scholarly journals Locked ward patients 25 years on

1998 ◽  
Vol 22 (10) ◽  
pp. 608-609
Author(s):  
Martin Feakins
Keyword(s):  
Cross Section ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
The Past ◽  
The Future

Aims and methodA retrospective case note study of 43 patients who were residents of a locked ward in 1970, augmented by a cross-section of the ward's current residents was undertaken.ResultsThe study established a profile of the 43 patients in 1970 and determined their outcomes. A brief comparison of the use of medication then and now was also undertaken.Clinical implicationsThis view of the past aimed to provide a prospective on why and how the field has changed, and to facilitate planning for the future.

Fathers’ Experience After the Death of Their Child (Aged 1–17 Years)

2016 ◽  
Vol 73 (4) ◽  
pp. 308-325 ◽  
Author(s):  
Marie-Claude Proulx ◽  
Anne-Marie Martinez ◽  
Franco Carnevale ◽  
Alain Legault
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Everyday Life ◽  
Phenomenological Study ◽  
Clinical Implications ◽  
Pediatric Hospital ◽  
Eastern Canada ◽  
The Past ◽  
The Future ◽  
Push Forward

The death of a child is traumatic for parents. The grief of bereaved fathers is inadequately understood since most studies on this subject have focused primarily on mothers. The goal of this phenomenological study was to understand fathers’ experiences following the death of their child. Interviews were conducted with 13 fathers whose child (aged 1–17 years) had died at least 1 and up to 6 years earlier, either from a life-limiting illness or unexpectedly in an intensive care unit in a pediatric hospital in Eastern Canada. The analysis indicates that fathers’ experience deep suffering after the death of their child and feel torn between the past and the future. Three major themes were identified: needing to push forward in order to avoid breakdown, keeping the child present in everyday life, and finding meaning in their experience of grief. Clinical implications for professionals working with this population are discussed.

scholarly journals Physical health of patients in rehabilitation and recovery: a survey of case note records

2005 ◽  
Vol 29 (6) ◽  
pp. 210-212 ◽  
Author(s):  
Jayne Greening
Keyword(s):  
Blood Pressure ◽  
Physical Health ◽  
Clinical Excellence ◽  
Case Note ◽  
Clinical Implications ◽  
Endocrine Disorders ◽  
Further Training ◽  
Health Indices ◽  
The Past ◽  
Erythrocyte Sedimentation

Aims and MethodThe aim of this survey was to determine details recorded about the physical health of patients in rehabilitation and recovery. All medical and nursing notes from January 1998 to March 2003 were reviewed. Case notes from 63 patients were studied.ResultsThere was mention in less than 13 of the patients' notes (18%) of smoking, diet, exercise or prolactin levels; weight, blood pressure, electrocardiogram, erythrocyte sedimentation rate or lipids were mentioned in less than 20 (30%). A blood sugar test was performed in only 16 patients (25%) in the past year and 38 patients (59%) had a record of a test in the past 5 years. These results suggest that there is inadequate recording of the physical health parameters in patients in rehabilitation and recovery.Clinical ImplicationsThe physical healthcare of patients with schizophrenia is prioritised in the National Institute for Clinical Excellence (NICE) clinical guidelines, which specifically mention the monitoring of endocrine disorders such as diabetes and hyperprolactinaemia, cardiovascular risk factors, such as blood pressure and lipids, and lifestyle factors such as smoking. Routine recording of physical health indices should be mandatory and staff may need further training to enable them to do this.

scholarly journals High dose neuroleptics – who gives them and why?

