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The physical health of residents of long-stay wards in Carlow/Kilkenny

Published online by Cambridge University Press:  13 June 2014

Itoro Udo  and
Mary Mooney
Itoro Udo*
Affiliation:
Liaison Psychiatry, Roseberry Park Hospital, Middlesbrough, UK
Mary Mooney
Affiliation:
St. John of God Hospital, Stillorgan, Dublin. Formerly Clinical Director, Carlow/Kilkenny Mental Health Service, Ireland
*
*Correspondence E-mail: itoroime.udo@tewv.nhs.uk
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Abstract

Objectives: This audit is supported by regulations within the Mental Health Act 2001. It is in response to the Mental Health Commission Strategic Priority Number One, Quality Framework, 2002-2008 which aims to promote high standards of physical examination in the care of long-stay residents of psychiatric facilities. It is based on improved awareness of adverse effects of mental illness or its treatment on physical health. This awareness informs better practice.

Method: Physical examination proforma and case notes of all long-stay residents in wards in Carlow and Kilkenny were assessed over a six month period to examine the quality of physical examination. Following departmental meetings and literature review, standards of care as recommended by the Royal College of Psychiatrists in Occasional Paper 67 and Irish statutory documents were agreed to be the appropriate benchmark.

Results: Areas of strength were the examination of ‘routine’ systems (> 92%), ie. cardiovascular, respiratory, alimentary, central nervous, genitourinary and the frequency of clinical review by treating psychiatric team. Areas needing improvement were eye (8%) and ear (3%) examinations, measurements of weight (58%), height (1.6%), body mass index (1.6%), waist circumference (0%), investigating for prostatic specific antigen (50%), discussion of results of physical examination and investigations with the residents (both 0%) and referral to BreastCheck (36%).

Conclusion: A new physical examination form has been created for long-stay residents to correct these deficiencies and a new departmental policy document setting out a standard of practice consistent with recommended practice and general statutory requirements has been put into place.

Keywords

Physical healthLong-stay residentsA Vision for ChangeHSE Transformation Programme
Type
Audit
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 4 , December 2011 , pp. 209 - 212
Copyright
Copyright © Cambridge University Press 2011

