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Service users at the heart of new research to help improve their care

28 Jun 24

Continuous observation has been the focus of a recently published research project undertaken by HPFT professionals to improve care, support and positive outcomes for service users.


Research background  

Continuous observation is a procedure often used in our psychiatric wards to keep service users and others safe, by providing one-to-one care and monitoring them all the time. This is generally done when a service user is experiencing severe mental health difficulties or is at risk of their condition deteriorating. For example, the service user could be at serious risk of self-harm.

Despite this being a frequently employed procedure in the Trust, the research team wanted to explore the best ways to improve the experience for service users, and understand their feelings about the procedure, as it can be quite distressing or restrictive. The team started this project to explore perspectives and experiences on this practice.

Semi-structured interviews and analysis of different themes meant that the voices of service users, informal carers and healthcare staff were central to the research.


Research insights 

The team gained valuable insights about what could improve service users’ experience and outcomes when undergoing continuous observation.

Firstly, this included developing therapeutic relationships between the service user and the staff observing them, with participants emphasising the importance of mutually positive interactions and communication. This can help those involved to feel a greater sense of comfort.

Moreover, it was found that service users, carers and staff would significantly benefit from co-developing how the approach would be personalised and implemented for each service user. For instance, this could mean tailoring the observation to allow service users extra autonomy or private time, or tailoring activities to their specific interests.

Finally, it was found that staff would greatly benefit from a more formalised approach to the procedure, as well as the establishment of consistent training.


This important research will feed into future changes to HPFT’s Safe and Supportive Observations Policy and help to foster cultural changes towards more shared and empowering approaches to risk and safety management across the Trust.

To find out more about this project, please visit the published article in the Journal of Psychiatric and Mental Health Nursing by clicking on the following link: doi.org/10.1111/jpm.13072

Please note that the full article is only accessible through a fee or subscription.

Thank you to everyone who supported this project and to our Experts by Experience for their valuable contributions. If you have any questions about the research, please contact lottie.anstee@nhs.net.

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