scholarly journals A qualitative exploration of the barriers to and facilitators of clozapine monitoring in a secure psychiatric setting

2020 ◽  
pp. 1-7
Author(s):  
Sarah Blagden ◽  
Jane Beenstock ◽  
Natalie Auld ◽  
Steve Noblett ◽  
Mark Limmer
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Clinical Implications ◽  
Health Unit ◽  
Structured Interviews ◽  
Staff Members ◽  
Psychiatric Setting ◽  
Important Barrier ◽  
Qualitative Exploration ◽  
Mental Health Unit

Aims and method To explore the beliefs and understanding of staff and patients at a secure mental health unit regarding clozapine monitoring, and to identify barriers to and facilitators of monitoring. Qualitative semi-structured interviews and focus groups were conducted with 17 staff members and six patients. Results Six key themes were identified. The key facilitator of effective monitoring was the motivation of staff to help patients to become independent and facilitate recovery. An important barrier was a lack of clarity around the roles of different staff groups in monitoring. Staff and patients widely supported the establishment of an in-patient clozapine clinic and perceived that it would prepare patients for discharge. Clinical implications An in-patient clozapine clinic is a robust mechanism for clozapine monitoring in secure settings. The barriers and facilitators identified here could be applied to other secure units to guide their systems of clozapine monitoring.

scholarly journals Improving prescription quality in an in-patient mental health unit: three cycles of clinical audit

2007 ◽  
Vol 31 (8) ◽  
pp. 293-294 ◽  
Author(s):  
Priti Ved ◽  
Tim Coupe
Keyword(s):  
Mental Health ◽  
Medical Staff ◽  
Clinical Audit ◽  
Clinical Implications ◽  
Health Unit ◽  
Patient Age ◽  
Patient Âgé ◽  
Mental Health Unit

Aims and MethodWe undertook three cycles of clinical audit of prescription charts to improve the quality of the prescriptions written in an in-patient unit. Pharmacy and medical staff reviewed a total of 1466 prescriptions on 242 prescription charts against local guidelines and provided feedback to medical staff. The pharmacist also regularly reviewed prescription charts on the wards between audits.ResultsAfter three cycles of audit, 99.5% of prescriptions written were legible. The recording of drug allergies, section 58 status and patient age remained poor.Clinical ImplicationsA combination of clinical audit and continual pharmacist review of prescription charts can improve the quality of prescriptions written by medical staff in an in-patient unit.

scholarly journals Attitudes of mental health practitioners to the Hippocratic Oath: tradition and modernity in psychiatry

2006 ◽  
Vol 30 (9) ◽  
pp. 327-329
Author(s):  
Marek Marzanski ◽  
Tim Coupe ◽  
Padmapriya Musunuri
Keyword(s):  
Mental Health ◽  
Medical Staff ◽  
Hippocratic Oath ◽  
Postal Questionnaire ◽  
Mental Health Practitioners ◽  
Clinical Implications ◽  
Health Unit ◽  
Health Practitioners ◽  
Mental Health Unit ◽  
Ethical Basis

Aims and MethodTo establish whether psychiatrists believe that medicine should be practised according to the principles of the Hippocratic Oath, an anonymised postal questionnaire survey was conducted of all medical staff at the Caludon Centre, an 80-bed in-patient mental health unit in Coventry.ResultsThirty-three respondents (82.5%) believed that medicine should be practised according to the Oath. Support for the 15 separate statements derived from the Oath varied considerably.Clinical ImplicationsThe principles of the Oath remain an important guide to the ethical basis of medical practice for most medical staff surveyed.

scholarly journals The PARALLEL Study (imPAct of expeRiencing Another’s seLf harm and suicidaL bEhaviour in hospitaL)

2017 ◽  
Vol 19 (4) ◽  
pp. 258-268
Author(s):  
Rebecca Hargate ◽  
Sharon Howden ◽  
Emma Tarpey ◽  
Tammi Walker
Keyword(s):  
Mental Health ◽  
Suicidal Behaviour ◽  
Interpretative Phenomenological Analysis ◽  
Health Unit ◽  
Structured Interviews ◽  
Content Type ◽  
The North ◽  
Self Harm ◽  
The Impact ◽  
Mental Health Unit

Purpose The purpose of this paper is to explore the experiences of both staff and patients in a medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm is highly prevalent in forensic settings and evidence suggests that experiencing other people’s self-harm and suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in hospitals where patients are highly dependent on staff for support. Design/methodology/approach Semi-structured interviews were conducted with five staff members and six patients in a medium-secure male mental health unit in the North of England. Data were analysed following interpretative phenomenological analysis guidelines. Findings Three dominant themes were identified during analysis: the impact of suicide and self-harm; the role of others; and the importance of understanding and experience. Various impacts were discussed including desensitization, negative emotions and the desire to help. Other people played an important role in protecting against negative impacts, with shared experiences and peer support reported as the biggest benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more positive attitudes. Additionally, the importance of training and education was highlighted. Originality/value This paper provides an insight into the experiences of staff and patients in medium-secure male mental health unit, which has benefits to practitioners when considering support mechanisms.

scholarly journals The unheard voice: a qualitative exploration of companions' experiences of liaison psychiatry and mental health crises in the emergency department

2019 ◽  
Vol 43 (5) ◽  
pp. 204-209
Author(s):  
Jennifer Collom ◽  
Emma Patterson ◽  
Geoff Lawrence-Smith ◽  
Derek K. Tracy
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Clinical Practice ◽  
Current Understanding ◽  
Clinical Implications ◽  
Structured Interviews ◽  
Liaison Psychiatry ◽  
Purposive Sampling ◽  
London Hospital ◽  
Qualitative Exploration

