Impact of a Crisis Assessment and Treatment Service on Admissions into an Acute Psychiatric Unit

2005 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Adesina Adesanya
Keyword(s):  
Psychiatric Hospitalization ◽  
Psychiatric Facility ◽  
Treatment Service ◽  
Treatment Services ◽  
Before And After ◽  
Assessment And Treatment ◽  
Adult Inpatient ◽  
Clinical Records ◽  
The Impact ◽  
Inpatient Psychiatric Facility

Objective: To assess the impact of a regional/rural crisis assessment and treatment service (CAT) on admissions into an acute adult inpatient psychiatric facility. Methods: Relevant data for admissions into an acute adult inpatient psychiatric facility in the 18 month periods before and after the establishment of a CAT were compared. Data extracted from available clinical records were transferred into an appropriately structured pro forma for statistical analysis. Results: There were 69 and 53 index inpatient unit admissions in the two time periods. The majority of these were for single, unemployed men aged in their 30s. Although statistically non-significant, the results appear to suggest that there were proportionately fewer readmissions and that admissions were likely to be influenced by illness severity and diagnostic considerations in the period following the establishment of the CAT. The establishment of CAT did not appear to have had much impact on the duration of psychiatric hospitalization. Conclusions: Crisis assessment and treatment services operating within a re-gional/rural integrated mental health setting appear to have only limited impact on hospitalization for psychiatric crisis presentations. There is a need for further studies looking at a broader range of outcome variables in the assessment of the impact of CAT on psychiatric hospitalization in such settings.

scholarly journals Alcohol withdrawal-related outcomes associated with gabapentin use in an inpatient psychiatric facility

2019 ◽  
Vol 9 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Taylor A. Nichols ◽  
Sophie Robert ◽  
David J. Taber ◽  
Jeffrey Cluver
Keyword(s):  
Alcohol Withdrawal ◽  
Length Of Hospital Stay ◽  
Control Cohort ◽  
Psychiatric Facility ◽  
Therapeutic Uses ◽  
Significant Difference ◽  
Benzodiazepine Use ◽  
The Impact ◽  
Hospital Stay Duration ◽  
Inpatient Psychiatric Facility

Abstract Introduction Limited evidence exists evaluating the impact of gabapentin in conjunction with benzodiazepines for the management of alcohol withdrawal. A review of outcomes associated with combination gabapentin and benzodiazepine therapy may illuminate new therapeutic uses in clinical practice. Methods This retrospective study evaluated the impact of gabapentin on as-needed use of benzodiazepines in inpatients being treated for acute alcohol withdrawal. The treatment cohort consisted of patients prescribed gabapentin while on a symptom-triggered alcohol withdrawal protocol. The control cohort consisted of patients on symptom-triggered alcohol withdrawal protocol without concurrent gabapentin use. Secondary objectives included length of hospital stay, duration on alcohol withdrawal protocol, frequency of complicated withdrawal, and use of additionally prescribed as-needed or scheduled benzodiazepines. Results The gabapentin cohort was on the alcohol withdrawal protocol for a similar duration, compared with the control cohort (median of 4 [interquartile range: 2,6] days vs 3 [2,4] days, P = .09, respectively). Similarly, the gabapentin cohort required a median of 1 [1,2] benzodiazepine dose for alcohol withdrawal symptoms compared with a median of 1 [1,2] dose in the control cohort, P = .89. No significant difference was found between cohorts for as-needed and scheduled benzodiazepine use. Length of stay in hospital was similar between groups. Discussion These results suggest that gabapentin use, in conjunction with benzodiazepines, impacts neither the time on alcohol withdrawal protocol or the number of benzodiazepine doses required for withdrawal. Larger, prospective studies are needed to detect if gabapentin alters benzodiazepine usage and to better elucidate gabapentin's role in acute alcohol withdrawal.

