Published online by Cambridge University Press: 02 January 2018
This audit is relevant to in-patient settings and can be modified according to local guidelines and patient groups.
Appropriate clinical investigations and blood tests form part of the work-up for many in-patient admissions. In particular, they are used to ascertain the role that medical conditions may play in a patient's presentation. They also serve as baseline investigations for the prescription of psychotropic medication and for monitoring physical parameters thereafter. The availability of venepuncture equipment on psychiatric wards is important in the investigation and treatment of patients on psychiatric wards.
The following standards were obtained from Physical Health in Mental Health (Royal College of Psychiatrists, 2009) and the Royal Marsden Manual of Clinical Nursing Procedures (Dougherty & Lister, 2008):
ᐅ Appropriate physical investigations should be completed during the first week of admission.
ᐅ The venepuncture equipment listed below must be available and accessible on each ward, maintained in working order:
▹ blood specimen bottles
▹ blood test request forms
▹ alcohol swab
▹ needle and syringe or vacuum system
▹ adhesive plaster
▹ sharps bin.
The target is that these standards are met for all patients and for all psychiatric wards.
The medical notes of patients on a given psychiatric ward were examined to determine whether appropriate physical investigations had been carried out within the recommended time frame.
The clinical rooms of each ward were inspected for the availability of each of the items of equipment required for venepuncture, and whether these items were in working order
The following were determined for each ward: the percentage of patients receiving appropriate physical investigations ᐅ within the recommended time frame
ᐅ whether all appropriate equipment for venepuncture was available
ᐅ whether all equipment was in good working order.
This audit was carried out by a single person, but might require the help of additional people to audit wards on different sites.
Two hours of data collection was required for a ward of 25 patients. The majority of this time was needed to gather information about investigations in the medical notes.