scholarly journals The impact of COVID-19 on an inpatient mother and baby unit: a service evaluation

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S316-S316
Author(s):  
Joanna Cranshaw ◽  
Gertrude Seneviratne ◽  
Ranga Rao ◽  
Julia Ogunmuyiwa ◽  
Rebecca McMillin ◽  
...  
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Social Services ◽  
Unit Length ◽  
Perinatal Period ◽  
Service Evaluation ◽  
Psychotic Illness ◽  
Mental Health Act ◽  
Mother And Baby Unit ◽  
The Impact

AimsUnique challenges have been faced by women in the perinatal period during the COVID-19 pandemic and the impact of this is compounded for women suffering from mental illness. This service evaluation looked at different aspects of the treatment pathway on a specialist inpatient psychiatric Mother and Baby Unit during the pandemic to identify what changes occurred.MethodData were collected for all admissions to the unit between January 2019 and October 2020, with the beginning of the pandemic being defined as on or after 1st March 2020. Information was collected retrospectively from electronic clinical notes on ethnicity, length of stay, diagnosis, mental health act use and restrictive practice, medication, psychology, occupational therapy and social services involvement.ResultThere were 114 admissions to the MBU during the study period. 4 were parenting assessments rather than acute psychiatric admissions and were excluded from the analysis, giving a sample of 110 women. 58% (62/110) were classed as “pre-pandemic” and 43.6% (48/110) were “during pandemic”. 95.45% (105/110) of women were postpartum 4.55% (5/110) were pregnant. Mean length of stay was shorter during the pandemic at 44 days, compared to 61 pre-pandemic. There was greater use of the mental health act during the pandemic: only 43.75% of patients were informal throughout admission, compared to 70.97% pre-pandemic. Mean duration of detention was shorter at 25 days (32 pre-pandemic). Psychotic illness made up a greater proportion of diagnoses during the pandemic: 56% (27/48) compared to 44% (27/62) pre-pandemic. The next most common diagnostic group was mood and anxiety disorders, which made up 29% (14/48) of diagnoses during the pandemic, but 43% (27/62) pre-pandemic. Outcomes as measured using the Health of the Nation Outcome Scale showed a mean improvement between admission and discharge of 6.65, compared to 5.15 pre-pandemic. HONOS scores were higher on admission during the pandemic (12.83, vs 10.88), suggesting a higher level of acuity.ConclusionDuring the COVID-19 pandemic on this Mother and Baby Unit, length of stay was shorter, a greater proportion of patients were detained under the mental health act (although length of detention was shorter) and psychotic illness was more prevalent. This study demonstrates that there were differences in this perinatal inpatient population during the pandemic and this may be a reflection on the wider impact of COVID-19 on perinatal mental health.

The impact of medical interventions on admission characteristics in children with congenital heart disease and cardiomyopathy

2020 ◽  
pp. 1-8
Author(s):  
Rohit S. Loomba ◽  
Jacqueline Rausa ◽  
Vincent Dorsey ◽  
Ronald A. Bronicki ◽  
Enrique G. Villarreal ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Length Of Stay ◽  
Congenital Heart ◽  
Unit Length ◽  
Channel Blockers ◽  
Regression Analyses ◽  
Converting Enzyme Inhibitors ◽  
Medical Interventions ◽  
The Impact

Abstract Introduction: Children with congenital heart disease and cardiomyopathy are a unique patient population. Different therapies continue to be introduced with large practice variability and questionable outcomes. The purpose of this study is to determine the impact of various medications on intensive care unit length of stay, total length of stay, billed charges, and mortality for admissions with congenital heart disease and cardiomyopathy. Materials and methods: We identified admissions of paediatric patients with cardiomyopathy using the Pediatric Health Information System database. The admissions were then separated into two groups: those with and without inpatient mortality. Univariate analyses were conducted between the groups and the significant variables were entered as independent variables into the regression analyses. Results: A total of 10,376 admissions were included these analyses. Of these, 904 (8.7%) experienced mortality. Comparing patients who experienced mortality with those who did not, there was increased rate of acute kidney injury with an odds ratio (OR) of 5.0 [95% confidence interval (CI) 4.3 to 5.8, p < 0.01], cardiac arrest with an OR 7.5 (95% CI 6.3 to 9.0, p < 0.01), and heart transplant with an OR 0.3 (95% CI 0.2 to 0.4, p < 0.01). The medical interventions with benefit for all endpoints after multivariate regression analyses in this cohort are methylprednisolone, captopril, enalapril, furosemide, and amlodipine. Conclusions: Diuretics, steroids, angiotensin-converting enzyme inhibitors, calcium channel blockers, and beta blockers all appear to offer beneficial effects in paediatric cardiomyopathy admission outcomes. Specific agents within each group have varying effects.

