scholarly journals Audit of the quality and content of discharge summaries from mental health inpatient units across Betsi Cadwaladr University Health Board

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S76-S76
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Laura Williams ◽  
Ediriverere Endurance Aghahowa ◽  
John Clifford
Keyword(s):  
Mental Health ◽  
Health Board ◽  
Care Coordinator ◽  
Male And Female ◽  
North Wales ◽  
Psychiatric Units ◽  
Audit Cycle ◽  
Open Wards ◽  
Inpatient Units ◽  
Discharge Summaries

AimsOur aim was to carry out an audit of summaries sent from inpatient psychiatric units across North Wales (namely Heddfan in Wrexham, Ablett in Rhyl, and Hergest in Bangor), against recommendations from ‘Standards for Inpatient Mental Health Services’ (RCPsych 2014) and PRSB Mental Health Discharge guidelines (2018).MethodAblett summaries are typed onto and electronically sent through the Welsh Clinical Portal (WCP) directly to the GP. Hergest and Heddfan both have their own templates which are then sent to the GP and filed in the case notes. Data were collected from both sources. The first audit cycle used 25 discharges selected at random from the male and female open wards in each site (n = 75 summaries). Data were collected over 3 months time using the audit proforma.ResultAll mandatory headings are automatically inputted into the WCP summary used in Ablett therefore documentation was 100% for information such as patient name, DOB, and GP Details. Documentation of allergies was poor across 3 sites, particularly in Hergest, in which there was no mention of allergy status in 96% of summaries. Only 13% of Ablett summaries and 0% of Hergest summaries reach the GP on the day of discharge, however, 100% of summaries from Heddfan do, possibly due to their method of ‘discharge notification’. The date and location of discharge were documented in 84% of Heddfan summaries, 100% of Hergest summaries, and 100% of Ablett summaries. This implies that this heading is already incorporated into the templates for the 2 sites which scored 100%. In the Ablett, medication was documented in 88%, but we found that in 49% of discharge summaries, the medication was the only field filled in! In these cases, the GP may not even know why the patient had been admitted. This is clearly unacceptable. Risk history is poorly documented across the sites, with 0% in Hergest and Heddfan, and 12% in Ablett. 0% of summaries across the Health Board mentioned crisis contacts. 0% of summaries in Heddfan and Ablett contained details of the patient's care coordinator.ConclusionOur audit has identified a lack of psychiatry-relevant headings in the discharge summaries, particularly for those working in Ablett.

How secure are the secure psychiatric units in New South Wales?

2018 ◽  
Vol 27 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Jonathon Adams ◽  
Stuart Thomas ◽  
Tobias Mackinnon ◽  
Damien Eggleton
Keyword(s):  
Mental Health ◽  
New South ◽  
New South Wales ◽  
Service Development ◽  
Forensic Mental Health ◽  
South Wales ◽  
Psychiatric Units ◽  
Security Levels ◽  
Inpatient Units ◽  
Security Structure

Objectives: To evaluate the therapeutic security characteristics of the secure forensic mental health inpatient units in New South Wales, Australia. Methods: This study evaluated all eight secure inpatient units in New South Wales using a validated tool, the Security Needs Assessment Profile. Results: A pattern of decreasing therapeutic security across the secure units was found, consistent with their intended security levels, from high security through to open security. However, important inconsistencies across and between levels of security were highlighted. Conclusions: This study clarifies the therapeutic security structure of the New South Wales forensic mental health service, which is an essential first step in service development and reform.

scholarly journals Junior doctor daytime bleep audit

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S75-S75
Author(s):  
Asha Dhandapani ◽  
Sathyan Soundararajan ◽  
Rajvinder Sambhi
Keyword(s):  
Mental Health ◽  
General Trend ◽  
Health Department ◽  
The West ◽  
North Wales ◽  
Educational Supervisor ◽  
Mental Health Department ◽  
The Impact ◽  
Mental Health Unit ◽  
Discharge Summaries

