NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.
Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK.
BMC Psychiatry. 2019 Nov 6;19(1):346. doi: 10.1186/s12888-019-2336-8.
Suicide and non-fatal self-harm represent key patient safety events in mental healthcare services. However, additional important learning can also be derived by highlighting examples of optimal practice that help to keep patients safe. In this study, we aimed to explore clinicians' views of what constitutes good practice in mental healthcare services in the context of suicide prevention.
Data were extracted from the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) database, a consecutive case series study of suicide by people in contact with mental healthcare services. A large national sample of clinicians' responses was analysed with a hybrid thematic analysis.
Responses (n = 2331) were submitted by clinicians across 62 mental healthcare providers. The following five themes illustrated good practice that helps to: 1) promote safer environments, 2) develop stronger relationships with patients and families, 3) provide timely access to tailored and appropriate care, 4) facilitate seamless transitions, and 5) establish a sufficiently skilled, resourced and supported staff team.
This study highlighted clinicians' views on key elements of good practice in mental health services. Respondents included practice specific to mental health services that focus on enhancing patient safety via prevention of self-harm and suicide. Clinicians possess important understanding of optimal practice but there are few opportunities to share such insight on a broader scale. A further challenge is to implement optimal practice into routine, daily care to improve patient safety and reduce suicide risk.
自杀和非致命性自伤是精神卫生保健服务中关键的患者安全事件。然而，通过强调有助于保障患者安全的最佳实践示例，还可以获得更多其他重要的经验教训。在这项研究中，我们旨在探讨临床医生对预防自杀背景下精神卫生保健服务中良好实践的看法。
从国家精神卫生保健自杀和安全机密调查（NCISH）数据库中提取数据，该数据库是一项针对与精神卫生保健服务有接触的人群自杀的连续病例系列研究。采用混合主题分析法分析了来自 62 个精神卫生保健提供者的大量临床医生的大量回复。
共有 2331 名临床医生提交了回复。以下五个主题说明了有助于以下几个方面的良好实践：1）促进更安全的环境；2）与患者和家属建立更牢固的关系；3）提供及时的个性化和适当的护理；4）促进顺利过渡；5）建立足够熟练、资源充足和得到支持的员工团队。
这项研究强调了临床医生对精神卫生服务中良好实践的关键要素的看法。回复者包括针对精神卫生服务的具体实践，这些实践侧重于通过预防自残和自杀来增强患者安全。临床医生对最佳实践有重要的理解，但很少有机会在更广泛的范围内分享这种见解。进一步的挑战是将最佳实践实施到常规日常护理中，以提高患者安全并降低自杀风险。