Aims and methodTo understand the experience of companions of patients seen in the emergency department by liaison psychiatry teams. Participants were recruited via purposive sampling following a recent visit to the emergency department of an inner- or outer-London hospital. Semi-structured interviews were administered to all participants.ResultsTwo major themes were generated. The first concerned the appropriateness of the clinical space, in which ‘noise’, ‘privacy’ and the ‘waiting area’ were subthemes. The second was communication with staff, including subthemes of ‘wanting more information’ and a ‘desire to be more involved’.Clinical implicationsLiaison psychiatry services should consider appropriateness of the clinical space, promoting improved communication between staff and patients' companions, and a review of the information provided to companions in the emergency department. This research offers a novel perspective on liaison psychiatry and will enhance current understanding and clinical practice.

scholarly journals Adherence to Public Health England (PHE) guidance for the use of personal protective equipment (PPE) in north Wales mental health unit- a regional audit

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S318-S318
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Alberto Salmoiraghi ◽  
Shona Ginty ◽  
Tajnin Mitu ◽  
...  
Keyword(s):  
Mental Health ◽  
Infection Prevention ◽  
Health And Safety ◽  
Health Unit ◽  
Staff Members ◽  
Global Pandemic ◽  
North Wales ◽  
Novel Coronavirus ◽  
Mental Health Unit ◽  
Inpatient Units

AimsTo ensure that the PPE guidance is strictly adhered to.To ensure that patient care is not compromised.To help us in areas of need in order to educate the staff regarding the techniques of PPE and thus ensure patient and staff safety and care during the pandemic.MethodNovel coronavirus 2019 was first described in December 2019 in Wuhan in China. Since those initial few cases, it has rapidly proliferated to a global pandemic, putting an inordinate amount of strain on healthcare systems around the world. We believe that the technique of donning and doffing if followed as per PHE guidelines would be of help in both preventing the infection and improve the care and safety of both patients and staff.This Audit includes both In-patient and Out-patient units in Psychiatric services across North Wales. Data were collected from 19 units out of 39. We observed covertly 325 staff members belonging to various cadres. Apart from the Donning and Doffing techniques, we also observed the availability of designated areas for this purpose and the availability of PPE as well.Data collection was by junior and senior doctors from various sites of the mental health unit in North Wales. A proforma was provided, the standards were based on PHE guidelines.ResultIt was noted that just about 50% of the staff followed donning as per guidance. Amongst all three sites, the Central team showed a better adherence with 85% of them donning PPE correctly. whereas only 22% adhered to donning in the West team.Only 21% of them managed to doff PPE as per guidance amongst all 3 centres in North Wales.It was also noted that there are no designated areas to Don and Doff in outpatient units. Staff, in general, seem to not adhere to the guidance of utilising a mask, especially when within 2 meters distance of other staff.ConclusionWe will be presenting the Audit at the regional meeting. After discussion with the infection prevention control team and Health and safety lead, we intend to improvise the wards with designated areas for donning and doffing. Teaching sessions for the staff in all three sites, reminders in various areas of the community mental health units and inpatient units.We are hoping that these recommendations will help us in achieving our aim of health and safety during this pandemic.

scholarly journals Effectiveness of audit in improving interview room safety

2001 ◽  
Vol 25 (3) ◽  
pp. 92-94 ◽  
Author(s):  
David P. J. Osborn ◽  
Sylvia Tang
Keyword(s):  
Mental Health ◽  
Clinical Implications ◽  
Health Unit ◽  
Audit Process ◽  
Clinical Interviews ◽  
Safety Standards ◽  
Pilot Survey ◽  
Audit Cycle ◽  
Safety Features ◽  
Mental Health Unit

Aims and MethodsSafety features of rooms used for clinical interviews were assessed throughout our mental health unit. Following this pilot survey, 12 safety standards were agreed and adopted by a multi-disciplinary audit meeting. Recommendations were disseminated throughout the trust. Adherence to the accepted standards for interview room safety was assessed at 6 months and 1 year after baseline. Following each assessment, results were presented so that the audit cycle was completed twice.ResultsAt 6 months 46 interview rooms were assessed against the 12 accepted standards and many were found to be unsatisfactory. After presentation of these results, the 1 year assessment discovered few changes in safety features of the 50 rooms now being used.Clinical ImplicationsUnsafe rooms compromise the safety of staff and patients and this is clearly unacceptable. The audit process in itself failed as amethod of improving standards.

scholarly journals Audit of disposal of clinically confidential information

2004 ◽  
Vol 28 (9) ◽  
pp. 324-325 ◽  
Author(s):  
Craige Dietrich ◽  
Zahir Khan ◽  
James Warner
Keyword(s):  
Mental Health ◽  
Patient Care ◽  
Clinical Implications ◽  
Sensitive Information ◽  
Health Unit ◽  
Confidential Information ◽  
Safe Disposal ◽  
Highly Sensitive ◽  
Mental Health Unit

Aims and MethodWe conducted a 3-cycle audit of disposal of clinically sensitive information in a mental health unit, in order to identify and reduce potential breaches in patients' confidentiality. Material from waste bins in administrative areas of a mental health unit was examined every evening during each period of the audit.ResultsThe first search, conducted over a 3-week period, yielded 11 documents containing highly-sensitive information about patients. After feedback to staff and improvement of shredding facilities, no sensitive information was found during the follow-up 3-week survey, 3 months later. However, a third survey 2 years later found 24 highly-sensitive items after one week, despite shredding facilities being maintained.Clinical ImplicationsChanges in behaviour identified in this audit appear to be due to education rather than improved facilities. All staff involved in patient care need to maintain awareness of the need for safe disposal of confidential material.

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