AimsThere had been ongoing concerns with regard to covering daytime duty bleeps across the three sites in the Mental health Department, BCUHB, North Wales.Frequent empty on-call slots meant some doctors being asked to hold the bleep between 9-5 in-order to cover the vacancy.Some felt this added to the existing workload and that it was unfair and unsafe.This issue was raised during a supervision session with the Educational supervisor, North Wales and an initial data collection was suggested.MethodData were collected over 2 week period to look at the Daytime bleep duties between 9 am to 5 pmWe hoped the data would demonstrate certain patterns of the task being asked to perform.ResultThe total number of bleeps were noted to be 249Discharge notification and prescription writing was noted to be the commonest reason for bleep in East and Central while Routine review and Discharge notification was the reason to be bleeped major number of times in the WestNearly 70% and 90% of the bleeps were found to be appropriate by the East and West respectively, while only a mere 15% were reported so in Central.While 30% of these bleeps in the West were considered to be deferred, 70% bleeps were deferrable in the East and almost 95% in Central.The general trend in all 3 centres was as follows:All three centres have high numbers of bleeps for discharge, prescribing tasks and routine patient reviewsMost think planned discharge paperwork could be done in advance and jobs can be deferred if there is a ward/team doctor availableConclusionA simple solution could be some jobs being planned ahead (e.g TTO/Discharge Summaries, Re-write charts) and done by the team/ward doctor. ECG could be arranged to be done by nurses/ECG technicians. Some nurses/HCAs are trained in phlebotomy, however, they have not been utilising the skills. That needed to be reinforced in safety huddles meeting.Apart from these suggestions, we were also wondering about the impact of the service models and how the juniors placed in the community mental health unit could stay involved in their team inpatients

scholarly journals Health professionals’ perceptions of how gender sensitive care is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carol O’Dwyer ◽  
Laura Tarzia ◽  
Sabin Fernbacher ◽  
Kelsey Hegarty
Keyword(s):  
Mental Health ◽  
Sexual Violence ◽  
Health Professionals ◽  
Psychiatric Inpatient ◽  
Models Of Care ◽  
Normalisation Process Theory ◽  
Biomedical Model ◽  
Case Study Methodology ◽  
Psychiatric Units ◽  
Inpatient Units

Abstract Background Sexual violence is a global public health issue. It is a form of gender-based violence commonly experienced by women accessing mental health services. The biomedical model has been the dominant model of care in acute psychiatric units, however, there has been a global movement towards more gender-sensitive and trauma-informed models. To date, only a small amount of research has focused on evaluating these models of care and health professionals’ experiences of providing this care. The aim of this study is to gain an in-depth understanding of healthcare professionals’ perceptions of how Gender Sensitive Care (GSC) is enacted across acute psychiatric inpatient units for women who are survivors of sexual violence. Methods This study used case study methodology and the Normalisation Process Theory (NPT) conceptual framework. NPT is a practical framework that can be used to evaluate the implementation of complex models of care in health settings. It included semi-structured interviews with 40 health professionals, document and policy reviews, and observations from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic and content analysis. Results Themes were developed under the four NPT core constructs; 1) Understanding GSC in acute psychiatric units: “Without the corridors there’s not a lot we can do”, 2) Engagement and Commitment to GSC in acute psychiatric units: “There are a few of us who have that gender sensitive lens”, 3) Organising, relating and involvement in GSC: “It’s band aid stuff”, 4) Monitoring and Evaluation of GSC in acute psychiatric units: “We are not perfect, we have to receive that feedback”. Discussion Many health professionals held a simplistic understanding of GSC and avoided the responsibility of implementing it. Additionally, the competing demands of the biomedical model and a lack of appraisal has resulted in an inconsistent enactment of GSC. Conclusions Health professionals in this study enacted GSC to varying levels. Our findings suggest the need to address each NPT construct comprehensively to adequately implement GSC.

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 Applications of artificial intelligence to improve patient flow on mental health inpatient units - Narrative literature review

Heliyon ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. e06626
Author(s):  
Paulina Cecula ◽  
Jiakun Yu ◽  
Fatema Mustansir Dawoodbhoy ◽  
Jack Delaney ◽  
Joseph Tan ◽  
...  
Keyword(s):  
Mental Health ◽  
Artificial Intelligence ◽  
Literature Review ◽  
Patient Flow ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
Inpatient Units ◽  
Improve Patient

scholarly journals The Emergency Assessment and Management of Non-Suicidal Self-Injury in Adolescents

2020 ◽  
Vol 9 (2) ◽  
pp. 92-99
Author(s):  
Sindhu A. Idicula ◽  
Amy Vyas ◽  
Nicole Garber
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Outpatient Clinics ◽  
Psychiatric Diagnoses ◽  
Mental Health Providers ◽  
Health Providers ◽  
Levels Of Care ◽  
Self Injury ◽  
History Of ◽  
Inpatient Units

