Practice Development Editor: Martin Ward Submissions address: Cawston Manor, Aylsham Road, Cawston, Norwich, NR10 4JD, UK The development of the Suicidal Patient Observation Chart (SPOC): Delphi study A. BJÖRKDAHL 1 rmn p h d , U. NYBERG 2 md p h d , B. RUNESON 3 md p h d & P. OMÉROV 4 rmn 1 Clinical Nurse Specialist, 2 Senior Physician, 3 Professor, and 4 Doctoral Student, Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden Keywords: observation, safety and security, scales and assessment, suicidal behaviour, suicide Correspondence: A. Björkdahl Division of Psychiatry Department of Clinical Neuroscience Karolinska Institutet SLSO, Box 179 14 SE-118 95 Stockholm Sweden E-mail: anna.bjorkdahl@sll.se Accepted for publication: 27 April 2011 doi: 10.1111/j.1365-2850.2011.01758.x Accessible summary • Constant observation is a widely used method to insure the safety of suicidal inpatients. • There is a risk that important observations go unnoticed by the observer or fail to be communicated to the multidisciplinary team. This in turn may involve a risk for the safety and well-being of the patient. • An expert panel of clinicians, service users and researchers reached consensus on 28 observations that was rated the most important to observe. This consensus was used to develop a systematic documen- tation chart. Abstract Constant observation is a method used to insure the safety of suicidal inpatients. It involves structure and control as well as flexibility and the development of a relationship between the observer and the patient. It has been found that important observations may go unno- ticed by the observer or fail to be communicated to the multidisci- plinary team because of a lack of sufficient training and systematic documentation. We therefore conducted a Delphi survey to collect opinions on what would be important to observe during constant observation of suicidal patients. A panel of experienced clinicians, service users and researchers reached consensus on 37 of 40 observa- tion items (92%). Of these, 28 were rated as the most important. As a result, we developed a form for systematic observer documentation in clinical practice, the Suicidal Patient Observation Chart. The Sui- cidal Patient Observation Chart includes the 28 items and covers 24 separate observation periods. Journal of Psychiatric and Mental Health Nursing, 2011, 18, 558–561 558 © 2011 Blackwell Publishing