Rethinking Observations in Mental Health

Study Overview
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Brief Summary
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To gain healthcare workers' perception of the current observations practices used in patient care and explore the benefits of using technology to enhance observations in inpatient mental health setting in the United Kingdom.

Detailed Description
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Periodic intermittent clinical observations are commonly used in mental health services at admission for risk assessment and then for the clinical management of patients. Nurses follow these practices as routine care to ensure patient well-being. However, being observed may make patients feel uncomfortable and anxious. The Department of Health (2006) stipulated for the practice of observation to be implemented in a manner that would enable patients to experience it as a healing and compassionate practice. This is apparently not always realised as there are reported differences on how patients are observed, and clinical data obtained. Whilst this may be attributed in part to lack of or limited training on the use of observations, it can also in part be attributed to lack of a standardised approach to implementation and documentation of the outcomes of observations (Stewart & Bowers 2012).This contributes to variability among healthcare workers in their interpretation of the outcomes/data of observations. Given that patients' care pathways are influenced by the outcomes/data of observations, it is critical to reduce the variability in the use of this practice. Doing so would lead to obtaining consistent and dependable data that reflect patients' mental state to guide their individual care pathways. The focus of this qualitative study is to document how clinicians perform routine patient observations, the essential aspects of observations through a clinician's point of view and how can application of modern technology aid this process. This systematic documentation will capture the strengths and limitations of current practice creating a service provide based dataset to inform focused improvements.

Official Title
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Rethinking Observations in Mental Health

Conditions
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Vital Signs

Intervention / Treatment
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* Other: Qualitative study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthcare workers such as nurse directors, matrons, ward managers, nurses, healthcare support workers, including; nurse associates, nurse assistants and assistant practioners who work in inpatient mental health settings Healthcare workers with at least two years' experience of working in inpatient mental settings Healthcare workers who conduct or have conducted patient observations, and have used it for at least two years Exclusion Criteria: Students and clinicians in training who do not carry out independent patient observations.
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthcare workers<br>Healthcare workers with patient care experience and are willing to share their experience of current practices of obtaining patient observations. | Other: Qualitative study<br>* Individual interviews and focus groups will be conducted to explore current strengthens and barriers in obtaining patient observations. Views on use of technology in assisting with patient observations will also be discussed and documented.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Strengthens and Limitations of current practice of clinical observations | Exploratory method, conducted in the form of individual and focus groups to document strengthens and barriers to current ways of obtaining clinical observations in in patient mental health setting.(qualitative method) | Day 1 of participation, during a one-off interview/focus group | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Views on use of technology in obtaining patient observations | Exploratory method to gain healthcare workers' perspective on using modern technology such as a contact free patient monitoring system to aid the practice of patient observations through individual interviews and focus groups. | Day 1 of participation, during a one-off interview/focus group | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nurse Observations, Clinical Observations