scholarly journals A Canadian Medical-Psychiatric Inpatient Service*

1992 ◽  
Vol 37 (5) ◽  
pp. 326-334 ◽  
Author(s):  
J. Robert Swenson ◽  
François M. Mai
Keyword(s):  
Somatoform Disorders ◽  
Psychiatric Inpatient ◽  
The United States ◽  
Inpatient Service ◽  
Adequate Care ◽  
Psychiatric Inpatient Unit ◽  
Present Complex ◽  
Psychiatric Units ◽  
Adult Inpatient ◽  
One Year

Patients with both psychiatric and medical illnesses present complex and, at times, difficult diagnostic and management problems. Medical-psychiatric units designed to provide integrated medical and psychiatric care have been established in the United States. This paper describes the development and structure of such a unit established at a Canadian general hospital, using psychiatric facilities and resources already in place. A one year review of the characteristics of patients discharged from the service found that their mean length of stay was similar to that of inpatients discharged from the general adult inpatient services, but shorter than that of patients discharged from the psychogeriatric service. Many of these patients had neurological conditions; coexisting affective disorders, substance abuse, organic mental syndromes and somatoform disorders were diagnosed frequently. We believe that a medical-psychiatric inpatient unit can provide integrated care to patients who might otherwise receive less than adequate care.

The effect of limited English proficiency and interpreter service use on clinical outcomes in psychiatric inpatient units

2019 ◽  
Vol 27 (5) ◽  
pp. 465-468
Author(s):  
Conor Daly ◽  
Karen Phillips ◽  
Richard Kanaan
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Limited English Proficiency ◽  
Service Use ◽  
English Proficiency ◽  
Psychiatric Inpatient ◽  
Psychiatric Units ◽  
Adult Inpatient ◽  
Interpreter Service ◽  
Inpatient Units

Objective: The effects of limited English and interpreter use on clinical outcomes in mental health are poorly understood. This paper describes an exploratory study examining those effects across three adult inpatient psychiatric units, predicting it would lead to increased length of stay. Methods: Forty-seven patients with limited English proficiency (LEP) were retrospectively identified and compared with 47 patients with proficient English. Length of stay, number of consultant reviews and discharge diagnosis were recorded and compared. Results: An increased length of stay for those with LEP was not statistically significant ( p=0.155). The LEP group did undergo more consultant reviews ( p=0.036), however, and attracted different discharge diagnoses, with no primary discharge diagnoses of personality disorder made ( p=0.018). Conclusions: This study provides evidence of significant effects of limited English on both service burden and outcome.

Improving use of resources-health care in patients with psychiatric pathology after introduction of risperidone long-acting injection (RLAI)

2011 ◽  
Vol 26 (S2) ◽  
pp. 1288-1288
Author(s):  
F. Valdivia ◽  
M. Asensio ◽  
A. Soler ◽  
L. López
Keyword(s):  
Mental Health Center ◽  
Psychiatric Inpatient ◽  
Ambulatory Monitoring ◽  
Adherence To Treatment ◽  
Use Of Resources ◽  
Psychiatric Inpatient Unit ◽  
Qualitative Variables ◽  
Oral Antipsychotic ◽  
One Year ◽  
Long Acting

Enhance adherence to treatment is one of the main objectives in psychiatric clinical practice. The aim of this study is to evaluate changes in the use of oral antipsychotic medication, the use of rehabilitation resources and the number and duration of income in Psychiatric Inpatient Unit, comparing one year before and one year after RLAI's introduction, in patients with different psychiatric disorders, followed up by Mental Health Center and have maintained adherence to treatment for a defined period. We performed an observational, retrospective study by reviewing medical records of patients in ambulatory monitoring. The sample consisted of all patients (112) who had maintained RLAI treatment for a year, excluding those who did not fulfill the guideline correctly (14), remaining n = 98. We included patients of various pathologies, establishing groups as qualitative variables (F.20 = 56; F.25 = 12; F.22–28 = 20; F.60 = 10); of both sexes (V = 71; M = 27) and all ages. The preliminary results obtained showed a greater use of rehabilitation resources and decreased use of oral antipsychotics.

scholarly journals The Psychogeriatric Patient in the Emergency Room: Focus on Management and Disposition

