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Effect of Electronic Rounding Board on Falls and Self-harm Among Psychiatric Inpatients: Quality Improvement Project
Mary Kay Shibley1, Son Chae Kim, Laurie Ecoff
1Clinical Informatics & Electric Convulsive Therapy Services, Sharp Mesa Vista Hospital, San Diego, California (Dr Shibley); School of Nursing, Point Loma Nazarene University, San Diego, California (Dr Kim); and Caster Nursing Institute, Sharp HealthCare, San Diego, California (Dr Ecoff). Dr Shibley is now at Invisalert Solutions, West Chester, Pennsylvania.
Implementing ObservSMART in psychiatric units improved the detection of patient self-harm, including suicide attempts, without affecting fall rates. This technology enhances patient safety and staff accountability in hospitals.
Area of Science:
- Healthcare Management
- Patient Safety
- Psychiatric Nursing
Background:
- Hospitals report over 1 million falls annually, with psychiatric inpatients facing high risks of self-harm and suicide.
- Effective patient observation is crucial for managing risks and preventing adverse safety incidents.
Purpose of the Study:
- To evaluate the impact of implementing a handheld electronic rounding board (ObservSMART) on falls and self-harm incidents in psychiatric inpatients.
- To assess changes in patient safety incident rates before and after ObservSMART implementation and staff training.
Main Methods:
- A retrospective review of adverse patient safety incidents was conducted.
- Data from a 6-month preimplementation period were compared with a 6-month postimplementation period (July 2019 onwards).
- Monthly fall rates per 1000 patient-days and self-harm incidence were analyzed.
Main Results:
- Monthly fall rates per 1000 patient-days showed no significant change (3.53 pre- vs. 3.80 postimplementation).
- The incidence of self-harm incidents increased from 3 to 7 overall, and from 1 to 6 among adult patients.
- ObservSMART implementation significantly improved the detection of patient self-harm, including self-injury and suicide attempts.
Conclusions:
- ObservSMART implementation did not alter fall rates but markedly enhanced the detection of self-harm incidents in psychiatric inpatients.
- The electronic rounding board improves staff accountability and facilitates timely, proximity-based patient observations.
- This technology represents a valuable tool for improving patient safety and risk management in psychiatric care settings.
