A systematic review of patient safety in mental health: a protocol based on the inpatient setting

Abstract

BackgroundDespite the growing international interest in patient safety as a discipline, there has been a lack of exploration of its application to mental health. It cannot be assumed that findings based upon physical health in acute care hospitals can be applied to mental health patients, disorders and settings. To the authors’ knowledge, there has only been one review of the literature that focuses on patient safety research in mental health settings, conducted in Canada in 2008. We have identified a need to update this review and develop the methodology in order to strengthen the findings and disseminate internationally for advancement in the field. This systematic review will explore the existing research base on patient safety in mental health within the inpatient setting.MethodsTo conduct this systematic review, a thorough search across multiple databases will be undertaken, based upon four search facets (“mental health”, “patient safety”, “research” and “inpatient setting”). The search strategy has been developed based upon the Canadian review accompanied with input from the National Reporting and Learning System (NRLS) taxonomy of patient safety incidents and the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). The screening process will involve perspectives from at least two researchers at all stages with a third researcher invited to review when discrepancies require resolution. Initial inclusion and exclusion criteria have been developed and will be refined iteratively throughout the process. Quality assessment and data extraction of included articles will be conducted by at least two researchers. A data extraction form will be developed, piloted and iterated as necessary in accordance with the research question. Extracted information will be analysed thematically.DiscussionWe believe that this systematic review will make a significant contribution to the advancement of patient safety in mental health inpatient settings. The findings will enable the development and implementation of interventions to improve the quality of care experienced by patients and support the identification of future research priorities.Systematic review registrationPROSPERO CRD42016034057 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0365-7) contains supplementary material, which is available to authorized users.

Systematic review of interventions to improve constant observation on adult inpatient psychiatric wards

“…Mental health is an underrepresented area in patient safety research, and clinical practices used regularly in mental health such as constant observations have not been subjected to rigorous evaluation (D'Lima et al ., ; Dewa et al ., ). Further research is needed to fully understand the practice in all its forms and identify what aspects of the practice can maximize benefits and minimize the risks for both patients and staff.…”

Patient safety in inpatient mental health settings: a systematic review

“…A systematic search was developed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 12. The protocol for this systematic review has been published elsewhere 11…”

“…The review presented here is exploratory in nature; building on previous reviews, we aimed to report an overview of the existing research base on patient safety in inpatient mental health settings. We also aimed to critically reflect on quality and methods used in included studies in the field 11. In addition to our original protocol,11 we aimed to collate, describe and construct the main research categories, allowing for an easily accessible reference index.…”

“…We also aimed to critically reflect on quality and methods used in included studies in the field 11. In addition to our original protocol,11 we aimed to collate, describe and construct the main research categories, allowing for an easily accessible reference index.…”

Harveian Oration 2018: Improving quality and safety in healthcare

“…[56][57][58][59] We might, for example, interrogate how problems of quality and safety are identified and defined, which problems and deficits in health systems are seen as worthy of attention (both in practice and in research) while others remain obscured or neglected, and which problems are selected as the focus for improvement efforts, on what warrant, for whose benefit. Why, for example, has surgery seen welcome improvements in safety over time, but improving the safety of those with mental illness or learning disability has received rather less attention in practice, policy and research 60 despite high levels of morbidity and mortality, and evidence of serious harm and failures of organisational learning? The challenge is also broader than the issue of how attentional resources get distributed to particular clinical areas, and extends to why, for example, the topic of social inequities in healthcare improvement has remained so muted.…”