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Development of a functional analytical nurse observation chart (FANOC)
David Veale1, Selina Warlow, Tara O'Donoghue
1NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, King's College London and The Priory Hospital North London, UK.
Behavioural and Cognitive Psychotherapy
|March 6, 2013
Summary
The new Functional Analytical Nurse Observation Charts (FANOC) showed moderate inter-rater reliability in psychiatric settings. Further training and support are needed to optimize their use in patient observation and care.
Area of Science:
- Psychiatric Nursing
- Clinical Observation Tools
- Behavioral Assessment
Background:
- Limited development of nurse observation charts in psychiatric in-patient units.
- Need for enhanced functional and contextual behavioral assessment.
Purpose of the Study:
- To develop a new nursing chart for functional and contextual behavioral assessment.
- To evaluate the initial utility of this chart in an in-patient psychiatric setting.
Main Methods:
- Development of the Functional Analytical Nurse Observation Charts (FANOC).
- Staff coded patient behaviors (daily life problems, improvements, non-clinically relevant).
- Evaluation with 14 in-patients, comparing staff coding to investigator coding.
Main Results:
- Initial inter-rater agreement was moderate (Kappa = 0.496).
- Excluding neutral behaviors improved agreement (Kappa = 0.546).
- Reliability remained moderate despite training.
Conclusions:
- FANOC demonstrated moderate inter-rater reliability.
- Requires ongoing training and management support for effective implementation.
- Further research needed on impact on staff satisfaction and patient experience.
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