Suicide and Self-Harm in Inpatient Psychiatric Units: a National Survey of Observation Policies

This paper reports a national survey of observation policies & usage based upon a stratified random sample of 27 psychiatric inpatient service providers in England & Wales. Extreme variation in terminology & practice was encountered. Further variation existed from place to place as to whether, & to what extent, student nurses & family members should be entrusted with the responsibility to observe patients. More than 1 in 10 services of the sample had no written observation policy, & 4 in 10 had no clinical recording system of the procedure in place. Nurses commonly amended the procedure & terminology on an ad hoc basis. It is suggested the Department of Health needs to set national standards for policy & procedures. (22 refs.)