Skip to main content
×
×
Home

How safe are patient interview rooms?

  • Helen L. Campbell (a1) and Nicole K. Fung (a2)
Abstract
Aims and Method

A cross-sectional survey was conducted to investigate the safety of rooms used by medical staff to interview patients in out-patient and in-patient settings of a mental health trust. An assessment tool was designed, and examined the features of an interview room that were likely to promote safety.

Results

The survey included 112 rooms and demonstrated shortcomings that compromised interview room safety. Rooms were frequently overcrowded with furniture (n=30), cluttered with loose objects (n=101, 90%) and used for multiple purposes (n=82, 73%). Room layout often compromised either access to alarm systems (n=51, 46%) or exit from rooms (n=99, 88%). Necessary facilities for summoning assistance were found to be lacking.

Clinical Implications

The safety of interview rooms has not been emphasised sufficiently within everyday working practice and should be revisited.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      How safe are patient interview rooms?
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      How safe are patient interview rooms?
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      How safe are patient interview rooms?
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
Hide All
Davies, W. (1989) The prevention of assault on professional helpers. In Clinical Approaches to Violence (eds Howells, K. & Hollin, C. R.) pp. 311328. John Wiley.
Department of Health (1998) Working Together: Securing a Quality Workforce for the NHS. Department of Health.
Department of Health (1999a) 1998/1999 Survey of Violence, Accidents and Harassment in the NHS. Department of Health.
Department of Health (1999b) Campaign to Stop Violence Against Staff Working in the NHS: NHS Zero Tolerance Zone. Department of Health.
Department of Health (2001a) 2000/2001 Survey of Violence, Accidents and Harassment in the NHS. Department of Health.
Department of Health (2001b) National Task Force on Violence and Aggression Against Social Care Staff: Report and National Action Plan. Department of Health.
Department of Health (2002) Mental Health Policy Implementation Guide: National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units (PICU) and Low Secure Environments. Department of Health.
Department of Health (2003) 2002/2003 Survey of Violence, Accidents and Harassment in the NHS. Department of Health.
Department of Health (2004) Mental Health Policy Implementation Guide: Developing Positive Practice to Support the Safe and Therapeutic Management of Aggression and Violence in Mental Health In-Patient Settings. Department of Health.
National Audit Office (1996) Health and Safety in NHS Acute Hospital Trusts in England. TSO (The Stationery Office).
National Audit Office (2003) A Safer Place to Work: Protecting NHS Hospital and Ambulance Staff from Violence and Aggression. TSO (The Stationery Office).
National Institute for Clinical Excellence (2005) Violence – The Short-term Management of Disturbed/Violent Behaviour in In-patient Psychiatric Settings and Emergency Departments. NICE.
Osborn, D. P. J. & Tang, S. (2001) Effectiveness of audit in improving interview room safety. Psychiatric Bulletin, 25, 9294.
Royal College of Psychiatrists (1998) Management of Imminent Violence: Clinical Practice Guidelines to Support Mental Health Services. (Occasional Paper OP41). Royal College of Psychiatrists.
Royal College of Psychiatrists (1999) Safety for Trainees in Psychiatry. Report of the Collegiate Trainees' Committee Working Party on the Safety of Trainees (Council Report CR78). Royal College of Psychiatrists.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 2
Total number of PDF views: 18 *
Loading metrics...

Abstract views

Total abstract views: 82 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 16th August 2018. This data will be updated every 24 hours.

How safe are patient interview rooms?

  • Helen L. Campbell (a1) and Nicole K. Fung (a2)
Submit a response

eLetters

Are we safe?

