Staff Perceptions of Q15 Minute Patient Safety Observations in Inpatient Psychiatric Settings

Abstract

Purpose: While patient observations have been a mainstay for maintaining safety in behavioral health environments, little is known about how staff perceive the practice. The purpose of this project was to evaluate staff perceptions of every 15-minute patient safety observations in inpatient psychiatric units. Methods: A mixed-methods survey was developed that involved demographic questions, eight Likert-like questions, and three free response items. The survey was constructed within REDcap and distributed as a link in an email that was sent to all RN, BHS, and ABHS employees at Vanderbilt Psychiatric Hospital. Data were collected over 3 weeks. Results: Participants (n= 26) mostly had a bachelor’s (n=14) or master’s degree (n=11) and were mostly RNs (n=19). Nearly half of participants (n=12) reported 10+ years of experience. Participants expressed neutral to slightly agreeable views of Q15 minute observations. Overwhelmingly, participants agreed or strongly agreed that observations improve patient and unit safety (n=22 [84.6%]). Participants disagreed or strongly disagreed that observations negatively impact care quality (n=18 [69.2%]). Qualitative analysis resulted in the generation of “Promotion of Safety” as a major theme and “Harm reduction” and “Tailoring Patient Care” as subthemes for the purpose of observations. Respondents reported physically ensuring patient safety as an important aspect of safety checks and recognized poor quality task performance as a factor making checks unimportant. Suggestions for improvement included increasing the use of technology, increasing flexibility of checks, and selecting more observant staff. Implications For Practice: Behavioral health staff seem to have positive to neutral views of current Q15 minute safety observation practices and assert that observations promote safety. Staff support the idea of increasing technology supports to completing observations. Future research should focus on investigating ways to optimize and support current safety observation practices through uses of technological resources.