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References

1.Royal College of Psychiatrists. Physical Health in Mental Health. Final Report of a Scoping Group. Occasional Paper 67. London: Royal College of Psychiatrists, 2009.Google Scholar
2.Koran, LMet al.Medical Evaluation of Psychiatric Patients. Arch Gen Psych 1989; 46(8): 733–40.CrossRefGoogle ScholarPubMed
3.Royal College of Psychiatrists. Linking Physical and Mental Health 2008 Available from: http://www.rcpsych.ac.uk/campaigns/fairdeal/whatisfairdeal/linkingphysicalandmh.aspx. (Accessed March 15, 2009).Google Scholar
4.Cormac, I, Ferriter, M, Benning, R, Saul, C. Physical Health and Health Risk Factors in a Population of Long-Stay Psychiatric Patients. Psych Bull 2005; 29: 18–20.CrossRefGoogle Scholar
5.Cormac, I, Martin, D, Ferriter, M. Improving the Physical Health of Long-stay Psychiatric In-patients. Adv Psych Treatment 2004; 10: 107–15.CrossRefGoogle Scholar
6.Santhouse, A, Holloway, F. Physical Health of Patients in Continuing Care. Adv Psych Treatment. 1999; 5: 455–62.CrossRefGoogle Scholar
7.Fisher, N, Roberts, J. Primary Health Care Services for Long-stay Psychiatric In-patients. Psych Bull 1998; 22: 610–2.CrossRefGoogle Scholar
8.Lester, H. Shared Care for People with Mental Illness: A GP's Perspective. Adv Psych Treatment. 2005; 11: 133–41.CrossRefGoogle Scholar
9.Garden, G. Physical Examination in Psychiatric Practice. Adv Psych Treatment. 2005; 11: 142–9.CrossRefGoogle Scholar
10.Connolly, M, Kelly, C. Lifestyle and Physical Health in Schizophrenia. Adv Psych Treatment. 2005; 11: 125–32.CrossRefGoogle Scholar
11.Fagiolini, A. Medical Monitoring in Patients with Bipolar Disorder: A Review of Data. J Clin Psych 2008; 69(6): e16.CrossRefGoogle ScholarPubMed
12.Osborn, DPJ. The Poor Physical Health of People with Mental Illness. West J Med. 2001; 175(5): 329–32.CrossRefGoogle ScholarPubMed
13.Taylor, D, Paton, C, Kerwin, R (eds). The Maudsley Prescribing Guidelines. 9th Ed. London: Informa Healthcare, 2007.CrossRefGoogle Scholar
14.Ryan, MC, Thakore, JH. Physical Consequences of Schizophrenia and Its Treatments. The Metabolic Syndrome. Life Sci 2003; 71: 239–57.Google Scholar
15.Department of Health and Children. Statutory Instrument No. 551 of 2006 Mental Health Act 2001 (Approved Centres) Regulations 2006. Dublin: The Stationery Office, 2006.Google Scholar
16.Department of Health and Children. A Vision for Change. Report of the Expert Group on Mental Health Policy. Dublin: The Stationery Office, 2005.Google Scholar
17.Health Service Executive. Vision for Change Implementation Plan 2009-2013. Master Draft. Health Service Executive, 2009.Google Scholar
18.Unutzer, J, Schoenbaum, M, Druss, B, Katon, WJ. Transforming Mental Health Care at the Interface with General Medicine: Report for the Presidents Commission. Psych Services 2006; 57: 37–47.CrossRefGoogle ScholarPubMed
19.Health Service Executive. Transformation Programme 2007-2010. Naas: Health Service Executive, 2006.Google Scholar
20.Mental Health Commission. Quality Framework. Mental Health Services in Ireland. Dublin: Mental Health Commission.Google Scholar
21.Royal College of Psychiatrists. Physical Health in Mental Health Scoping Group Report. Available from http://www.rcpsych.ac.uk/pdf/PHYSICAL%20HEALTH%20IN%20MENTAL%20HEALTH%20-%20service%20specific%20standards.pdf (Accessed March 15, 2009).Google Scholar
22.Royal College of Psychiatrists. Good Psychiatric Practice. 2nd Ed. London: Royal College of Psychiatrists, 2004.Google Scholar
23.Osborn, DPJ, Warner, JP. Assessing the Physical Health of Psychiatric Patients. Psych Bull 1988; 22: 695–7.CrossRefGoogle Scholar
24.Phelan, M, Blair, G. Medical History-taking in Psychiatry. Adv Psych Treatment. 2008; 14: 229–34.CrossRefGoogle Scholar
25.Dixon, L, Postrado, L, Delahunty, J, Fischer, PJ, Lehman, A. The Association of Medical Co-morbidity in Schizophrenia with Poor Physical and Mental Health. J Nerv Mental Dis 1999; 187(8): 496–502.CrossRefGoogle ScholarPubMed
26.Cormac, I, Jenkins, P. Understanding the Importance of Oral Health in Psychiatric Patients. Adv Psych Treatment 1999; 5: 53–60.CrossRefGoogle Scholar
27.British Medical Association, Royal Pharmaceutical Society, (eds). British National Formulary 57. London: BMJ Group, RPS Publishing, 2009.Google Scholar
28.O'Brien, S, Devitt, E, Mohammed, A, Colm, M. High Prevalence of Risk Factors for Physical Illness in a Long-stay Psychiatric Unit. Ir J Psychol Med 2007; 24(2): 55–8.CrossRefGoogle Scholar
29.National Cancer Screening Programmes. NHS Cervical Screening Programme. National Health Service. Available from http://www.cancerscreening.nhs.uk/cervical/index.html. (Accessed March 14, 2009).Google Scholar
30.Stein, W. Modified Sainsbury Tool: An Initial Risk Assessment Tool for Primary Care Mental Health and Learning Disability Services. J Psych Mental Health Nurs 2005; 12(5): 620–33.CrossRefGoogle ScholarPubMed