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Where do we draw the line on providing a ‘home from home’ environment on a PICU?

Published online by Cambridge University Press:  28 March 2012

Catherine Adams ,
Maja Lazarevic ,
Emily Simon Thomas  and
John Lowe
Catherine Adams*
Affiliation:
Central and North West London NHS Foundation Trust (CNWL), UK
Maja Lazarevic
Affiliation:
Central and North West London NHS Foundation Trust (CNWL), UK
Emily Simon Thomas
Affiliation:
Central and North West London NHS Foundation Trust (CNWL), UK
John Lowe
Affiliation:
Central and North West London NHS Foundation Trust (CNWL), UK
*
Correspondence to: Catherine Adams, E-mail: Cassie_adams@hotmail.com
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Abstract

Background: A proposal to introduce metal cutlery onto a PICU in order to create a more homely environment prompted staff concerns about safety.

Aims: Based on the premise that past behaviour is a strong predictor of future behaviour, we undertook a pilot audit of history of weapon use as a measure to guide decision making on weapons security on our PICU.

Methods: Retrospective case note audit of 30 PICU patients to determine historical rates of weapon use. Secondary measures included level and type of weapon use, and mental disorder. 30 ‘non PICU pathway’ general ward patients were sampled as a ‘control’.

Results: 19/30 patients on the PICU had a history of weapon use, compared to 7/30 on the general ward. There were 23 recorded incidents in the PICU sample and 7 on the general ward.

Conclusions: The majority of the PICU sample had a history of weapon use, often recent, including improvised and bladed weapons, at times of acute disturbance and non-compliance with medications. Comparison with the non-PICU group indicates that the measure had good construct validity as rates in this group were significantly lower. Therefore history of weapon use could be a useful measure in guiding decision making about security protocols on PICU, however, further research is required.

Keywords

Inpatient psychiatryweapon useward environmentsafety
Type
Review Article
Information
Journal of Psychiatric Intensive Care , Volume 8 , Issue 2 , August 2012 , pp. 126 - 133
Copyright
Copyright © NAPICU 2012

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