Patient safety in inpatient mental health settings: a systematic review
Objectives Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may r...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/12/e030230.full |
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| author | Ara Darzi Stephanie Archer Hutan Ashrafian Bethan Thibaut Lindsay Helen Dewa Sonny Christian Ramtale Danielle D'Lima Sheila Adam |
| author_facet | Ara Darzi Stephanie Archer Hutan Ashrafian Bethan Thibaut Lindsay Helen Dewa Sonny Christian Ramtale Danielle D'Lima Sheila Adam |
| author_sort | Ara Darzi |
| collection | DOAJ |
| description | Objectives Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.Design Systematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.Results Of the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.Conclusions Patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration number CRD42016034057. |
| format | Article |
| id | doaj-art-bebda676b0c949d98f345d929b59bdb1 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-bebda676b0c949d98f345d929b59bdb12024-12-03T14:50:11ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-030230Patient safety in inpatient mental health settings: a systematic reviewAra Darzi0Stephanie Archer1Hutan Ashrafian2Bethan Thibaut3Lindsay Helen Dewa4Sonny Christian Ramtale5Danielle D'Lima6Sheila Adam71 NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK3 Department of Public Health and Primary Care and Department of Psychology, University of Cambridge, Cambridge, UKInstitute of Global Health Innovation, Imperial College London, London, UK1 NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UKPatient Safety Translational Research Centre, Imperial College London, London, UK1 NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK2 Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK1 NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UKObjectives Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.Design Systematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.Results Of the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.Conclusions Patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration number CRD42016034057.https://bmjopen.bmj.com/content/9/12/e030230.full |
| spellingShingle | Ara Darzi Stephanie Archer Hutan Ashrafian Bethan Thibaut Lindsay Helen Dewa Sonny Christian Ramtale Danielle D'Lima Sheila Adam Patient safety in inpatient mental health settings: a systematic review BMJ Open |
| title | Patient safety in inpatient mental health settings: a systematic review |
| title_full | Patient safety in inpatient mental health settings: a systematic review |
| title_fullStr | Patient safety in inpatient mental health settings: a systematic review |
| title_full_unstemmed | Patient safety in inpatient mental health settings: a systematic review |
| title_short | Patient safety in inpatient mental health settings: a systematic review |
| title_sort | patient safety in inpatient mental health settings a systematic review |
| url | https://bmjopen.bmj.com/content/9/12/e030230.full |
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