ABSTRACT
This chapter provides some methods used to manage risk in inpatient wards. It explains the impact of observations on the patient, carers, staff and ward environment. The chapter explores some of the methods used in acute inpatient mental health wards to manage and minimize risk. The aim of a hospital admission is to provide a safe and contained environment for people while they are acutely unwell. However, there are associated dangers, including risk of harm from others who are unwell, trauma from observing disturbed behaviour in others, institutionalization, harm caused by medication, being physically restrained by staff and the impact of being away from friends and family. Despite the widespread use of observation, there was no national policy in the United Kingdom (UK) to guide its implementation for many years. In 1999 the Standing Nursing and Midwifery Advisory Committee published practice guidance in order to minimize the variance between observation practice and policies across the UK.
