QI Project Improves Safer Psychiatric Physical Health and Informed Prescribing

Dr Bjørn Varder (CT1 Psychiatry), Emma Livesey (Advance Clinical Practitioner), Dr Sally Arnold (Consultant Perinatal Psychiatrist).

Further improvements to the physical health board to make it more comprehensive with colour coding to improve physical health investigations further. .

Re-audit and review

Physical health review should be undertaken within 24 hours

Pre-intervention: 75% had a physical assessment within 6 hours of admission, 10% within 24 hours, and 15% with no assessment. Post implementation: All but 1 had a physical health assessment done within 6 hours of admission and the remaining 1 had an assessment done with 24 hours.

Recognising the importance of physical health and how we needed to improve.

Pre-audit, and implementation of a physical health board to recognise what interventions are needed.

ECG investigation

Pre-implementation: 15 patients had an ECG completed, 3 not completed and 1 patient who declined.

Post implementation: All patients had an ECG completed.

Blood monitoring for patients on antipsychotics.

Antipsychotic monitoring ensures safe prescribing. Data post intervention showed further scope for improvement, and now on the board there is a list of which blood tests required for antipsychotic monitoring

Contraception

All patient should have contraception discussed before discharge.

Pre-implementation 55% had a discussion regarding contraception.

Post-implementation: 85% had a discussion around contraception. Reason for not discussing was due to the patient being too psychiatrically unwell to engage. The board then changed to reflect discussions and contraception being in place.

Green (on contraception)

Yellow (discussion about contraception has taken place, but not on contraception yet)

Red (contraception discussion needed).

Contraception

Discussed During Admission? (PreIntervention)