Sarah Kendal, Gemma Louch, Lauren Walker, Saba Shafiq, Daisy Halligan, Lyn Brierley-Jones, John Baker
{"title":"在成人急症精神病房实施和评估以患者为中心的安全技术。","authors":"Sarah Kendal, Gemma Louch, Lauren Walker, Saba Shafiq, Daisy Halligan, Lyn Brierley-Jones, John Baker","doi":"10.1111/jpm.13028","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> What is known on the subject</h3>\n \n <div>\n \n <ul>\n \n \n <li>Mental health wards can feel unsafe. We know that patients and staff have different ideas about what makes a hospital ward safe or unsafe.</li>\n \n \n <li>Patients are often the first to know when the atmosphere on a ward becomes tense, but often, no one asks them for their views.</li>\n \n \n <li>Patients and staff are experts and should be included in discussions about how to make wards safer.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n <h3> What this paper adds to existing knowledge</h3>\n \n <div>\n \n <ul>\n \n \n <li>We got together with some service users and staff, and made an app that helps patients to tell staff when they are not feeling safe on a mental health ward. We tried it out on six wards and we asked patients and staff what they thought.</li>\n \n \n <li>The app was easy to use and most people liked the look of it.</li>\n \n \n <li>Patients said staff did not talk with them enough and so they liked using the app. However, some staff said they could tell how patients were feeling without an app and so they did not need it. Ward managers told us that staff were often very busy and did not always have time to use the app.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n <h3> What are the implications for practice</h3>\n \n <div>\n \n <ul>\n \n \n <li>This app could help staff know straightaway when patients do not feel safe on the ward, so that they can act quickly to calm things down.</li>\n \n \n <li>To make the most of the app, staff need to get used to it and bring it into ward routines.</li>\n </ul>\n </div>\n </section>\n \n <section>\n \n </section>\n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Safety improvement on mental health wards is of international concern. It should incorporate patient perspectives.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>Implementation and evaluation of ‘WardSonar’, a digital safety-monitoring tool for adult acute mental health wards, developed with stakeholders to communicate patients' real-time safety perceptions to staff.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>Six acute adult mental health wards in England implemented the tool in 2022. Evaluation over 10 weeks involved qualitative interviews (34 patients, 33 staff), 39 focused ethnographic observations, and analysis of pen portraits.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Implementation and evaluation of the WardSonar tool was feasible despite challenging conditions. Most patients valued the opportunity to communicate their immediate safety concerns, stating that staff had a poor understanding of them. Some staff said the WardSonar tool could help enhanced ward safety but recognised a need to incorporate its use into daily routines. Others said they did not need the tool to understand patients' safety concerns.</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>Foreseeable challenges, including staff ambivalence and practical issues, appeared intensified by the post-COVID-19 context.</p>\n </section>\n \n <section>\n \n <h3> Implications for Practice</h3>\n \n <p>The WardSonar tool could improve ward safety, especially from patients' perspectives. Future implementation could support staff to use the real-time data to inform proactive safety interventions.</p>\n </section>\n </div>","PeriodicalId":50076,"journal":{"name":"Journal of Psychiatric and Mental Health Nursing","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpm.13028","citationCount":"0","resultStr":"{\"title\":\"Implementing and evaluating patient-focused safety technology on adult acute mental health wards\",\"authors\":\"Sarah Kendal, Gemma Louch, Lauren Walker, Saba Shafiq, Daisy Halligan, Lyn Brierley-Jones, John Baker\",\"doi\":\"10.1111/jpm.13028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> What is known on the subject</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>Mental health wards can feel unsafe. We know that patients and staff have different ideas about what makes a hospital ward safe or unsafe.</li>\\n \\n \\n <li>Patients are often the first to know when the atmosphere on a ward becomes tense, but often, no one asks them for their views.</li>\\n \\n \\n <li>Patients and staff are experts and should be included in discussions about how to make wards safer.</li>\\n </ul>\\n </div>\\n </section>\\n \\n <section>\\n \\n <h3> What this paper adds to existing knowledge</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>We got together with some service users and staff, and made an app that helps patients to tell staff when they are not feeling safe on a mental health ward. We tried it out on six wards and we asked patients and staff what they thought.</li>\\n \\n \\n <li>The app was easy to use and most people liked the look of it.