The impact on clinical practice of the 2015 reforms to the New South Wales Mental Health Act

2016 ◽  
Vol 25 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Christopher James Ryan ◽  
Sascha Callaghan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Practice ◽  
Persons With Disabilities ◽  
Mental Health Act ◽  
Recovery Movement ◽  
South Wales ◽  
Management Plans ◽  
Decision Making Model ◽  
The Impact

Objectives: The Mental Health Act 2007 (NSW) ( MHA) was recently reformed in light of the recovery movement and the United Nations Convention on the Rights of Persons with Disabilities. We analyse the changes and describe the impact that these reforms should have upon clinical practice. Conclusions: The principles of care and treatment added to the MHA place a strong onus on clinicians to monitor patients’ decision-making capacity, institute a supported decision-making model and obtain consent to any treatment proposed. Patients competently refusing treatment should only be subject to involuntary treatment in extraordinary circumstances. Even when patients incompetently refuse treatment, clinicians must make every effort reasonably practicable to tailor management plans to take account of any views and preferences expressed by them or made known via friends, family or advance statements.

scholarly journals The Use of Procalcitonin as a Sepsis Marker in a Community Hospital

2019 ◽  
Vol 3 (4) ◽  
pp. 545-552
Author(s):  
Nathalia De Oro ◽  
Maria E Gauthreaux ◽  
Julie Lamoureux ◽  
Joseph Scott
Keyword(s):  
Lactic Acid ◽  
Length Of Stay ◽  
Community Hospital ◽  
Unit Length ◽  
Hospital Setting ◽  
Control Group ◽  
Before And After ◽  
Quasi Experimental ◽  
Current Cutoff ◽  
The Impact

Abstract Background Procalcitonin (PCT) is a biomarker that shows good sensitivity and specificity in identifying septic patients. Methods This study investigated the diagnostic accuracy of PCT in a community hospital setting and how it compared to that of lactic acid. It explored the impact on patient care before and after PCT implementation regarding costs and length of stay. Two comparative groups were analyzed using an exploratory descriptive case–control study with data from a 19-month period after PCT implementation and a retrospective quasi-experimental study using a control group of emergency department patients diagnosed with sepsis using data before PCT implementation. Results Post-procalcitonin implementation samples included 165 cases and pre-procalcitonin implementation sample included 69 cases. From the 165 sepsis cases who had positive blood cultures, PCT had a sensitivity of 89.7%. In comparison, lactic acid's sensitivity at the current cutoff of 18.02 mg/dL (2.0 mmol/L) was 64.9%. There was a 32% decrease in median cost before and after PCT implementation, even with the length of stay remaining at 5 days in both time periods. Conclusions There was a significant decrease after the implementation of PCT in cost of hospitalization compared to costs before implementation. This cost is highly correlated with length of stay; neither the hospital nor the intensive care unit length of stay showed a difference with before and after implementation. There was a positive correlation between lactic acid and PCT values. PCT values had a higher predictive usefulness than the lactic acid values.

scholarly journals The Impact of the Sars Cov-2 Pandemic on the Mental Health and Well-Being of Seniors in Social Care Facilities

2021 ◽  
Vol 12 (3) ◽  
pp. 104-110
Author(s):  
Z. Budayova ◽  
L. Ludvigh Cintulova
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Research Study ◽  
Social Care ◽  
Well Being ◽  
Structured Interviews ◽  
Care Facilities ◽  
Open Coding ◽  
The Impact ◽  
Health And Well Being

The research study analyses the effects of the Covid-19 pandemic and identifies changes in the life satisfaction of seniors in social services facilities. The research sample consisted of 79 seniors in social services facilities, the sample consisted of ten participants, data collection took place in the period from November 2020 to April 2021, where the method of qualitative research was used in empirical research, through semi-structured interviews to determine the impact of Covid-19 on We collected the data collected by open coding and pointed to those dimensions of the lives of seniors that were most marked by pandemic measures against the spread of Covid-19.

scholarly journals Aftercare: who attends section 117 meetings?

1995 ◽  
Vol 19 (2) ◽  
pp. 106-107
Author(s):  
Rosemary Lethem
Keyword(s):  
Mental Health ◽  
Nursing Home ◽  
Patient Care ◽  
Social Services ◽  
Local Health ◽  
Hospital Department ◽  
Health And Social Services ◽  
Mental Health Act ◽  
Department Of Health ◽  
Legal Duty

The purpose of aftercare is to enable patients to return to their home or accommodation other than a hospital or nursing home, and to minimse the need for future in-patient care. Under section 117 of the Mental Health Act 1983, local health and social services authorities have a legal duty to provide aftercare for certain categories of patients when they leave hospital (Department of Health and Welsh Office, 1993).

scholarly journals The impact of first COVID-19 peak on patient referrals to Liaison Psychiatry Service and staff perception about service provision in Birmingham and Solihull Mental Health Trust Birmingham - a service evaluation project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S329-S329
Author(s):  
Saima Jehanzeb ◽  
Muhammad Suleman ◽  
Ella Tumelty ◽  
Joanne Okusanya ◽  
Laxsan Karunanithy ◽  
...  
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Quantitative Methods ◽  
Service Evaluation ◽  
Psychotic Symptoms ◽  
Healthcare Provision ◽  
Liaison Psychiatry ◽  
Clinical Databases ◽  
The Impact ◽  
Health Trust

AimsBased on recommendations from the Royal College of Psychiatrists, this project aimed to evaluate the impact of the first peak of the COVID-19 pandemic on referral patterns to the Queen Elizabeth Hospital Birmingham (QEHB) Liaison Psychiatry (LP) service. Additionally, we aimed to explore staff experiences in LP services across Birmingham and Solihull Mental Health Trust (BSMHFT) in order to generate Trust recommendations promoting optimal healthcare provision amidst the on-going pandemic.MethodA mixed method service evaluation was conducted using quantitative and qualitative analysis. Quantitative methods involved reviewing referrals made to the QEHB LP service from March to June 2020, compared with the equivalent time period in 2019. Data were retrospectively extracted from the electronic clinical databases RIO and PICS, and subsequently analysed using Microsoft Office. The number of, and reasons for referrals to LP were identified, whilst focus groups were conducted to explore the subjective experiences of staff working across BSMHFT LP services.ResultBetween 1st March and 30th June 2020, 984 referrals were made to the QEHB LP service, compared to 1020 referrals in 2019, representing a 3.5% reduction. From 2019 to 2020, referrals due to psychotic symptoms and deliberate self-harm rose by 12.8% and 14.1% respectively, whilst referrals for drug and alcohol-related causes reduced by 28.3%. A significant increase (150%) in referrals for medication or management advice was seen. Focus groups indicated that staff perceived an initial reduction in number of referrals, but an increase in the acuity of patient presentations.Staff reported anxiety around contracting and transmitting SARS-Cov-2, exacerbated by uncertainty around patients’ COVID-19 status. In QEHB, sixty-five of the 984 referrals (7%) had a positive SARS-Cov-2 PCR swab, with the remaining 919 referrals being either negative (68%) or unknown (25%). Ninety-six percent of consultations were conducted face-to-face in QEHB. There were conflicting views amongst staff regarding whether more consultations could have been conducted remotely. Furthermore, varying perceptions of support and communication from both the physical and mental health trust were reported.ConclusionQuantitative data indicates that COVID-19 impacted LP healthcare provision in BSMHFT. Whilst referral numbers remained similar between the equivalent period in 2019 and 2020, a change in the nature of referrals to LP at QEHB was seen. This was corroborated by qualitative data which highlighted a perceived change in acuity of referrals. These findings have been disseminated across the Trust and subsequent recommendations are being implemented during the on-going pandemic.

Introduction

2017 ◽  
Author(s):  
David Bolton
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Social Services ◽  
Social Worker ◽  
Well Being ◽  
Conflict Processes ◽  
Post Conflict ◽  
Personal Experiences ◽  
The Impact ◽  
Health And Well Being

In the Introduction, the author describes the background to the book and his personal experiences of violence in Northern Ireland - as a social worker and health and social services manager in Enniskillen and Omagh. He addresses the impact of loss and trauma linked to conflict and the implications for mental health and well-being. The structure of the book is outlined and the author sets the rest of the book in the argument that the mental health of conflict affected communities should be an early and key consideration in peace talks, politics and post-conflict processes.

