Rethinking Nurse Observations in Mental Health
Periodic intermittent observations are commonly performed by staff in inpatient mental health settings to support patient safety, risk assessment and clinical management. These observations follow long-established processes and are typically conducted hourly or every 15 minutes for each patient. However, this approach may have inherent challenges for patients and staff. For example, patients may experience disturbance to their sleep from observations carried out at night by members of ward staff visiting their room.
The purpose of this research project is to review the evidence supporting widely-used observation practices, gather information on their advantages and disadvantages by interviewing ward staff and managers, and consider whether there are opportunities to enhance or redesign standard processes in the light of technology now available to support staff.
This work is taking place in a research study with Health Research Authority approval. The project was initiated and is being led by Ade Odunlade (Chief Operating Officer at Derbyshire Healthcare NHS Foundation Trust) who has partnered with Margaret Rioga (Buckinghamshire New University) and Dr Peter Sandy (University of West London) to execute it.
The research team first conducted a review of the literature to search for evidence to support long-established observations processes.
The researchers then conducted interviews with ward staff and managers at a range of NHS trusts which provide mental health services. The interviews were designed to document how routine observations are performed, the essential aspects of observations from a clinician’s point of view and the strengths and limitations of current practice. The role technology like Oxevision may play in supporting observations was also considered. The interviews are being reviewed to identify common themes around the advantages and disadvantages of commonly-used systems of observations.
It is anticipated that findings from the literature review and interviews will be published in 2022.