A longitudinal description of incompetent to stand trial admissions to a state hospital

CNS Spectrums ◽  
2019 ◽  
Vol 25 (2) ◽  
pp. 223-236
Author(s):  
Barbara E. McDermott ◽  
Katherine Warburton ◽  
Chloe Auletta-Young
Keyword(s):  
Psychiatric Hospitalization ◽  
The Body ◽  
Psychiatric Facility ◽  
Department Of State ◽  
State Hospitals ◽  
Time Period ◽  
Forensic Inpatient ◽  
Incompetent To Stand Trial ◽  
Inpatient Psychiatric Facility ◽  
Growing Population

Objective.Evidence is clear that the nation is experiencing an increasing number of incompetent to stand trial (IST) admissions to state hospitals. As a result, defendants in need of treatment can wait in jail for weeks for admission for restoration. This study was conducted to better understand this growing population and to inform hospital administration about the characteristics of IST admissions.Methods.The study was conducted at the Department of State Hospitals (DSH) facility in Napa (DSH-Napa), a 1200-bed primarily forensic inpatient psychiatric facility located in northern California. The records of patients found IST and admitted to DSH-Napa for restoration of competence between the dates of 1/1/2009 and 12/31/2016 were eligible for inclusion in the study.Results.There were a total of 3158 unduplicated IST admissions available during the specified time period. Our data indicate that the number of admissions with more than 15 prior arrests increased significantly, from 17.7% in 2009 to 46.4% in 2016. In contrast, the percent of patients reporting prior inpatient psychiatric hospitalization evidenced a consistent decrease over time from over 76% in 2009 to less than 50% in 2016.Conclusion.Our data add to the body of literature on the potential causes of the nationwide increase in competency referrals. The literature is clear that jails and prisons are now the primary provider of the nation’s mental health care. Our data suggest that another system has assumed this role: state hospitals and other providers charged with restoring individuals to competence.

scholarly journals Affiliation to alcoholics anonymous or narcotics anonymous among patients attending an English specialist addiction service

2019 ◽  
Vol 19 (4) ◽  
pp. 257-269
Author(s):  
Edward Day ◽  
Sabrina Kirberg ◽  
Nicola Metrebian
Keyword(s):  
Alcoholics Anonymous ◽  
Narcotics Anonymous ◽  
Treatment Service ◽  
Content Type ◽  
The Past ◽  
Treatment Services ◽  
Potential Benefits ◽  
Specialist Treatment ◽  
Professional Treatment ◽  
The Impact

Purpose Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues. Design/methodology/approach A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS). Findings A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001). Practical implications A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate. Originality/value The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.

A mixed methods study of clinician reported challenges in the assessment of ADHD and treatment decisions for children with ADHD in Brazil

2021 ◽  
pp. 135910452199463
Author(s):  
Fabiola Honorio Neto ◽  
Ana Paula Camargo ◽  
Gilherme Polanczyk ◽  
Dimitrios Adamis ◽  
Fiona McNicholas
Keyword(s):  
Combined Treatment ◽  
Original Data ◽  
Children With Adhd ◽  
Public Practice ◽  
Treatment Services ◽  
Specialist Services ◽  
Assessment And Treatment ◽  
Practice Method ◽  
The Impact ◽  
Child Psychiatrists

Objective: This ADHD national survey has obtained original data on the assessment and treatment of attention deficit hyperactivity disorder (ADHD) reported by Brazilian paediatricians and child psychiatrists; and has compared their practice. Method: The study questionnaire was delivered to 165 neuro/community paediatricians and 272 child and adolescent psychiatrists. Quantitative and qualitative data were collected and analysed. Results: Paediatricians assess children with a suspected ADHD, but do not feel confident to prescribe methylphenidate alone. Both paediatricians and child psychiatrists consider combined treatment of medication and psychotherapy more effective. Clinicians want to involve other professionals in the medical decisions but experience difficulties accessing specialist services, especially in public practice. Conclusion: This study showed the impact of the public–private mix in the delivery of and access to appropriate assessment and treatment services for children with ADHD in Brazil.

scholarly journals The Effect of Follow-up Contact in Reoccurrence of Psychiatric Readmission

2019 ◽  
Author(s):  
David Mallo ◽  
Ian E. Wickramasekera
Keyword(s):  
Case Management ◽  
Intervention Strategies ◽  
Psychiatric Facility ◽  
Readmission Rates ◽  
Psychiatric Readmission ◽  
Inpatient Facility ◽  
The Impact ◽  
Number Of Individuals ◽  
Inpatient Psychiatric Facility

This study examined if clinical contact with clients within one week of discharge from an inpatient psychiatric facility had an influence on their readmission. One of the factors explored in this study was whether the impact of clinical contact could reduce readmission rates after discharge used to develop intervention strategies to reduce readmission. The study found that those individuals who had a case management appointment set within the first seven days of discharge from an inpatient psychiatric facility was approximately eight times more likely than non-clinical referrals, 32 % vs. 4 %, to be not readmitted to an inpatient psychiatric facility. When this was examined even more closely, it was determined that case management appointments attended within the first day following discharge from an inpatient psychiatric facility was significantly associated with attendance following discharge. The number of individuals who attended case management appointments dropped approximately 50% within 24 hours of discharge, as compared with the number of individuals who attended appointments following two days after discharge (18 % to 8 %). This trend continued as time progressed for the first two to seven days following discharge from an inpatient psychiatric facility, where the attendance of a clinical appointment dropped to 4% within seven days following discharge. These findings have implications on what type of clinical contact should be pursued following discharge from an inpatient facility, and how soon that appointment should be accomplished in order to decrease readmissions.

