Does the Nursing Care Plan help in the management of psychiatric risk?
The Nursing Care Plan (NCP) is routinely used to direct the nursing care of psychiatric in-patients, but the impact of NCPs on patient care and clinical outcome is not firmly established. NCPs from 246 patients, chosen at random from admissions to acute psychiatric wards, were analysed. The NCPs were scored for quality and also specifically for the presence of recorded risk assessment and appropriate level of nursing supervision. NCPs were evaluated in relation to psychiatric risk factors present prior to admission, and in relation to risk behaviour during hospitalization. Quality of NCP records was generally poor, with scores in all areas assessed being approximately half of the possible maximum. Patients with a perceived high risk of suicide prior to admission had significantly better NCP quality than other patients, but about a third of these high risk patients had no recorded risk assessment or supervision level in the nursing notes. Patients who had actually self-harmed within 4 w
