Quality statement 4: Monitoring

Quality statement

People who have self‑harmed receive the monitoring they need while in the healthcare setting, in order to reduce the risk of further self‑harm.

Rationale

Monitoring people who have self‑harmed when they are in a healthcare setting can reduce distress, ensure that the person feels supported and help reduce the risk of further self‑harm while in the healthcare setting.

Quality measure

Structure: Evidence of local arrangements to ensure that people who have self‑harmed receive the monitoring they need while in the healthcare setting, in order to reduce the risk of further self‑harm while in the healthcare setting.

Process: Proportion of people who have self‑harmed who have a record of monitoring arrangements while in the healthcare setting, in order to reduce the risk of further self‑harm.

Numerator – the number of people in the denominator with a record of monitoring arrangements while in the healthcare setting, in order to reduce the risk of further self‑harm.

Denominator – the number of people with a new episode of self‑harm.

Outcome: Number of episodes of self‑harm occurring in healthcare settings.

What the quality statement means for each audience

Service providers ensure that staff carry out monitoring in the healthcare setting according to the needs of people who have self‑harmed, in order to reduce the risk of further self‑harm.

Healthcare professionals ensure that people who have self‑harmed receive the monitoring they need while in the healthcare setting, in order to reduce the risk of further self‑harm.

Commissioners ensure that they commission services that monitor people who have self‑harmed according to their needs while in the healthcare setting, in order to reduce the risk of further self‑harm.

People who have self‑harmed are checked regularly by healthcare staff, and are accompanied when required, when they are in hospital or another part of the health service, to make sure they are safe.  

Source guidance

NICE clinical guideline 16 recommendation 1.4.2.3 (key priority for implementation).

Data source

Structure: Local data collection. NHS Litigation Authority risk management standards assess the process for managing the risks associated with the observation and engagement of patients.

Process: Local data collection.

Outcome: Local data collection. The National Reporting and Learning System contains national and local figures on patient safety incidents including self‑harm.

Definitions

People who have self‑harmed

Children or young people (aged 8 years and older) and adults who have carried out an act of self‑poisoning or self‑injury, irrespective of motivation.

Monitoring

Includes observation and accompaniment of people who have self‑harmed, either by healthcare professionals or by their families or carers with support from healthcare professionals.

Monitoring applies to people being treated in primary care, ambulance services, emergency departments and inpatient settings.

Equality and diversity considerations

NICE clinical guideline 16 recommendation 1.9.1.1 states that children and young people under 16 years who have self‑harmed should be assessed and treated by appropriately trained children's nurses and doctors in a separate children's area of the emergency department.