Uncovering the Value and Meaning of a Horticulture Therapy Program for Clients at a Long-Term Adult Inpatient Psychiatric Facility

2018 ◽  
Vol 34 (3) ◽  
pp. 242-257 ◽  
Author(s):  
Joseph Cipriani ◽  
Jenna Georgia ◽  
Megan McChesney ◽  
Jaclyn Swanson ◽  
Janelle Zigon ◽  
...  
Keyword(s):  
Psychiatric Facility ◽  
Therapy Program ◽  
Horticulture Therapy ◽  
Adult Inpatient ◽  
Inpatient Psychiatric Facility

Minimizing negative outcomes associated with potentially harmful lithium levels by means of pharmacist-led educational interventions in an inpatient psychiatric facility

2015 ◽  
Vol 5 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Erika E. Tillery
Keyword(s):  
Adverse Events ◽  
Drug Monitoring ◽  
Medical Staff ◽  
Educational Interventions ◽  
Therapeutic Drug ◽  
Negative Outcomes ◽  
Psychiatric Facility ◽  
Progress Notes ◽  
The Impact ◽  
Inpatient Psychiatric Facility

Introduction: Studies examining educational interventions led by pharmacists to minimize negative outcomes associated with elevated and potentially harmful lithium levels in inpatient psychiatric facilities are lacking. Other studies indicate a need for improvement of therapeutic drug monitoring for lithium. The aim of this article is to identify potential improvements in negative outcomes associated with harmful lithium blood levels after educational interventions are delivered by a clinical pharmacist to providers of an inpatient psychiatric facility. Methods: Medication reports were queried from the pharmacy database to identify all patients who were taking lithium within 1 year. Laboratory results, physician progress notes, nursing progress notes, and treatment plans were studied to detect any adverse events associated with lithium levels. Educational interventions created by pharmacy services were tailored toward medical staff and delivered over a 3 month period. Learning was assessed at pre-educational and posteducational interventions. Results: One hundred fifteen patients received lithium between March 2012 and March 2013. The most-frequent adverse effects reported associated with lithium included tremor, dizziness, slurred speech, and lethargy. Two patients were sent to the local emergency department for lithium toxicity and required dialysis. Fifty-two patients received lithium after educational interventions, and no adverse events were reported. A lithium drug-monitoring spreadsheet was created for pharmacy use, and drug-monitoring guidelines were revised and disseminated throughout the facility. Discussion: A reduction in negative outcomes associated with lithium was noted after educational interventions to medical staff occurred. The impact of pharmacist-led educational interventions demonstrated a high potential for success.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

Technology and Hospital Information System: A Case of Implementation of Electronic Clinical Records in Hospital Maternity Irene Neto in Lubango, Angola

2019 ◽  
Vol 10 (11) ◽  
pp. 1131-1135
Author(s):  
Tomas Hambili Paulo Sanjuluca ◽  
◽  
Ricardo Correia ◽  
Anabela Antunes de Almeida ◽  
Ana Gloria Diaz Martinez ◽  
...  
Keyword(s):  
Maternity Hospital ◽  
Management Support ◽  
Retrospective Case ◽  
System A ◽  
Clinical Records ◽  
Retrospective Case Study ◽  
The Impact ◽  
And Child Health

Introduction: In order to have a good assessment of the quality of maternal and child health care, it is essential that there is up-to-date and reliable information. Objective: To evaluate the impact of the implementation of a computerized database of clinical processes in the admission, archive and medical statistics section, of Maternity hospital Irene Neto/Lubango-Angola. Methodology: A descriptive study with a quantitative and qualitative approach to carry out a retrospective case study deliveries and newborns, records from 2014 to 2017. Final considerations: The implementation of this project may contribute to the improvement of clinical management support management of the hospital as well as facilitating access to information for research and scientific production.

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