Julian Bustin, Specialist Registrar in Old Age Psychiatry
16 February 2007

Campbell and Fung (Psychiatric Bulletin, January 2007, 31: 10-13) raise concerns about the safety of interview rooms and the lack of emphasis that is placed on this aspect of clinical practice. They highlight problems such as overcrowding with furniture, the presence of loose objects, the use of rooms for multiple purposes and inaccessibility to alarms and exits. Similar concerns were first raised five years ago in your journal by Osborn and Tang (Psychiatric Bulletin, March 2001, 25:92-94)

In January 2006, we undertook an audit to look at the safety of roomsused by doctors for interviewing adult patients in South Liverpool. This included rooms in inpatient units, outpatient clinics and day hospitals. We used the twelve standards as devised by Osborn and Tang.(Psychiatric Bulletin, March 2001, 25:92-94) These standards were based on the recommendations made by Davies in 1989 and The Royal College of Psychiatrist in 1998. Rooms were identified by asking the nurse in charge or receptionist which rooms were used by doctors to interview patients. Nurses and receptionist were blinded to the objectives of the audit.

We looked at all 67 rooms used by psychiatrists and trainees in SouthLiverpool. Of these, 3 rooms (4%) fulfilled all 12 standards; 55 (81%) rooms had an alarm, but only 29 (43%) rooms had an alarm which could be accessed in an emergency; 19 (29%) rooms were isolated and 35 (53%) did not have a viewing window; 39 (59%) of rooms did not have a clear exit; 56(84%) of rooms had at least one object which could be used as a weapon. Wealso found that many interview rooms had multiple purposes and that inappropriate rooms, such as clinic rooms, were being used in some units. 2 units did not have any designated interview rooms.

Our findings led us to a similar conclusion to that of previous authors. Little emphasis is placed on safety of interview rooms in everyday practice. At present, we are not interviewing in safe conditions.The evidence for this has been accumulating during the last five years andurgent measures are needed to address it.

Bibliography:

Campbell, HL and Fung, NK (2007). How safe are patients interview rooms? Psychiatric Bulletin, 31: 10-13)

Davies,W. (1989) The prevention of assault on professional helpers. In Clinical Approaches to Violence (eds K. Howells & C. R. Hollin) Chichester: John Wiley & Sons.

Osborn, D.P.J. and Tang, S. (2001) Effectiveness of audit in improving interview room safety. .Psychiatric Bulletin, 25: 92-95

ROYAL COLLEGE OF PSYCHIATRISTS (1998) Management of Imminent Violence: Clinical Practice Guidelines to Support Mental Health Services. Occasional Paper OP41. London: Royal College of Psychiatrists.
... More

Conflict of interest: None Declared

Write a reply

SAFETY AT WORKPLACE

Ovais Wadoo, SHO
16 February 2007

Violence in the workplace is of increasing concern to junior doctors in general and trainee psychiatrist in particular(1).Research also suggests that staff safety in interview rooms in all mental healthcare settings remains inadequate in many situations(2).Although the college hastried to address issues around trainees safety and has issued a number of clear recommendations regarding safety training, induction courses, local policy and procedures and safety standards for interview rooms(3), this study (4) has revealed that the issue of interview room safety in everydaypractice still remains a concern. As trainees, we share the concern and feel vulnerable. It draws our attention to safety awareness and safety at workplace, particularly at a time of major reforms in the postgraduate medical training in UK. It is the time when the Royal College of Psychiatrists, PMETB need to do more to put strategies in place which would promote safety in the workplace so that training takes place in safeenvironment.

References

(1)Bhugra, D., Smith, J. & Junaid,O.(1990) Doctors’safety:Who cares? BMJ, 301, 43.

(2) Sipos, A., Balmer, R. & Tattan, T. (2003) Better safe than sorry: a survey of safety awareness and safety provisions in the workplaceamong specialist registrars in the South West. Psychiatric Bulletin, 27, 354–357

(3) Cormac, I., Crean, J. & Motreja, S. (1999) Report of the CTC Working Party on the Safety ofTrainees. London: Royal College of Psychiatrists.

