scholarly journals Developing A Hospital Specific and Evidence-Based Management Protocol for Pregnancies of Unknown Location and Ectopic Pregnancies: A Retrospective Chart Review and Quality Improvement Project

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Elena Siani ◽  
Roberto Levi D'Ancona ◽  
Rachel Nelson Rigg ◽  
Pallavi Khanna
Author(s):  
Darren Savarimuthu ◽  
Katja Jung

Background/aims This article describes a quality improvement project that aimed to reduce restrictive interventions on an acute psychiatric ward. In light of a service level agreement and based on a trust-wide target, the purpose of the project was to reduce restrictive interventions by 20% within a period of 6 months. It was also anticipated that a least restrictive environment could have a positive impact on patient experience. Methods Three evidence-based interventions were introduced to the ward during the quality improvement project. These included positive behaviour support, the Safewards model and the productive ward initiative. Results There was a 63% reduction in restrictive interventions over a 6-month period through the successful implementation of a series of evidence-based interventions to manage behaviours that challenge on the mental health ward. Conclusions The project identified collaborative team working, staff training and adequate resources as essential elements in the success of the quality improvement initiative. However, co-production was found to be crucially significant in bringing sustainable changes in ward environment and in addressing restrictive practices.


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.


2019 ◽  
Vol 6 (4) ◽  
pp. 352-361
Author(s):  
Anne Maria Eskes ◽  
Anne Marthe Schreuder ◽  
Hester Vermeulen ◽  
Els Jacqueline Maria Nieveen van Dijkum ◽  
Wendy Chaboyer

2006 ◽  
Vol 32 (9) ◽  
pp. 517-527 ◽  
Author(s):  
Stacey Stoeckle-Roberts ◽  
Mathew J. Reeves ◽  
Bradley S. Jacobs ◽  
Kate Maddox ◽  
Lisa Choate ◽  
...  

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