scholarly journals 73.2 FAMILY THERAPY AND SAFETY PLANNING IN THE INPATIENT PSYCHIATRIC UNIT

Author(s):  
Hun Millard
Author(s):  
James P Lepage ◽  
Florence Hatton ◽  
Scott Pollard ◽  
Linda VanHorn ◽  
Patty Coffield ◽  
...  

2018 ◽  
Vol 54 (2) ◽  
pp. 235-242
Author(s):  
Brian S. Barnett ◽  
Veronica Kusunzi ◽  
Lucy Magola ◽  
Christina P. C. Borba ◽  
Michael Udedi ◽  
...  

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S183-S183
Author(s):  
Emma Davies ◽  
Ijeoma Enemo-Okonkwo

AimsTo study the quality of handover, between nursing staff and doctors, on an inpatient psychiatric unit.Effective handover between professionals is vital to ensure the accurate transfer of useful information to enable quality care and patient safety.Implementation of a handover tool has been shown to improve patient safety, especially when used to structure communication over the phone.Feedback at trainee doctor forums highlighted insufficient handover from nursing staff whilst on-call, a problem which prompted further exploration.MethodStandards were developed for the expected quality of handover, consisting of a set of criteria for the minimum information required to ensure a safe and effective handover, stemming from the SBAR (Situation, Background, Assessment, Recommendation) approach, with adequate identification of patients, clear communication of the current situation and relevant details.In an inpatient psychiatric setting, telephone calls to the on-call doctor were recorded for a two-week period, documenting whether key information was communicated.ResultTotal number of calls to on-call doctor recorded: 68. The patients name was given in 49% and the ID number in just 10%. Both relevant diagnosis/history and NEWS score was provided in 18%. However, the current issue and recommendation was given in 90% and 95% respectively.ConclusionThe results thus far demonstrate a lack of structure and often limited information delivered in handover from nursing staff to the on-call doctor. This leads to difficulties in prioritisation, identifying the urgency of the situation and inefficiencies, as time is spent requesting further information which is not readily available.After nursing colleagues were made aware, results from a further two-week period, from 65 total calls, demonstrated some improvement. Patient name given in 51%, ID number in 18%, relevant diagnosis/history in 12%, NEWS score in 17%, current issue in 92% and recommendation in 51%. It is clear that with marginal improvement, there remains a problem which we aim to address by collaborating further with senior nursing leads whilst implementing a succinct handover proforma. It is likely that with COVID-19 as the priority on the agenda this past year, quality improvement projects such as this has not been the main focus. We hope that we will be able to implement these changes in the coming months.


Author(s):  
Avishay A. Adri

INTRODUCTION: Acute manic episodes are a psychiatric emergency related to violence and poor patient outcomes. Combination psychotropic therapy utilizing a mood stabilizer and an atypical antipsychotic has been shown to be more efficacious for treating acute mania compared to monotherapy with either mood stabilizers or antipsychotics alone. This quality improvement project implemented evidence-based interventions for treating acute mania. The mania pathway protocol was created as a comprehensive clinical guide for guiding mania treatment. The protocol was implemented on an inpatient psychiatric unit for patients with mania diagnoses including manic/mixed episodes of bipolar disorder or schizoaffective disorder. AIMS: (1) to improve the treatment of mania by using evidence-based interventions for rapid mood stabilization and (2) to educate psychiatric providers on up-to-date interventions for treating acute manic states. METHOD: Psychiatric providers were evaluated for knowledge enhancement through a pre-/post–educational session quiz. A retrospective chart review was used for data collection for patients treated with the mania pathway protocol. The retrospective chart review spanned 8 weeks post project implementation. Young Mania Rating Scale (YMRS) scores were analyzed to measure the effect on mania severity. RESULTS: The percentage decrease in mean Young Mania Rating Scale scores from admission to the fifth day of hospitalization was 61%. All psychiatric providers proved knowledge attainment by scoring 100% on the postintervention quiz. CONCLUSIONS: Rapid mood stabilization may be achieved by using a combination therapy–based mania protocol. Educational sessions can enhance psychiatric provider knowledge with regard to evidence-based treatments for mania.


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