer DA, Miller KA. A naturalistic study of the relationship between self-harm behaviors and Axis I diagnostic groupings among inpatients. Int J Psychiatry Clin Pract. 2007;11:73–75
  29. Appleby L, Shaw J, Amos T, et al. Suicide within 12 months of contact with mental health services: national clinical survey. BMJ. 1999;318:1235–1239
  30. Bateman A, Fonagy P. Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. Am J Psychiatry. 1999;156:1563–1569
  31. Kettles A, Moir E, Woods P, Porter S, Sutherland E. Is there a relationship between risk assessment and observation level?. J Psychiatr Ment Health Nurs. 2004;11:156–164
  32. Moore P, Berman K, Knight M, Devine J. Constant observation: implications for nursing practice. J Psychosoc Nurs. 1995;33:46–50
  33. Flood C, Bowers L, Parkin D. Estimating the Costs of Conflict and Containment on Adult Acute Inpatient Psychiatric Wards. Nurs Econ 2008;26:325–30, 324.
  34. Cutcliffe J, Barker P. Considering the care of the suicidal client and the case for ‘engagement and inspiring hope’ or ‘observations’. J Psychiatr Ment Health Nurs. 2002;9:611–621
  35. Gournay K, Bowers L. Suicide and self-harm in in-patient psychiatric units: a study of nursing issues in 31 cases. J Adv Nurs. 2000;32:124–131

PII: S0163-8343(09)00095-4

doi: 10.1016/j.genhosppsych.2009.05.008

General Hospital Psychiatry
Volume 31, Issue 6 , Pages 523-530 , November 2009

Article Tools

* Image Usage & Resolution