2001 ◽  
Vol 25 (5) ◽  
pp. 179-183 ◽  
Author(s):  
Alcuin Wilkie ◽  
Neil Preston ◽  
Roger Wesby
Keyword(s):  
Case Note ◽  
Clinical Implications ◽  
High Dose ◽  
Retrospective Case ◽  
Cross Sectional ◽  
History Of ◽  
Relationship Of ◽  
The Relationship ◽  
Higher Doses ◽  
Current Behaviour

Aims and MethodNeuroleptic medication is often used in excess of the BNF maximum. The purpose of this study was to examine the relationship of neuroleptic dose to patient, prescriber and environmental factors, by using a cross sectional ‘snapshot’ study of psychiatric in-patient prescriptions combined with a retrospective case note survey.ResultsIt was found that certain consultants prescribe higher doses of neuroleptics than others. Patients with a history of aggression had a nine and a half times higher chance of being prescribed higher doses of neuroleptics. Patients with a greater than 5-year history of neuroleptic prescription received higher doses.Clinical ImplicationsHigh neuroleptic prescription is related more to patients' past reputation and prescriber differences than to patients' current behaviour.

scholarly journals Access to a child mental health service

2002 ◽  
Vol 26 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Graeme Lamb ◽  
Anita Anfield ◽  
Anne Sheeran
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Child Mental Health ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Consultation Service ◽  
Child Mental Health Service ◽  
Initial Appointment

Aims and MethodThis was a retrospective case note analysis of all referrals to an inner-London child and family consultation service aiming to examine any changes in patterns of referral and attendance of Bangladeshi and indigenous families over the previous 10-year period.ResultsBangladeshi referrals increased over the period but remained under-represented compared to indigenous families. They were less likely to attend an initial appointment, but once engaged with the service dropout rates were unaffected by ethnicity.Clinical ImplicationsImproved communication between the department, families and referrers may help to increase understanding of the function of the department and lead to more equitable uptake of services in the future.

scholarly journals Experience of thioridazine use before and after the Committee on Safety of Medicines warning

2003 ◽  
Vol 27 (03) ◽  
pp. 87-89
Author(s):  
Tim Matthews ◽  
Sian Nersy Weston
Keyword(s):  
Adverse Events ◽  
Learning Disability ◽  
Drug Withdrawal ◽  
Drug Dosage ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Before And After ◽  
Adults With Learning Disabilities ◽  
Severe Degree

Aims and Method To describe the use of thioridazine in a population of adults with learning disabilities at the time of the warning issued by the Committee on Safety of Medicines (CSM). Also, to observe the result of discontinuation of thioridazine and to examine factors that were associated with adverse events. Retrospective case note analysis was carried out for a sample of individuals with a learning disability. Results Over 50% of those on regular thioridazine experienced adverse events during or following drug withdrawal. Adverse events were significantly associated with the duration of previous thioridazine prescription. Higher drug dosage and a more severe degree of learning disability may also be factors linked to poorer outcomes. Clinical Implications More caution may be required when reducing or withdrawing antipsychotic medication in this patient group.

scholarly journals Drug Analyses in Poisoned Patients—The Need to Be Specific

1982 ◽  
Vol 19 (4) ◽  
pp. 254-257 ◽  
Author(s):  
M J Stewart
Keyword(s):  
Clinical Implications ◽  
The Past ◽  
Modern Methods ◽  
The Future ◽  
Drugs In Blood ◽  
Qualitative Determination

Methods for the qualitative determination of drugs in blood and urine which have been used over the past 20 years have on several occasions given rise to incorrect interpretation due to their lack of specificity, which has resulted in falsely high values being reported for commonly requested drugs. Modern methods provide an opportunity to ensure specificity in the future but analysts must continue to be aware of the potential pitfalls. Examples of non-specificity in colorimetric, UV spectrophotometric, and immunological techniques are described and the clinical implications are demonstrated.

scholarly journals Changes in practice of ECT: a follow-on study

1998 ◽  
Vol 22 (11) ◽  
pp. 687-690 ◽  
Author(s):  
Kate Trezise
Keyword(s):  
Electroconvulsive Therapy ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Risk Of Treatment

Aims and methodA retrospective case note study examining the effects of increased supervision on practice of electroconvulsive therapy (ECT).ResultsIncreasing the level of supervision of ECT sessions was associated with patients receiving on average almost two fewer treatment applications per course of ECT.Clinical implicationsThe risk of treatment is reduced because patients receive fewer anaesthetics, and they may be discharged home sooner. Such improvements in ECT practice should be relatively easily achievable in many ECT clinics.

