%0 Journal Article
%T ¡®Nurse specialling¡¯: Direct nursing observation in the emergency department compared to other wards of an urban teaching hospital in Sydney
%A Bethany White
%A Maryssa Portelli
%A Nicholas Glozier
%A Paul S Haber
%A Timothy Wand
%J Australasian Psychiatry
%@ 1440-1665
%D 2018
%R 10.1177/1039856215626645
%X This study examined the patterns of direct observation of patients by nursing staff (¡®nurse specials¡¯) and compared those required for mental health/drug health (MH/DH)-related presentations to other patient groups in different care settings. A retrospective review of nurse special shifts requested during the 2014 calendar year at an urban teaching hospital. Hospital-wide 14,021 8-hour nursing shifts were ordered for special observation of patients, an average of 39 per day. Of these, 30% were requested for MH/DH-related presentations, with the majority (70%) required for medically unstable patients. However, of the 1917 shifts required in the emergency department, 1841 (96%) were for MH/DH presentations compared to 76 (4%) for patients with unrelated medical conditions (odds ratio 98.2; 95% confidence interval 77.71¨C124.06, P<0.0001). In contrast to the rest of the hospital, emergency department-based nurse special requests were significantly more likely to be for MH/DH presentations. This figure represents a considerable staff and financial burden and may be reduced by diversion or more rapid transfer of such presentations to an appropriate inpatient ward
%K nurse special
%K direct observation
%K emergency department
%K mental health
%K drug health
%K comorbidity
%K medical instability
%U https://journals.sagepub.com/doi/full/10.1177/1039856215626645