Audit of the Rapid Tranquilization Policy in the 2gether NHS Foundation Trust

Abstract

Rapid tranquilization (RT) is a procedure used in an inpatient setting to deal with acute behavioural disturbance not manageable by other means. The ²gether NHS Foundation Trust has an RT policy which incorporates the National Institute of Clinical Excellence (NICE) guidance on best practice which breaks down into eight domains.

The aim of this audit was to scrutinize practice in relation to this policy.

The audit team sampled 50 Prevention and Management of Violence and Aggression (PMVA) incidents that occurred over a four month period at Wotton Lawn Hospital and the Montpellier Low Secure Unit in Gloucester. PMVA is a method of organized restraint involving a team of three staff used to administer parenteral RT as well as managing disturbance. Data was collected using an audit proforma.

This audit demonstrated adherence to the majority of standards in the RT policy in most incidents. However, there was a significant non-compliance in two areas: appropriate physical observations being carried out after an RT incident and administration of RT in a private area. It may be that standards were in fact met but that there was no evidence for this in the documents examined.

The authors believe that clinical practice can be improved by effective training of staff that emphasizes the need to meet standards and the importance of contemporaneous documentation following an RT incident. They have disseminated the results of this audit to appropriate clinical leads and trainers.

The audit will be repeated in 12 months’ time.