EPO on inpatient units in England

  • Research type

    Research Study

  • Full title

    NIHR159868 The acceptability, effectiveness and cost-effectiveness of Enhanced Patient Observation in reducing the risk of self-harm and suicide on psychiatric wards

  • IRAS ID

    338074

  • Contact name

    Alexandra Pitman

  • Contact email

    a.pitman@ucl.ac.uk

  • Sponsor organisation

    North London NHS Foundation Trust

  • Clinicaltrials.gov Identifier

    P-2597 , Noclor sponsorship reference; NIHR159868 , NIHR HSDR application reference

  • Duration of Study in the UK

    2 years, 11 months, 30 days

  • Research summary

    Suicide prevention in hospitals is an important national priority. Enhanced patient observation (EPO) or enhanced nursing observation is a clinical intervention commonly used on hospital wards in England to support patients thought to be at risk of self-harm or suicide. It includes the practices of continuous and intermittent observations, which aim to help patients feel safe and to stop them from hurting themselves. However, some patients can find them threatening or invasive. We also don't know if it actually works to keep patients safe.
    In this project our research team, including lived experience experts, plan to investigate the acceptability of enhanced patient observations in hospitals for patients at risk of self-harm. By acceptability we mean whether patients, their carers, and the staff delivering enhanced patient observations feel that it is helpful to patients at risk of self-harm or suicide in keeping them safe.
    We will carry out an online qualitative interview study with current or recent inpatients, carers and ward staff. Our lived experience interviewers will ask them about their experiences of different levels of observations and any suggestions about how to make them better. We will analyse the data to identify any positive, negative or neutral views about the practice of enhanced patient observations for patients at risk of self-harm. We will summarise suggestions for improvements. These findings, and the findings of our other studies on the clinical effectiveness of continuous and intermittent observations, will help us to develop co-produced patient/carer information, practice guidelines, staff training resources and policy guidelines. These will help staff to support inpatients at risk of self-harm by improving the quality of care, making sure that patients feel safe on wards.

  • REC name

    South Central - Oxford C Research Ethics Committee

  • REC reference

    25/SC/0091

  • Date of REC Opinion

    3 Apr 2025

  • REC opinion

    Favourable Opinion