Document Detail

Continuous observation for psychiatric inpatients: a critical evaluation.
MedLine Citation:
PMID:  2297984     Owner:  NLM     Status:  MEDLINE    
Continuous observation is a procedure used in most psychiatric inpatient units to manage acute and escalating risk in patients. Yet, it is virtually unstudied and unreported. The present study, conducted in a psychiatric teaching hospital, compared 102 inpatients who required continuous observation with 102 control subjects. Continuous observation was provided by nursing staff, and was used for 13% of inpatients. The most common reasons for continuous observation were risk of self-harm, overstimulation by the environment, and violence. Five clinical factors that predicted the use of continuous observation as well as another set of factors that correlated with a history of violence were found. Almost two thirds of patients required brief episodes lasting less than 72 hours (mean, 28 hours). These appeared to be effective and practical. However, when continuous observation exceeded 72 hours, it often became problematic and ineffective. We recommend that after 72 hours of continuous observation, patients' clinical management should be reviewed by the treatment team and changed.
G Shugar; R Rehaluk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Comprehensive psychiatry     Volume:  31     ISSN:  0010-440X     ISO Abbreviation:  Compr Psychiatry     Publication Date:    1990 Jan-Feb
Date Detail:
Created Date:  1990-03-08     Completed Date:  1990-03-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372612     Medline TA:  Compr Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  48-55     Citation Subset:  IM    
Assessment and Treatment Division, Clarke Institute of Psychiatry, Toronto, Canada.
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MeSH Terms
Cognition Disorders / prevention & control*
Confusion / prevention & control*,  psychology
Crisis Intervention*
Mental Disorders / psychology
Nurse-Patient Relations*
Psychiatric Department, Hospital
Risk Factors
Self Mutilation / prevention & control*,  psychology
Social Environment
Suicide / prevention & control*,  psychology

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