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sherry Tang ◽  
Priyanka Patel ◽  
Jagdish Khubchandani ◽  
George T. Grossberg
Keyword(s):  
Emergency Room ◽  
Psychiatric Inpatient ◽  
The Elderly ◽  
The United States ◽  
Psychiatric Consultation ◽  
Urban Hospital ◽  
Geriatric Population ◽  
Psychiatric Inpatient Unit ◽  
The Usa ◽  
Psychogeriatric Patients

Background. The growing geriatric population in the United States (US) has prompted better understanding of treatment of the elderly in the hospital and emergency room (ER) settings. This study examines factors influencing the disposition of psychogeriatric patients after their initial presentation in the ER. Methods. Data was collected on patients 65 years of age or older arriving at the ER of a large urban hospital in the USA (January 2009–December 2010). Results. Of the total subjects (n=95) included in the study, majority were females (66.3%) with an average age of 75.5 years. The chief complaint for psychogeriatric patients coming to the ER was delirium (61.6%). Caucasians were significantly more likely than African-American patients to get a psychiatric consult (33% versus 9%). Patients with delirium were less likely than patients with other psychiatric complaints to get a psychiatric consult in the ER (1.2% versus 47.2%) and less likely to be referred to a psychiatric inpatient unit compared to patients with other psychiatric complaints (2.4% versus 16.7%). Conclusion. Even though delirium is the most common reason for ER visits among psychogeriatric patients, very few delirium patients got a psychiatric consultation in the ER. A well-equipped geriatric psychiatry unit can manage delirium and associated causes.

Factitious AIDS in a Psychiatric Inpatient

1989 ◽  
Vol 34 (4) ◽  
pp. 320-322 ◽  
Author(s):  
J. Arturo Silva ◽  
Gregory B. Leong ◽  
Robert Weinstock ◽  
David J. Ready
Keyword(s):  
Psychiatric Inpatient ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Psychiatric Evaluation ◽  
Factitious Disorder ◽  
Medical Assessment ◽  
Psychiatric Inpatient Unit ◽  
Psychiatric Units ◽  
History Of ◽  
Acquired Immune Deficiency

This article reports the case of a 28 year-old female presenting to a psychiatric inpatient unit with depression and a history of acquired immune deficiency syndrome (AIDS). Although medical assessment was negative for AIDS, psychiatric evaluation and psychological testing were consistent with a presentation of factitious disorder. This case illustrates the need to be on the alert for individuals admitted to psychiatric units who report they have AIDS or its related conditions.

Teenagers in adult psychiatric inpatient care in Northern Ireland

2000 ◽  
Vol 17 (2) ◽  
pp. 54-58 ◽  
Author(s):  
Sinead McGilloway ◽  
Michael Donnelly ◽  
David Scott
Keyword(s):  
Northern Ireland ◽  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Conduct Disorders ◽  
Hospital Data ◽  
Psychiatric Units ◽  
Adult Inpatient ◽  
Self Harm ◽  
Depth Interviews ◽  
Effective Service

AbstractObjectives: To investigate the nature and pattern of teenage admissions (13-18yrs) to the 14 adult psychiatric units in Northern Ireland (NI) between 1989 and 1995.Method: An analysis of routine hospital data, a review of case-notes at one hospital and in-depth interviews with young people previously admitted to adult inpatient care.Results: Sixteen per cent of all under 25s admitted during the six-year period (443/2823) were under 18. There was an increasing trend over time in admissions and re-admissions to hospital. More than half of the teenagers were female and the most common diagnoses included emotional/conduct disorders, ‘stress’ and neurotic illnesses. Self-harm, substance abuse and exposure to violent/abusive environments or behaviour were the most commonly recorded factors preceding admission. All but one of the small number of people interviewed had attempted suicide prior to admission to hospital.Conclusions: The increase in the use of adult inpatient care by young teenagers is of considerable concern but may be unavoidable in the absence of suitable alternatives especially for adolescents at risk of self-harm or suicide. Further research is required to determine the most appropriat e and effective service response for this vulnerable group . The findings have important implications for the future development of adolescent mental health services.