Background and Goals: Non-suicidal self-injury (NSSI) is a common presenting issue mental health providers experience in all levels of care from outpatient clinics to inpatient units. It is common among adolescents seen in emergency settings, either as a presenting problem or as a covert condition that may not be detected unless specifically assessed for. The presence of NSSI increases the risk of suicide. This article aims to help the clinician develop a better understanding of NSSI – what it may entail, the prevalence, and the motivations for why young people engage in it. Methods: We review the reasons adolescents injure themselves, the link between NSSI and psychiatric diagnoses and suicide, the assessment of NSSI, and treatment planning, with emphasis on ways to screen for NSSI and interventions that can be implemented in the Emergency Department. We illustrate the complexity of NSSI with the case of a young patient with a complex psychiatric history and an extensive history of self-injury. Results and Discussion: Despite the seeming intractability of NSSI, a number of evidencebased treatments exist. Treatment primarily involves specialized forms of psychotherapy, but interventions can be implemented in the ED that will reduce the immediate risk of NSSI while more definitive intervention is awaited. Conclusion: Mental health consultations in the ED should always include screening for NSSI. Mental health professionals in the ED can play an important role in the detection and treatment of this condition..

scholarly journals Prevalence of mental health symptoms among male and female Australian professional footballers

2021 ◽  
Vol 7 (3) ◽  
pp. e001043
Author(s):  
Özgür Kilic ◽  
Sean Carmody ◽  
Judith Upmeijer ◽  
Gino M M J Kerkhoffs ◽  
Rosemary Purcell ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Problem Gambling ◽  
Sleep Disturbance ◽  
Alcohol Misuse ◽  
Control Group ◽  
Psychological Resilience ◽  
Mental Health Symptoms ◽  
Male And Female ◽  
Health Symptoms

ObjectiveDetermining the prevalence of mental health symptoms (MHS) among Australian professional footballers compared with former players. A secondary aim was to assess whether MHS were associated with recent injury and psychological resilience.MethodsThis cross-sectional study included 149 male (mean age: 24 years) and 132 female (mean age: 23 years) Australian A-League and W-League professional footballers (study group) and 81 former male footballers (control group, mean age: 39 years) for analysis. MHS and psychological resilience were assessed through validated questionnaires. Severe injuries were assessed through a single question. The adjusted Wald method was used to assess the primary aim. Logistic regression analyses was used to assess the secondary aim.ResultsThe most prevalent MHS among active footballers and former footballers was sport-related psychological distress (63%) and alcohol misuse (69%), respectively. Global psychological distress, sleep disturbance, alcohol misuse and substance misuse were significantly lower among active male footballers than among former players. Increased psychological resilience among active male footballers was associated with a decrease in symptoms of sport-related and global psychological distress, anxiety and depression of 9%, 14%, 23% and 20%, respectively. Increased psychological resilience among female players was associated with 10% decrease in symptoms of depression. Problem gambling and sleep disturbance was associated with injury in the previous 6 months among active male and female footballers, respectively.ConclusionsMHS are prevalent among active and former professional footballers. Higher level of psychological resilience is associated with decreased reporting of MHS. Severe injury is associated with problem gambling and sleep disturbance.

Transfer Delays in a Special Hospital Population

1995 ◽  
Vol 35 (3) ◽  
pp. 237-244 ◽  
Author(s):  
M Dolan ◽  
G C Shetty
Keyword(s):  
Mental Health ◽  
Transfer Trial ◽  
Home Office ◽  
Maximum Security ◽  
Psychiatric Units ◽  
Hospital Population ◽  
Special Hospital ◽  
Current Standards

Forty-four cases referred for transfer/trial leave from a Special Hospital in the latter part of 1989 were followed up and their progress on 1 January 1992 was examined. Thirty-four were accepted but only 19 moved out to psychiatric units offering treatment under conditions of lesser security. Three of the original 44 patients were discharged by Mental Health Tribunals and one has died. Twenty-three have never left maximum security. Factors largely beyond the control of Special Hospital consultants accounted for most of the delay in the transfer procedure. Fifty-eight per cent of the total time taken for transfer was attributable to delays by regional/district services in the assessment, response and admission of cases. Noticeable delays in receiving Home Office recommendations were also encountered in restricted cases. Suggestions for improving current standards are made.

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