scholarly journals New long-stay patients in a psychiatric admission ward setting

2005 ◽  
Vol 29 (12) ◽  
pp. 452-454 ◽  
Author(s):  
Colin Cowan ◽  
Philippa Walker
Keyword(s):  
Patient Care ◽  
Descriptive Study ◽  
Case Note ◽  
Living Alone ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Psychiatric Admission ◽  
Admission Ward ◽  
Early Readmission ◽  
Case Note Review

Aims and MethodThis is a descriptive study of the admissions of new long-stay patients and their outcome in a district with minimal access to longer-stay in-patient beds. Cases were identified through an ongoing in-patient census and information was gathered by retrospective case-note review.ResultsThirty-nine new long-stay admissions were identified. High rates of living alone, early readmission following previous discharge and use of the Mental Health Act 1983 were noted. The 39 admissions occupied 12% of the unit's capacity. Four patients returned to a family residence but 27 went into residential or in-patient care. Of those discharged to settings not providing patient care, 48% were readmitted in the year after discharge.Clinical ImplicationsNew long-stay admissions continue to absorb a high proportion of the bed resources of an in-patient unit for their numbers and these patients are at risk of unsuccessful discharge.

scholarly journals Continuity of supply of psychiatric medicines for newly received prisoners

2011 ◽  
Vol 35 (7) ◽  
pp. 244-248 ◽  
Author(s):  
Lamiece Hassan ◽  
Jane Senior ◽  
Dawn Edge ◽  
Jenny Shaw
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Clinical Assessment ◽  
Mental Health Policy ◽  
Case Note ◽  
Additional Stress ◽  
Clinical Implications ◽  
Psychiatric Medication ◽  
Retrospective Case ◽  
Case Note Review

Aims and methodA retrospective case-note review was undertaken at five English prisons between June 2008 and March 2009 to estimate the proportion of psychiatric medicines (antidepressants, antipsychotics and hypnotics/anxiolytics) reported at prison reception that are discontinued on entry to prison.ResultsOf the 1006 records sampled, the review showed that 18% of prisoners had been prescribed psychiatric medication before being placed in custody. Altogether, 240 separate psychiatric medicines were recorded among prisoners at reception. Of these, 47% were not prescribed during the first week of custody. In only 11% of cases where medication was discontinued had psychiatric assessment been completed.Clinical implicationsPrison mental health policy states that psychiatric medication should not be withdrawn in custody without proper clinical assessment. Denial of medication in the absence of clinical assessment during early custody has the potential to create additional stress in individuals during a period of increased vulnerability and risk.

Experience of thioridazine use before and after the Committee on Safety of Medicines warning

2003 ◽  
Vol 27 (3) ◽  
pp. 87-89 ◽  
Author(s):  
Tim Matthews ◽  
Sian Nersy Weston
Keyword(s):  
Adverse Events ◽  
Learning Disability ◽  
Drug Withdrawal ◽  
Drug Dosage ◽  
Case Note ◽  
Clinical Implications ◽  
Retrospective Case ◽  
Before And After ◽  
Adults With Learning Disabilities ◽  
Severe Degree

Aims and MethodTo describe the use of thioridazine in a population of adults with learning disabilities at the time of the warning issued by the Committee on Safety of Medicines (CSM). Also, to observe the result of discontinuation of thioridazine and to examine factors that were associated with adverse events. Retrospective case note analysis was carried out for a sample of individuals with a learning disability.ResultsOver 50% of those on regular thioridazine experienced adverse events during or following drug withdrawal. Adverse events were significantly associated with the duration of previous thioridazine prescription. Higher drug dosage and a more severe degree of learning disability may also be factors linked to poorer outcomes.Clinical ImplicationsMore caution may be required when reducing or withdrawing antipsychotic medication in this patient group.

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