Bridging the Gap Between Individualized Inpatient Safety Planning and Postdischarge Efficacy

2021 ◽  
pp. 107839032199971
Author(s):  
Jessica Leonard ◽  
Laurel Chiappetta ◽  
Stacy Stark ◽  
Ann M. Mitchell
Keyword(s):  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Safety Planning ◽  
Improvement Project ◽  
Psychiatric Inpatient Unit ◽  
Safety Plan ◽  
Adult Inpatient ◽  
Planning Group ◽  
Inpatient Psychiatric Unit ◽  
Inpatient Safety

INTRODUCTION Implementation of programs that increase both psychiatric patient education and their involvement in treatment programming can lead to positive outcomes postdischarge. Patients involved in programs focusing on skills, recovery, and that are individualized show a reduction in symptoms as well as an increase in engagement, treatment, and recovery posthospitalization. AIMS This quality improvement project examines (1) the effectiveness of a safety planning group on an inpatient psychiatric unit for developing individualized safety plans, (2) the usefulness of the safety plans upon discharge, and (3) how helpful the patient found them. METHODS A standardized safety plan was presented during 1-hour groups on an adult inpatient unit. Completed safety plans scored using a rubric to determine how patients individualized the content. One week postdischarge, patients were contacted to determine location and use of the safety plan since discharge. RESULTS Patient’s ( n = 124) safety plans were relatively individualized when compared to the standardized safety plan (mean [ SD] = 32.85 [8.27] on a 44-point rating). Of those patients who were contacted postdischarge ( n = 76), 73 (96.1%) had a copy of their safety plan 1-week postdischarge while 28 (36.8%) reported using their safety plan since discharge. Many of the patients who used their safety plan reported that it was helpful ( n = 19; 67.9%). CONCLUSIONS Developing a safety plan can be a helpful tool for individuals admitted to a psychiatric inpatient unit.

Relationship between the risk of relapse and via of administration of treatment antipsychotic

2017 ◽  
Vol 41 (S1) ◽  
pp. S691-S691
Author(s):  
L.F. Laura ◽  
A. González Suárez ◽  
A. Alonso Huerta ◽  
S. Ocio León ◽  
M. Gómez Simon ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Oral Treatment ◽  
Psychiatric Inpatient ◽  
Protective Role ◽  
The Past ◽  
Psychiatric Inpatient Unit ◽  
Injectable Treatment ◽  
Competing Interest ◽  
One Year

IntroductionHe income hospital represents a rupture in the continuity of life of the patient. It would be advisable to determine those variables that help to reduce them. Some studies are running to a paper protector of the treatment injection in the relapses and number of hospitalizations.ObjectivesCompare the risk of decompensation, measured in terms of income hospital or consultations to emergency, between patients to treatment injection versus oral.Aims/methodsHe is a descriptive study which assesses the number of hospital admissions and consultations to emergency departments in the period of one year (between September 2015 and September 2016) of a sample of 28 patients registered as TMS and the results are compared with the type used for antipsicotivo treatment via.ResultsWe start from a sample of 28 patients, of which 17 are still a treatment intramuscular and 11 have all your guideline prescribed in oral. Patients injection treatment group needed to be admitted to a psychiatric inpatient unit at least on one occasionin the past year, 7 patients and 11 patients to oral treatment, only 2 patients wereadmitted and other 2 came once to your referral hospital emergency department.ConclusionsOf the 17 patients to treatment with injectable ingresason or needed care urgently a 41.18%, facing the 36.36% of those patients to treatment by via oral. These results do not have a protective role of injectable treatment compared with decompensation measures according to need hospitalization or urgent attention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Patterns of Long Acting Injectable Antipsychotic Prescription During Criminal Acts in a Portuguese Psychiatric Hospital

2016 ◽  
Vol 33 (S1) ◽  
pp. S458-S458
Author(s):  
M.A. Duarte ◽  
F. Vieira ◽  
A. Ponte
Keyword(s):  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
The United States ◽  
Security Measures ◽  
Court Records ◽  
Psychiatric Units ◽  
Icd 10 ◽  
History Of ◽  
Competing Interest ◽  
Long Acting

