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Management of violent behaviour and rapid tranquillisation during acute psychotic episode: discrepancy between routine practice and evidence. The SIEP-DIRECT's Project

Published online by Cambridge University Press:  11 April 2011

Antonio Lora*
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera di Vimercate, Vimercate (Milano)
Carla Morganti
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera Niguarda, Ca' Granda (Milano)
Arcadio Erlicher
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera Niguarda, Ca' Granda (Milano)
Lorenzo Burti
Affiliation:
Sezione di Psichiatria e di Psicologia Clinica, Università di Verona, Verona
Giacinto Buscaglia
Affiliation:
Dipartimento di Salute Mentale, Azienda Sanitaria Locale Savona, Savona
Marco Pegoraro
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera di Crema, Crema
Jacchetti Davide
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera di Crema, Crema
Doriana Cristofalo
Affiliation:
Sezione di Psichiatria e di Psicologia Clinica, Università di Verona, Verona
Mirella Ruggeri
Affiliation:
Sezione di Psichiatria e di Psicologia Clinica, Università di Verona, Verona
Domenico Semisa
Affiliation:
Dipartimento Salute Mentale ASL Provinciale di Bari, Centro di Salute Mentale Acquaviva delle Fonti (Bari)
*
Address fo correspondence: Dr. A. Lora, Dipartimento di Salute Mentale, Azienda Ospedaliera di Vimercate (Milano), Servizio Psichiatrico di Diagnosi e Cura, Presidio di Desio, Via Mazzini 1, 20033 Desio (Milano). Fax: +39-0362-383.865 E-mail: antoniolora@virgilio.it

Summary

Aims – To evaluate the quality of acute psychiatric care concerning the management of violent behaviour and rapid tran-quilization. Methods – Data concerning 13 indicators, drawn from NICE recommendations, were collected in 19 Departments of Mental Health, in the frame of the SIEP-DIRECT's Project, to evaluate the implementation of NICE recommendations in Italian Mental Health Services. Results – In about two thirds of Departments of Mental Health (DMHs) professionals were trained in the management of violent behaviour, while written procedures existed only in one fourth of DMHs. About a half of the professionals working in Psychiatric Wards in General Hospital were trained in rapid tranquilization, while procedures on this topic are practically absent and specific care for monitoring intensively the heavily sedated patient was not frequent. Conclusions – Management of violent behaviour and rapid tranquilization are two critical areas in the care performed by Psychiatric Wards in General Hospital. Training on these topics is more frequent than implementation of procedures. NICE recommendations and SIEP indicators are useful tools for improving the quality of acute psychiatric care.

Declaration of Interest: None.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2008

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References

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