Are nurses empowered to make decisions about levels of patient observation in mental health?

The Clinical Resource and Audit Group (2002) guidelines emphasise that local policies should make the procedure for deciding and maintaining patient observation levels clear.To investigate the views of nurses, doctors and other members of the multidisciplinary team on patient observation.A postal survey of all acute adultinpatient facilities and intensive patient care units in Scotland was carried out, followed by 38 interviews, 37 with staff members and one with a service user.We found a lack of multidisciplinary team involvement, limited pre agreed plans for nurses to reduce levels of observation and limited use of validated risk assessment tools.There is a need to ensure that local practice follows national policy recommendations more closely.