(4) Campbell and Fung Psychiatric Bulletin (2007) 31: 10-13
... More

Conflict of interest: None Declared

Write a reply

Safety of psychiatry professionals should not be compromised

Reji Jayan, Senior House Officer
16 February 2007

Dear Editor,This study has been an excellent overview of the current situation affecting psychiatry professionals and their safety issues. It should be acknowledged that most psychiatric hospitals have well maintained interview rooms. However this is not the case when a psychiatry doctor or the crisis team assess patients in the emergency medical unit (EMU), wherethey are often called. Most of the time they are asked to assess patients in an available room without the help of a staff nurse and no proper system to monitor the interview. Such rooms in EMU do not have an alarm system and no closed circuit television monitoring. This definitely compromises the safety of the professionals involved.The 4 hour waiting rules in accident and emergency (A&E)have created a situation where patients coming with overdose and alcoholic intoxication are referred to psychiatry oncalls within a short span of time, necessitating their assessment as soon as possible in a less than ideal setup. I think it is high time that we demand such facilities before we could interview patients in accident and emergency and medical units. ... More

Conflict of interest: None Declared

Write a reply

Response letter on How safe are patient interview rooms?Psychiatr Bull 2007; 31: 10-13

Raafat S Labib Mishriky, SHO in Psychiatry
16 January 2007

Reply letterHow safe are patient interview rooms?Psychiatr Bull 2007; 31: 10-13

Sir

It was suggested in the cross sectional survey that more than a quarter of the rooms (27%) were being used for multiple purposes, including art therapy, group activities and multidisciplinary team meetings. I agree with the authors that rooms which are originally used for purposes other than an interview should not be used as interview rooms. But this does not mean that interview rooms should not be used for other purposes if there are shortages in the number of rooms. Having a group meeting at a different time in the interview room may not necessarily affect the safety measures in these rooms.It was also mentioned that the median number of furniture were 7 and 9 foroutpatients and inpatients respectively. This reflected a statistical significant of P < 0.005. In addition Davies W (1989) proposed a suitable layout for furniture to maximize safety. It is still unclear whether the more the number of furniture in itself can have a direct effect on the safety. I wonder if the median number of furniture has a relevant clinical significance in relation to violence. Finaly although itwill be ideal to have a proper phone in the room for several reasons, there may not be time in some situations to make a phone call at all. Thisis especially if the patient attacked the interviewer suddenly. In this situation other measures can be taken.

Name and Address:

Raafat Labib Mishriky

SHO, General Adult Psychiatry

Combined North Staffordshire NHS Trust

Lymbrook Mental Health center

Bradwell Hospital site

Talke Road

NewCastle-under-Lyme

ST5 7TLPhone: 07725127013Email: raafatmishriky@hotmail.com
... More

Conflict of interest: None Declared

Write a reply

Compromised safety of patient interview rooms

Joji George, Queen Elizabeth Psychiatric Hospital Birmingham
08 January 2007

It was such a coincidence to read the cross-sectional survey: “How Safe are patient interview rooms?� by Helen Campbell and Nicole Fung (Psychiatric Bulletin January 2007, 31, 10-13) the day after my colleague was assaulted in an inpatient ward. There is increasing incidence in violence and aggression against NHS Staff and this is three times more common in mental health and community trusts. Even though the Department of health had set targets to reduce the incidence of violence it is clearly evident that it is on the increase.

It was not surprising to know that more than a quarter of the rooms were used for multiple purposes but was astonishing to know that none of the inpatient rooms had fixed alarms. This survey throws light onto the simple measures which are overlooked. These include avoiding clutter and loose furniture, provisions of alarms and telephones, and modification of room characteristics.

Even though there are many strategies to promote the safety at workplace, I agree with the authors that interview room safety is one of the simplest ways to achieve safety in workplace. Other measure like risk assessments, personal safety training and provisions of safety alarms should be considered. Annual updating of the personnel safety training is one of the mandatory training and should be incorporated in the annual appraisal of all the clinical staffs. This survey also highlights the various factors which could be addressed by the service managers to improve safety at work.

DEPARTMENT OF HEALTH (2003) 2002/2003 Survey of Violence, Accidents and Harassment in the NHS. Department of Health.

NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (2005) Violence – The Short-term Management of Disturbed/Violent Behavior in In-patient Psychiatric Settings and Emergency Departments. NICE.

DEPARTMENT OF HEALTH (2002) Mental Health Policy Implementation Guide: National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units (PICU) and Low Secure Environments. Department of Health.
... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *