A mixed‐methods survey to explore views of staff and patients from mental health wards prior to introduction of a digital early warning system for physical deterioration

Abstract

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.

Mental health consumers' perspectives of physical health interventions: An integrative review

“…Interventions include: (i) a physical deterioration screening tool (Brimblecombe et al . 2019), (ii) healthy lifestyle programs categorized as lifestyle interventions (Park et al . 2017; Rönngren et al .…”

“…The amended project plan included educating staff members on the importance of providing results of the physical observations and leaflets for consumers explaining the eNEWS system, particularly issues around confidentiality (Brimblecombe et al . 2019).…”

“…These studies provided consumers with the opportunity to evaluate the impact of these interventions and inform future direction. For instance, consumer feedback regarding the novel implementation of an electronic National Early Warning Score (eNEWS) system in six mental health inpatient wards, designed to promptly detect and respond to physical deterioration, led to an amendment of the project plan (Brimblecombe et al 2019). The amended project plan included educating staff members on the importance of providing results of the physical observations and leaflets for consumers explaining the eNEWS system, particularly issues around confidentiality (Brimblecombe et al 2019).…”

“…The present review identified 19 studies exploring consumer experiences with a physical health intervention. Interventions include: (i) a physical deterioration screening tool (Brimblecombe et al 2019), (ii) healthy lifestyle programs categorized as lifestyle interventions (Park et al 2017;R€ onngren et al 2014;Wardig et al 2015;Watkins et al 2020), weight loss management (Vazin et al 2016), education (Roberts & Bailey 2013), physical activity (Crone 2007;Fogarty & Happell 2005;Kern et al 2020;Matthews et al 2021;Pickard et al 2017;Stanton et al 2016), nutrition (Henning Cruickshank et al 2020, smoking cessation programs (Edmunds 2018), and (iii) discipline-specific interventions led by mental health nurses (Furness et al 2020;Hassan et al 2020aHassan et al , 2020bR€ onngren et al 2018) and a physiotherapist (Hemmings & Soundy 2020). These studies provided consumers with the opportunity to evaluate the impact of these interventions and inform future direction.…”

Actor‐network theory for Psychiatric and Mental Health Nursing

“…Mental Health Nursing is a profession that has long had to figure out, and integrate, non‐human entities such as technologies, guidelines and standards into its practice (Brimblecome et al, 2019; Jones, 2004). Some researchers look upon the involvement of non‐human entities in mental health care positively, as a necessary (or at least, a necessary evil) tool to diagnose, regulate or alleviate acute or chronic mental health issues (Khullar, 2023).…”