</li>\\n \\n \\n <li>Patients said staff did not talk with them enough and so they liked using the app. However, some staff said they could tell how patients were feeling without an app and so they did not need it. Ward managers told us that staff were often very busy and did not always have time to use the app.</li>\\n </ul>\\n </div>\\n </section>\\n \\n <section>\\n \\n <h3> What are the implications for practice</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>This app could help staff know straightaway when patients do not feel safe on the ward, so that they can act quickly to calm things down.</li>\\n \\n \\n <li>To make the most of the app, staff need to get used to it and bring it into ward routines.</li>\\n </ul>\\n </div>\\n </section>\\n \\n <section>\\n \\n </section>\\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Safety improvement on mental health wards is of international concern. 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Some staff said the WardSonar tool could help enhanced ward safety but recognised a need to incorporate its use into daily routines. Others said they did not need the tool to understand patients' safety concerns.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Discussion</h3>\\n \\n <p>Foreseeable challenges, including staff ambivalence and practical issues, appeared intensified by the post-COVID-19 context.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Implications for Practice</h3>\\n \\n <p>The WardSonar tool could improve ward safety, especially from patients' perspectives. 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Implementing and evaluating patient-focused safety technology on adult acute mental health wards
What is known on the subject
Mental health wards can feel unsafe. We know that patients and staff have different ideas about what makes a hospital ward safe or unsafe.
Patients are often the first to know when the atmosphere on a ward becomes tense, but often, no one asks them for their views.
Patients and staff are experts and should be included in discussions about how to make wards safer.
What this paper adds to existing knowledge
We got together with some service users and staff, and made an app that helps patients to tell staff when they are not feeling safe on a mental health ward. We tried it out on six wards and we asked patients and staff what they thought.
The app was easy to use and most people liked the look of it.
Patients said staff did not talk with them enough and so they liked using the app. However, some staff said they could tell how patients were feeling without an app and so they did not need it. Ward managers told us that staff were often very busy and did not always have time to use the app.
What are the implications for practice
This app could help staff know straightaway when patients do not feel safe on the ward, so that they can act quickly to calm things down.
To make the most of the app, staff need to get used to it and bring it into ward routines.
Introduction
Safety improvement on mental health wards is of international concern. It should incorporate patient perspectives.
Aim
Implementation and evaluation of ‘WardSonar’, a digital safety-monitoring tool for adult acute mental health wards, developed with stakeholders to communicate patients' real-time safety perceptions to staff.
Method
Six acute adult mental health wards in England implemented the tool in 2022. Evaluation over 10 weeks involved qualitative interviews (34 patients, 33 staff), 39 focused ethnographic observations, and analysis of pen portraits.
Results
Implementation and evaluation of the WardSonar tool was feasible despite challenging conditions. Most patients valued the opportunity to communicate their immediate safety concerns, stating that staff had a poor understanding of them. Some staff said the WardSonar tool could help enhanced ward safety but recognised a need to incorporate its use into daily routines. Others said they did not need the tool to understand patients' safety concerns.
Discussion
Foreseeable challenges, including staff ambivalence and practical issues, appeared intensified by the post-COVID-19 context.
Implications for Practice
The WardSonar tool could improve ward safety, especially from patients' perspectives. Future implementation could support staff to use the real-time data to inform proactive safety interventions.
期刊介绍:
The Journal of Psychiatric and Mental Health Nursing is an international journal which publishes research and scholarly papers that advance the development of policy, practice, research and education in all aspects of mental health nursing. We publish rigorously conducted research, literature reviews, essays and debates, and consumer practitioner narratives; all of which add new knowledge and advance practice globally.
All papers must have clear implications for mental health nursing either solely or part of multidisciplinary practice. Papers are welcomed which draw on single or multiple research and academic disciplines. We give space to practitioner and consumer perspectives and ensure research published in the journal can be understood by a wide audience. We encourage critical debate and exchange of ideas and therefore welcome letters to the editor and essays and debates in mental health.