The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness,Centre for Mental Health and Safety, University of Manchester,Jean McFarlane Building,Oxford Road,Manchester,UK.
Psychol Med. 2017 Oct;47(13):2238-2245. doi: 10.1017/S0033291717000630. Epub 2017 Apr 11.
Observations in psychiatric in-patient settings are used to reduce suicide, self-harm, violence and absconding risk. The study aims were to describe the characteristics of in-patients who died by suicide under observation and examine their service-related antecedents.
A national consecutive case series in England and Wales (2006-2012) was examined.
There were 113 suicides by in-patients under observation, an average of 16 per year. Most were under intermittent observation. Five deaths occurred while patients were under constant observation. Patient deaths were linked with the use of less experienced staff or staff unfamiliar with the patient, deviation from procedures and absconding.
We identified key elements of observation that could improve safety, including only using experienced and skilled staff for the intervention and using observation levels determined by clinical need not resources.
在精神科住院环境中进行观察可降低自杀、自残、暴力和逃跑风险。本研究旨在描述在观察下自杀身亡的住院患者的特征，并探讨其与服务相关的前因。
在英格兰和威尔士（2006-2012 年）进行了一项全国性连续病例系列研究。
共有 113 例在观察下的住院患者自杀，平均每年 16 例。大多数患者接受间歇性观察。有 5 例死亡发生在患者持续观察期间。患者死亡与使用经验较少或不熟悉患者的工作人员、偏离程序和逃跑有关。
我们确定了可以提高安全性的观察关键要素，包括仅对干预措施使用经验丰富和熟练的工作人员，并根据临床需要而不是资源确定观察水平。
