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Assessment of physical monitoring following rapid tranquillisation: a national survey

Published online by Cambridge University Press:  22 November 2012

Benjamin Loynes ,
James Innes  and
Stephen Dye
Benjamin Loynes
Affiliation:
CT3 Psychiatry, South London and Maudsley Trust, Maudsley Hospital, UK
James Innes*
Affiliation:
Deputy Chief Pharmacist, East London NHS Foundation Trust, Mile End Hospital, London, UK
Stephen Dye
Affiliation:
Consultant In-Patient Psychiatrist, Norfolk and Suffolk NHS Foundation Trust, Ipswich Hospital Site, UK
*
Correspondence to: James Innes, East London NHS Foundation Trust, Pharmacy Department, Mile End Hospital, Bancroft Rd, London E1 4DG. E-mail: james.innes@eastlondon.nhs.uk
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Abstract

Background

Rapid tranquillisation (RT) is a high risk clinical intervention in terms of potential physical health complications. There has been no published work in the UK to survey nationally whether standards for post RT physical monitoring (as set out in organisation's RT documents) are being adequately audited.

Aim

To review current auditing of RT practice in England, with particular emphasis on examination of post RT physical monitoring.

Method

A scrutiny of evidence provided by English NHS mental health trusts to illustrate auditing of adult RT documents.

Results

Fifty-eight mental health trusts in England were contacted. Less than one-third could provide evidence of an audit of post RT physical health monitoring. These audits were variable with respect to what aspect of physical health monitoring they focused on. When results of all audits were combined, it revealed a concerning finding that basic physical observations and investigations were not performed consistently following RT.

Conclusions and Implications for Clinical Practice

The current paucity of trust audits of post RT physical monitoring and the poor practice observed in those audits could reflect a lack of clarity in both trust and national guidelines, as well as poor clinical practice. Given the risks to a patient's physical health associated with RT it is essential to ensure high quality care in this area.

Keywords

Rapid tranquillisationphysical health monitoringaudit
Type
Original Research Article
Information
Journal of Psychiatric Intensive Care , Volume 9 , Issue 2 , August 2013 , pp. 85 - 90
Copyright
Copyright © NAPICU 2012 

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References

Health and Safety Executive (2006) Violence and Aggression Management Training for Trainers and Managers: A national evaluation of the training provision in healthcare settings. Research Report 440. London: HMSO.Google Scholar
Innes, J., Iyeke, L. (2011) A review of the practice and position of monitoring in today's rapid tranquillisation protocols. Journal of Psychiatric Intensive Care. 8: 15–24.CrossRefGoogle Scholar
Joint Committee on Human Rights (2004) Joint Committee on Human Rights Third Report. House of Lords and House of Commons. HL 15-I/HC 137-I. http://www.publications.parliament.uk/pa/jt200405/jtselect/jtrights/15/1502.htmGoogle Scholar
MacPherson, R., Dix, R., Morgan, S. (2005) A growing evidence base for management guidelines. Revisiting guidelines for management of acutely disturbed psychiatric patients. Advances in Psychiatric Treatment. 11: 404–415.Google Scholar
National Institute for Clinical Excellence (2002) Principles for Best Practice in Clinical Audit. Radcliffe Medical Press, 206pp. http://www.nice.org.uk/media/796/23/BestPracticeClinicalAudit.pdfGoogle Scholar
National Institute for Clinical Excellence (2005) Violence: The short term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments. Clinical Guideline 25. NICE. http://guidance.nice.org.uk/CG25/Guidance/pdf/EnglishGoogle Scholar
National Institute for Mental Health in England (2004) Mental Health Policy Implementation Guide: Developing positive practice to support the safe and therapeutic management of aggression and violence in mental health in-patient settings. NIMHE.Google Scholar
Dale, C., O'Hare, G., Rae, M. (2006) The NIMHE/NPSA Project on the Prevention and Management of Violence in Mental Health Services Final Report. NIMHE/NPSA. http://its-services.org.uk/silo/files/report-on-the-prevention-and-management-of-aggression-and-violence.pdfGoogle Scholar
Police Complaints Authority (2002) Safer Restraint: Report of the conference held in April 2002 at Church House, Westminster. London: PCA. http://webarchive.nationalarchives.gov.uk/20100908152737/ipcc.gov.uk/safer_restraint_june2003.pdfGoogle Scholar
Parker, C., Khwaja, M. (2011) What is new in rapid tranquillisation? Journal of Psychiatric Intensive Care. 7(2): 91–101.Google Scholar
Royal College of Psychiatrists (2006) Consensus Statement on High-Dose Antipsychotic Medication. Council Report 138. London: Royal College of Psychiatrists.Google Scholar
Taylor, D., Paton, C., Kapur, S. (2012) The Maudsley Prescribing Guidelines in Psychiatry, 11th ed. Wiley-Blackwell.Google Scholar