Development and Pilot Implementation of a Search Protocol to Improve Patient Safety on a Psychiatric Inpatient Unit

Patient Safety Strategies in Psychiatry and How They Construct the Notion of Preventable Harm: A Scoping Review

OBJECTIVES

The literature on patient safety in psychiatry has not been explored systematically in terms of what interventions are used, how they are used, and what type of (preventable) harm is targeted. The aims of this scoping review are to explore patient safety strategies used in psychiatry and determine how they construct the notion of preventable harm.

METHOD

A scoping review of literature on patient safety in psychiatry published in English between 2000 and 2019 was conducted using Scopus, MEDLINE, PsycInfo, and CINAHL. Keywords of patient safety strategies and possible outcomes were coded from the results, discussion, or conclusion. Patient safety strategies were inductively categorized into themes according to the focus of the strategy.

RESULTS

The review introduces 7 focus areas of patient safety strategies identified within the psychiatric literature: "risk management," "healthcare practitioners," "patient observation," "patient involvement," "computerized methods," "admission and discharge," and "security." The result shows that patient safety strategies mainly aim to reduce suicide, self-harm, violence, and falls and present a large diversity of measures, often aimed at reducing variability while increasing standardization.

CONCLUSIONS

The strategies that are supported in the literature to achieve safer psychiatry mainly arise from linear cause-effect models and rely on staff performance, competence, and compliance. Contemporary safety science acknowledges the performance variability of everyday normal work and sees risk as the dynamic migration of these daily activities. The field of psychiatry has not yet included this view of safety in the strategic actions to reduce preventable harm.

Safety of patients with mental disorders: a collective construction of strategies

OBJECTIVE

to describe risk management implementation in the safety of patients with mental disorders through action research.

METHOD

an action research carried out with a multidisciplinary team from a reference hospital in mental health in Southeast Brazil.

RESULTS

three strategies considered as managerial technologies for the mentally ill patient were developed: risk management diagram for patient safety; patient safety protocols; and textual proposal of software for internal management of incident notifications.

FINAL CONSIDERATIONS

this action research allowed a collective discussion by the whole multidisciplinary team, enabling strategy drafting for risk management implementation and improvement of care quality in the safety of patients with mental disorders at the study site.

Safe Searches: The Scale and Spread of a Quality Improvement Project

To ensure the safety of staff, patients, and visitors to psychiatric inpatient units, a standardized safe search protocol was developed and implemented across a psychiatric facility. This article provides an overview of the methods used in the planning, implementation, and spread of this quality improvement initiative, focusing on the concepts of change management, leadership, and team involvement. The professional development of point-of-care staff is enhanced by active engagement in quality improvement initiatives.