Abstract：
WHAT IS KNOWN ON THE SUBJECT?: Continuous observation is often used in mental health wards to support the safety of service users, where they will be constantly watched by a member of staff. Evidence suggests that continuous observations may be unhelpful and restrictive, but not enough is known about the practice or the best ways to improve it. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This evaluation integrates the perspectives of service users, informal carers and staff to explore current continuous observation experiences and inform future improvements. While previous research highlights the importance of therapeutic engagement, this study additionally emphasizes how the observation procedure could be adapted to individual needs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Continuous observations could be more beneficial if they are therapeutic, proportional to the level of risk and co-developed with the service user, informal carer and staff. Further training about communication could support staff engagement and the observation process could be formalized to ensure regular collaborative reviews.
UNASSIGNED: INTRODUCTION: Continuous observation is a frequently used tool to manage high levels of risk on psychiatric wards. However, there is little previous research on its use in practice.
OBJECTIVE: This qualitative service evaluation aims to explore the continuous observation experiences of service users, informal carers and staff in a local NHS Mental Health Trust, informing suggested future improvements to current practice.
METHODS: Five service users, three informal carers and seven healthcare staff completed semi-structured interviews, which were thematically analysed to create four themes.
RESULTS: Positive interaction and engagement in activities were critical for a therapeutic approach to observations, supporting service users and staff to minimize the unproductive behaviours that can arise. Difficulties balancing safety with privacy could suggest the importance of proportionate and tailored observation procedures for each service user. Ensuring the voices of service users and informal carers remain central to decisions regarding care could further improve the observation experience.
CONCLUSIONS: This study highlights therapeutic, proportionate and co-produced observations as key characteristics to improve practice. Further training and formalization of the observation process could foster cultural changes towards more long-term approaches to risk management.
UNASSIGNED: INTRODUCTION: Continuous observation is a frequently used tool to manage high levels of risk on psychiatric wards. However, there is little previous research on its use in practice.
OBJECTIVE: This qualitative service evaluation aims to explore the continuous observation experiences of service users, informal carers and staff in a local NHS Mental Health Trust, informing suggested future improvements to current practice.
METHODS: Five service users, three informal carers and seven healthcare staff completed semi-structured interviews, which were thematically analysed to create four themes.
RESULTS: Positive interaction and engagement in activities were critical for a therapeutic approach to observations, supporting service users and staff to minimize the unproductive behaviours that can arise. Difficulties balancing safety with privacy could suggest the importance of proportionate and tailored observation procedures for each service user. Ensuring the voices of service users and informal carers remain central to decisions regarding care could further improve the observation experience.
CONCLUSIONS: This study highlights therapeutic, proportionate and co-produced observations as key characteristics to improve practice. Further training and formalization of the observation process could foster cultural changes towards more long-term approaches to risk management.
摘要：
对受试者有什么了解？：持续观察通常用于心理健康病房，以支持服务使用者的安全，在那里，他们将不断受到工作人员的关注。有证据表明，连续的观察可能是无益的和限制性的，但对实践或改进它的最佳方法知之甚少。这篇论文对现有知识有什么帮助？：这项评估整合了服务用户的观点，非正式护理人员和工作人员探索当前的持续观察经验，并告知未来的改进。虽然先前的研究强调了治疗参与的重要性，这项研究还强调了观察程序如何适应个人需求.实践的含义是什么？：如果连续观察是治疗性的，可能会更有益，与风险水平成正比，并与服务用户共同开发，非正式的照顾者和工作人员。关于沟通的进一步培训可以支持工作人员的参与，观察过程可以正规化，以确保定期进行协作审查。
■介绍：连续观察是管理精神科病房高风险的常用工具。然而,关于它在实践中的使用，以前的研究很少。
目的：本定性服务评估旨在探索服务用户的持续观察体验，当地NHS心理健康信托基金的非正式护理人员和工作人员，告知对当前实践的未来改进建议。
方法：五个服务用户，三名非正式护理人员和七名医护人员完成了半结构化面试，对其进行了主题分析，以创建四个主题。
结果：积极的互动和参与活动对于观察的治疗方法至关重要，支持服务用户和员工，以尽量减少可能出现的非生产性行为。在安全与隐私之间取得平衡的困难可能表明，为每个服务用户制定相称和量身定制的观察程序的重要性。确保服务用户和非正式护理人员的声音仍然是有关护理的决策的核心，可以进一步改善观察体验。
结论：本研究强调治疗，按比例和共同产生的观察结果作为改进实践的关键特征。观察过程的进一步培训和形式化可以促进文化变革，朝着更长期的风险管理方法发展。
■介绍：连续观察是管理精神科病房高风险的常用工具。然而,关于它在实践中的使用，以前的研究很少。
目的：本定性服务评估旨在探索服务用户的持续观察体验，当地NHS心理健康信托基金的非正式护理人员和工作人员，告知对当前实践的未来改进建议。
方法：五个服务用户，三名非正式护理人员和七名医护人员完成了半结构化面试，对其进行了主题分析，以创建四个主题。
结果：积极的互动和参与活动对于观察的治疗方法至关重要，支持服务用户和员工，以尽量减少可能出现的非生产性行为。在安全与隐私之间取得平衡的困难可能表明，为每个服务用户制定相称和量身定制的观察程序的重要性。确保服务用户和非正式护理人员的声音仍然是有关护理的决策的核心，可以进一步改善观察体验。
结论：本研究强调治疗，按比例和共同产生的观察结果作为改进实践的关键特征。观察过程的进一步培训和形式化可以促进文化变革，朝着更长期的风险管理方法发展。
