HCAs undertaking special observation of patients with neurological conditions

Abstract

This paper reports on a study carried out at an acute neurosciences hospital trust. The aim was to evaluate the effectiveness of a training programme for healthcare assistants undertaking special observation of patients. Some patients being cared for at the hospital have neurological complaints that are accompanied by confusion and agitation and require close observation in order to preserve their own and other's safety. The literature review revealed an abundance of literature related to special observation in mental health care. However, there is very little research related to the care of patients with neurological conditions. Some 20 experienced, female healthcare assistants (HCAs) took part in a training programme on special observation of patients. Attitudes to undertaking special observation at the start of the study were negative. The training programme included topics such as communication, management of extreme agitation, de-escalation strategies and diversional activities. Participants' confidence levels concerning assessment for suitable activities, using distraction techniques, de-escalation and restraint methods, increased on completion of the programme. It is concluded that caring for confused patients in acute hospital settings may sometimes be a passive, non-therapeutic type activity. Increasing the range of patient activities available and encouraging meaningful interactions with carers and patients will improve the caring experience for all concerned.