scholarly journals Confidentiality and security of clinical information in mental health practice

2002 ◽  
Vol 8 (4) ◽  
pp. 291-296 ◽  
Author(s):  
Roy McClelland ◽  
Victoria Thomas
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Information And Communication Technologies ◽  
New Technologies ◽  
Personal Information ◽  
Health Sector ◽  
Clinical Information ◽  
Health Care Organisation ◽  
Good Communication ◽  
The Impact

‘Security holds the key’ was the title of a newspaper article concerned with e-commerce (D. Sumner-Smith, The Sunday Times, 6 February, 2000, p. 3.13). However, it applies just as readily to the health sector. The need to safeguard the confidentiality of information that patients share with clinicians is as fundamental as the principle of consent. This issue has come to the fore in the context of the rapid developments and applications of information and communication technologies within society in general and within the health sector in particular. There are also changing societal expectations regarding access to information, confidentiality and disclosure. The emerging scenarios present significant challenges in relation to the traditional methods used to deal with the privacy and confidentiality of personal information (Anderson, 1995). In addition to the impact of new technologies, consideration also needs to be given to the impact of changes in health care organisation and practice, for example multidisciplinary and multi-agency working. Mental health services are in many respects at the vanguard of these changes, where the ideals of community care, shared care and seamless care depend fundamentally on good communication and information sharing. Failures in communicating information, particularly across sectoral boundaries, have led to significant problems in patient care, as revealed in several recent enquiries into homicides (Northamptonshire Health Authority & Northamptonshire Social Services, 1999)

An Objective Study of the Impact of the Electronic Medical Record on Outcomes in Trauma Patients

2012 ◽  
Vol 78 (11) ◽  
pp. 1249-1254 ◽  
Author(s):  
Paul J. Schenarts ◽  
Claudia E. Goettler ◽  
Michael A. White ◽  
Brett H. Waibel
Keyword(s):  
Length Of Stay ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Injury Severity ◽  
Unit Length ◽  
Traumatic Injury ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Delay In Diagnosis ◽  
The Impact

It is commonly believed that the electronic medical record (EMR) will improve patient outcomes. However, there is scant published literature to support this claim and no studies in any surgical population. Our hypothesis was that the EMR would not improve objective outcome measures in patients with traumatic injury. Prospectively collected data from our university-based Level I trauma center was retrospectively reviewed. Demographic, injury severity as well as outcomes and complications data were compared for all patients admitted over a 20-month period before introduction of the EMR and a 20-month period after full, hospital-wide use of the EMR. Implementation of the EMR was associated with a decreased hospital length of stay, P = 0.02; intensive care unit length of stay, P = 0.001; ventilator days, P = 0.002; acute respiratory distress syndrome, P = 0.006, pneumonia, P = 0.008; myocardial infarction, P = 0.001; line infection, P = 0.03; septicemia, P = 0.000; renal failure, P = 0.000; drug complication, P = 0.001; and delay in diagnosis, P = 0.04. There was no difference in mortality, unexpected cardiac arrest, missed injury, pulmonary embolism/deep vein thrombosis, or late urinary tract infection. This is the first study to investigate the impact of the EMR in surgical patients. Although there was an improvement in some complications, the overall impact was inconsistent.

The frequency of references to decision-making capacity in reports to the NSW Mental Health Review Tribunal did not change after legislative reforms that promoted them

2020 ◽  
Vol 28 (2) ◽  
pp. 171-174
Author(s):  
Tim Foley ◽  
Christopher J Ryan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Education Campaign ◽  
Mental Health Act ◽  
Decision Making Capacity ◽  
Before And After ◽  
Legislative Reforms ◽  
The Impact ◽  
Health Review

Objective: To assess the impact of a 2015 reform to the Mental Health Act 2007 (NSW) ( MHA) that was interpreted as requiring a reference to decision-making capacity (DMC) in reports to the NSW Mental Health Review Tribunal (MHRT). Method: A sample of reports to the MHRT were audited for references to the MHA’s treatment criteria and DMC in periods before and after the reforms, and the frequency of references between the two periods was compared. Results: The frequency of references to DMC did not change significantly after the reforms. (However, references to the ‘least restriction’ criterion increased markedly between the two periods). Conclusion: Despite legislative reforms and a supporting education campaign promoting the importance of consideration of DMC, references to DMC did not increase after the reforms.

Sign in / Sign up

Export Citation Format

Share Document