“Cuts are costly”: A review of deliberate self-harm admissions to a district general hospital plastic surgery department over a 12-month period

2014 ◽  
Vol 67 (4) ◽  
pp. e109-e110 ◽  
Author(s):  
Fionnuala M. O'Leary ◽  
Michelle C.I. Lo ◽  
Frederik B. Schreuder
Keyword(s):  
Plastic Surgery ◽  
General Hospital ◽  
District General Hospital ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Surgery Department

scholarly journals Deliberate self-harm: service development in Kettering

1995 ◽  
Vol 19 (8) ◽  
pp. 475-477 ◽  
Author(s):  
Catherine Gordon ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Service Provision ◽  
Public Health Problem ◽  
District General Hospital ◽  
Service Development ◽  
Paracetamol Poisoning ◽  
Deliberate Self Harm ◽  
Threefold Increase ◽  
Self Harm ◽  
Recent Trends

Services for deliberate self-harm patients in the general hospital are unsatisfactory in many respects. A survey of activity and quality in a district general hospital confirmed recent trends observed elsewhere and highlights areas in which service provision can be improved.High rates of deliberate self-harm (DSH) are a public health problem. A study in Oxford showed rising rates among young women during the late 1980s, and a threefold increase in the proportion due to paracetamol poisoning between 1976 and 1990 (Hawton & Fagg, 1992). A multicentre European study found a trend of increasing peak age, a declining female to male ratio, and unexplained differences between regions (Platt, 1992). In the year following DSH, 9% repeat (Hawton & Fagg, 1992); and suicide rates reach 1.1 to 1.3% of patients in the three years following an episode of DSH (Owens et al. 1991).

A Psychiatric Liaison Service in a General Hospital Referrals and Their Appropriateness

1994 ◽  
Vol 39 (5) ◽  
pp. 141-144 ◽  
Author(s):  
D.J. Hall
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Psychiatric Problem ◽  
Prior Training ◽  
Liaison Psychiatry ◽  
Deliberate Self Harm ◽  
Intensive Training ◽  
Psychiatric Referral ◽  
Self Harm

Referrals to a liaison psychiatry service, based in a District General Hospital, were studied over a six month period. 190 [89%] of the 214 referrals were for assessment following an episode of deliberate self harm. An excess of these referrals were male [57%] and a large proportion particularly of the males [36%] were diagnosed as having a significant alcohol problem. Many were felt to have no significant psychiatric problem [31%], and a large proportion were discharged with no psychiatric follow-up [28%]. Patterns of diagnosis and disposal differed between the sexes. Referring junior medical staff when asked to give their opinions on the likely management and overall need for psychiatric referral of patients were found to reach reasonable agreement with the assessing psychiatrist, even without prior training, and to be more cautious in their assessment. In many centres the trend is towards selective referral of deliberate self harm patients, and this appears a safe and appropriate development which can be achieved without intensive training or major alterations to working patterns, and which will result in modest but important reductions in inappropriate referrals.

scholarly journals Discriminating levels of alcohol use associated with self-harm in individuals presenting to a district general hospital

2010 ◽  
Vol 34 (6) ◽  
pp. 226-230 ◽  
Author(s):  
Nicholas Holdsworth ◽  
Hugh Griffiths ◽  
David Crawford
Keyword(s):  
Alcohol Use ◽  
General Hospital ◽  
Screening Tool ◽  
District General Hospital ◽  
Alcohol Screening ◽  
Screening Tools ◽  
Psychosocial Assessment ◽  
Different Types ◽  
Self Harm ◽  
Problematic Alcohol Use

Aims and methodAlthough alcohol is reported as commonly associated with self-harm, there is nothing in the literature that bases the association on validated screening tools. We sought to discern the different types of alcohol use as discriminated by the Alcohol Use Disorders Identification Test (AUDIT). Completed AUDITs from a 2-year period were analysed, all relating to people who had presented to a district general hospital in Northumberland following self-harm.ResultsThe proportion of dependent, harmful and hazardous drinkers identified using AUDIT was many times higher than previously estimated in similar studies that had not used a validated alcohol screening tool.Clinical implicationsThe routine use of an alcohol screening tool should be part of any standard psychosocial assessment of self-harm, to guide appropriate interventions for problematic alcohol use that might otherwise be overlooked.

scholarly journals The appropriateness of pre-operative blood tests at a district general hospital breast surgery department

2013 ◽  
Vol 11 (8) ◽  
pp. 609
Author(s):  
Rashad Jurangpathy ◽  
Annakan Navaratnam ◽  
Arunmoy Chakravorty ◽  
Sankaran Chandrasekharan
Keyword(s):  
General Hospital ◽  
Breast Surgery ◽  
District General Hospital ◽  
Blood Tests ◽  
Surgery Department

Deliberate Self-Harm Patients Who Discharge Themselves from the General Hospital Without Adequate Psychosocial Assessment

Crisis ◽  
2004 ◽  
Vol 25 (4) ◽  
pp. 183-186 ◽  
Author(s):  
Rachel Crowder ◽  
Rohan Van Der Putt ◽  
Ceri-Anne Ashby ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Care Pathway ◽  
Alcohol Intoxication ◽  
Psychosocial Assessment ◽  
Hospital Environment ◽  
Control Group ◽  
Deliberate Self Harm ◽  
Increased Risk ◽  
Self Harm ◽  
Integrated Care Pathway

Abstract: Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.

COVID-19: Adapting to change, general surgery at a district general hospital in the United Kingdom

2019 ◽  
Vol 30 (10) ◽  
pp. 301-308
Author(s):  
Sonia Ike ◽  
Chijioke Ikechi ◽  
Jaideep Rait ◽  
Ankur Shah
Keyword(s):  
United Kingdom ◽  
General Hospital ◽  
General Surgery ◽  
Major Change ◽  
Holistic Approach ◽  
District General Hospital ◽  
Viral Spread ◽  
The United Kingdom ◽  
Staff Wellbeing ◽  
Surgery Department

The Coronavirus pandemic has caused major change across the world and in the National Health Service. In order to cope and help limit contagion, numerous institutions recognised the need to adjust clinical practice quickly yet safely. In this paper, we aim to describe the changes implemented in a general surgery department at a district general hospital in the United Kingdom. Across the surgical specialties, frameworks, protocols and guidelines have been established locally and nationally. The aerosol generating procedures involved in general surgery required us to alter our daily activities. Modifications to patient management were necessary to try and reduce viral spread. Staff wellbeing was heavily promoted in order to help maintain the frontline workforce. A holistic approach was required.

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