title: A feasibility study comparing UK older adult mental health inpatient wards which use protected engagement time with other wards which do not: study protocol.
abstract: BACKGROUND
  Protected engagement time (PET) is a concept of managing staff time on mental health inpatient wards with the aim of increasing staff and patient interaction. Despite apparent widespread use of PET, there remains a dearth of evidence as to how it is implemented and whether it carries benefits for staff or patients. This protocol describes a study which is being carried out on mental health wards caring for older adults (aged over 65) in England. The study shares a large proportion of the procedures, measures and study team membership of a recently completed investigation of the impact of PET in adult acute mental health wards. The study aims to identify prevalence and components of PET to construct a model for the intervention, in addition to testing the feasibility of the measures and procedures in preparation for a randomised trial.
  
  
  METHODS
  The study comprises four modules and uses a mixed methods approach. Module 1 involves mapping all inpatient wards in England which provide care for older adults, including those with dementia, ascertaining how many of these provide PET and in what way. Module 2 uses a prospective cohort method to compare five older adult mental health wards that use PET with five that do not across three National Health Service (NHS) Foundation Trust sites. The comparison comprises questionnaires, observation tools and routinely collected clinical service data and combines validated measures with questions developed specifically for the study. Module 3 entails an in-depth case study evaluation of three of the participating PET wards (one from each NHS Trust site) using semi-structured interviews with patients, carers and staff. Module 4 describes the development of a model and fidelity scale for PET using the information derived from the other modules with a working group of patients, carers and staff.
  
  
  CONCLUSIONS
  This is a feasibility study to test the application of the measures and methods in inpatient wards for older adults and develop a draft model for the intervention. The next stage will prospectively involve testing of the model and fidelity scale in randomised conditions to provide evidence for the effectiveness of PET as an intervention.
  
  
  BACKGROUND
  ISRCTN31919196.
authors.affiliation: Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, WC1E 7HB UK.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Nolan
authors.affiliation: Department of Clinical Psychology, Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Earlham Road, Norwich, NR4 7TJ UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Fox
authors.affiliation: Health and Social Sciences, University of the West of England, Glenside Campus, Bristol, BS16 1DD UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Cheston
authors.affiliation: Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Earlham Road, Norwich, NR4 7TJ UK.
authors.forename: David
authors.initials: D
authors.lastname: Turner
authors.affiliation: Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Earlham Road, Norwich, NR4 7TJ UK.
authors.forename: Allan
authors.initials: A
authors.lastname: Clark
authors.affiliation: University of the West of England, Room 2G05, Glenside Campus, Blackberry Hill, Bristol, BS16 1DD UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Dodd
authors.affiliation: Camden and Islington NHS Foundation Trust, 1st Floor East Wing, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK.
authors.forename: Mary-Ellen
authors.initials: ME
authors.lastname: Khoo
authors.affiliation: Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
authors.forename: Richard
authors.initials: R
authors.lastname: Gray
keywords: Mental health inpatient wards; Older adult; Protected engagement time; Therapeutic engagement; Ward activity