Management of self-harming patients in an acute psychiatric ward

Abstract

Aims: This audit compared the current management of self-harming patients, admitted to Aston ward, Lister Hospital Mental Health Unit, Stevenage, with the National Institute of Clinical Excellence(NICE) Clinical Guidelines(CG)16 published 07-2004 on: The short term physical and psychological management and secondary prevention of selfharm in primary and secondary care. Methods: Data was collected retrospectively from the Hertfordshire Partnership Trust computerised care notes for a period of three months from 08-09- 2008 to 08-12- 2008. Questionnaires were given to service users on admission to Aston ward (from 11-12- 2008 to 11-02-2009), and at the same time to ward staff. Results: There were four standards derived from the above NICE Guidelines (CG16).i Questionnaires were given to staff on the ward including doctors, however all the respondents were nurses- 14/ 26 nurses. 5/ 10 service users on admission with self – harming behaviour responded. 78 service users admitted with history of self –harming behaviour three months prior to the audit had all their clinical entries examined retrospectively. 73 / 78 service users had a comprehensive assessment from healthcare professionals. 14/14 nurses stated they were respectful and understanding to service users but one service user disagreed on this standard. 9 of the nurses had in-house training but none had formal training; 40% of the service users were not happy with the quality of information about treatment options. Conclusions: The audit revealed that the current management of service users with self-harming history falls short of the NICE Guidelines (CG16). Therefore, the conclusion of this comparison is that there is a need for service improvement. Recommendations. All nurses, doctors and relevant healthcare professionals should receive adequate training in the short term physical and psychological management and secondary prevention of self harm in primary and secondary care. A re-audit will be done in 12 months.