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An audit of the use of advance statements surrounding management of disturbed behaviour on a PICU

Published online by Cambridge University Press:  01 September 2010

Stephen Dye
Stephen Dye*
Affiliation:
Consultant Psychiatrist, Suffolk Mental Health Partnership NHS Trust
*
Correspondence to: Dr Stephen Dye, St Clements Hospital, Foxhall Rd, Ipswich, Suffolk, UK, IP3 8LS. E-mail: stephen.dye@smhp.nhs.uk
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Abstract

Background: PICUs traditionally manage patients who can display disturbed behaviour. Recent guidance has advocated patient engagement in outlining preferences regarding management strategies should they display such behaviour.

Aim: To audit the use, within one PICU, of a mechanism that formally records individual patient preference in management of episodes of acute disturbed behaviour.

Method: Two sets of fifteen retrospective case note analyses in an audit cycle.

Results: Initial findings revealed that advance statements were completed by eight of the fifteen patients admitted (53%). Patients’ wishes were followed for two thirds of patients following incidents needing interventions. Following changes to practice, although only minimal improvement occurred in patients completing advance statements, they were completed sooner after admission and, despite more incidents needing interventions, patients’ wishes following episodes of disturbed behaviour were followed in two thirds of those who completed an advance statement.

Conclusion: Use of advance statements regarding management of disturbed behaviour can be introduced in PICUs and this should be advocated.

Keywords

Advance statementdisturbed behaviourPICUNICE guidelinesseclusionrestraint
Type
Original Article
Information
Journal of Psychiatric Intensive Care , Volume 7 , Issue 1 , June 2011 , pp. 27 - 33
Copyright
Copyright © NAPICU 2011

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