Accessible summaryWhat is known on the subject?:• The potential benefits of introducing technological innovation into all types of health services are recognized internationally.• There are few studies exploring the use of technology in inpatient mental health settings, or the views of staff and patients regarding such developments.• "Early warning systems" are increasingly used in inpatient mental health services to detect physical deterioration in patients and prompt staff to take appropriate action. We have identified no peer-reviewed publications concerning this development.What the paper adds to existing knowledge?:• Using a questionnaire survey, this project gathered views from staff and patients on a planned change from a paper-based "early warning system" to one using handheld electronic devices (tablets).• This study adds to the existing evidence by reporting specific staff and patient concerns about a technological development in an inpatient mental health setting.Some patients were concerned about confidentiality of data entered onto tablets.Whilst were either positive or neutral in attitude to the planned change some staff raised concerns that electronic devices could be used as weapons, and also that patients or visitors might misinterpret their use.What are the implications for practice?:• Views of staff and patients must be considered when introducing new technology into clinical practice, in order to make the change successful and sustainable.• Inadequate or unclear information about the use and purpose of electronic devices may lead to misunderstandings as to their purpose and the security of their data, particularly in mental health settings.• Further exploration across a range of services and countries would be useful in determining whether attitudes towards implementing similar technological change in mental health practice are commonly shared.

The use of electronic monitoring of vital signs is becoming increasingly widespread in general hospital settings in the National Health Service (NHS) in the United Kingdom, and numerous advantages when compared to using paper charts have been shown. However, electronic systems are not yet widely used within mental health inpatient care. We present a pilot implementation of a novel system of electronic vital signs monitoring introduced in two adult mental health inpatient wards, designed to assess feasibility and acceptability to staff and patients. Development and implementation of the new system, adapted from a system designed for use in acute medical nursing, has presented challenges. However, over the course of the 10-month period presented here, nursing compliance, measured by percentage of observations recorded on time, improved by 72.7%. Service users and clinical staff both reported positively to the new system. Efforts to improve monitoring psychiatirc inpatients’ physical health are of increasing importance. Implementing electronic recording of observations is practical, affordable and feasible within the mental health inpatient setting, and offers many potential advantages over the use of paper charts.

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