IntroductionUnder the Portuguese law, criminal offenders that are designated as non-criminal responsible – “inimputáveis”, similar those in the United States of America found “not guilty by reason of insanity”, are forced to be committed to inpatient forensic units either in psychiatric hospitals or prison hospitals for mandatory security measures.Objectives/aimsTo evaluate if patients committed in a regional forensic inpatient unit (RFIU) who had a psychiatric history preceding the crime, were under long acting injectable antipsychotic (LAIA) in during the period of the crime.MethodsDuring September/October 2015, patients committed to the RFIU in Centro Hospitalar Psiquiátrico de Lisboa were characterized using medical and court records regarding clinical and demographic variables. The type of crime and previous number of criminal acts were also accounted for.ResultsWe included 33 patients in the study. During time of the crime, 25 patients (75.8%) had history of previous psychiatric appointments, with an average of 3 commitments to the psychiatric inpatient units. The majority (n = 17; 68%) had a diagnose of “schizophrenia, schizotypal and delusional disorders” (F20–29; ICD 10) and committed “crimes against life” (n = 13; 52%). They had an average of 0.8 previous criminal acts. During the crime, 7 patients (28%) were taking LAIA. Those, 16% (n = 4) were doing an unknown antipsychotic and 12% (n = 3) were doing Haloperidol.ConclusionsDespite several studies showing the clinical and rehabilitative benefit of using LAIA early in the disease course, most of the patients in our study, who were already being followed in outpatient psychiatric units, did not benefit from them.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Changing Utilization of Pro Re Nata (‘As Needed’) Sedation in a Child and Adolescent Psychiatric Inpatient Unit

2009 ◽  
Vol 43 (4) ◽  
pp. 360-365 ◽  
Author(s):  
Angela J. Dean ◽  
Brett M. McDermott ◽  
James Scott
Keyword(s):  
Psychiatric Inpatient ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Child And Adolescent ◽  
Inpatient Unit ◽  
Inpatient Service ◽  
Psychiatric Inpatient Unit ◽  
High Utilization ◽  
Pro Re Nata ◽  
Over Time

Objective: The primary purpose of the present study was to examine changes in utilization of pro re nata (PRN; ‘as required’) sedation over time within a child and adolescent psychiatric inpatient unit. The secondary purpose was to assess whether changes in PRN sedation were related to changing patient characteristics. Methods: A retrospective chart review examined 257 medical charts from a child and youth mental health inpatient service over two time periods (wave I, n = 122; wave II, n = 135) and collected data on PRN sedation, patient characteristics and routine medications. Results: Over time a significant reduction was observed in the proportion of patients prescribed PRN sedation from 70% to 54% (p < 0.01), and a reduction in the proportion of patients given PRN sedation from 46% to 26% (p < 0.01). The most commonly administered drug was chlorpromazine in wave I, and diazepam in wave II. Multivariate analysis indicated that reductions in PRN sedation occurred independently of changes in patient characteristics. Conclusions: High utilization rates of PRN sedation are not inevitable in a child and adolescent psychiatric inpatient unit and may be reduced over time. Changing utilization of PRN sedation occurred independently from changing patient characteristics. More treatment outcome studies are required to optimize use of PRN sedation in young people.

scholarly journals Coping with information style and family burden: Possible roles of self-stigma and hope among parents of children in a psychiatric inpatient unit

2017 ◽  
Vol 42 ◽  
pp. 8-13 ◽  
Author(s):  
I. Hasson-Ohayon ◽  
G.H.M. Pijnenborg ◽  
A. Ben-Pazi ◽  
S. Taitel ◽  
G. Goldzweig
Keyword(s):  
Coping Styles ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Family Burden ◽  
Related Information ◽  
Psychiatric Inpatient Unit ◽  
The Family ◽  
Psychiatric Units ◽  
Negative Effect ◽  
The Relationship

AbstractObjectiveParents of children who are hospitalized in inpatient psychiatric units must cope with significant challenges. One of these challenges relates to the way in which they cope with illness-related information. The current study examined the relationship between two such coping styles – monitoring and blunting – and family burden among parents of children in a psychiatric inpatient unit. Moreover, the possible moderating roles played by hope and self-stigma in these associations were also examined.MethodsQuestionnaires regarding coping with information style, self-stigma, hope and family burden were administered to 70 parents.ResultsA main positive effect of hope and a main negative effect of self-stigma were uncovered. An interaction between self-stigma and monitoring was also revealed, suggesting that for parents with high self-stigma, compared to those with low self-stigma, more monitoring was related to more burden.ConclusionsTailoring family interventions according to coping style and self-stigma is highly recommended as a mean to reduce the family burden of parents whose child is hospitalized in a psychiatric inpatient unit.

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