Abstract
The management of acute behavioural disturbance in psychiatric patients is an area that continues to require investigation, as it is potentially dangerous for both patients and staff. We conducted an audit of the management of these episodes, looking particularly at the drugs given, the doses and any polypharmacy. We also examined whether the issue of guidelines led to any changes in prescribing patterns. We found that we were prescribing appropriately and that the guidelines did lead to some shift toward safer prescribing.
Highlights
The management of acute behavioural disturbance in psychiatric patients is an area that continues to require investigation, as it is potentially dangerous for both patients and staff
We set three standards: (a) all prescriptions were to be within British National Formulary (BNF) limits; (b) only two drugs from any class were to be prescribed within 48
There were no significant differences by age or sex between the acute behavioural disturbance (ABD) group and the total 609
Summary
The management of acute behavioural disturbance in psychiatric patients is an area that continues to require investigation, as it is potentially dangerous for both patients and staff. In March 1994 a manic patient admitted to Fulbourn Hospital received, over 48 hours, six different neuroleptic medications This incident led us to review the literature on the manage ment of the acutely disturbed psychotic patient. Following the literature review and discussion with medical and nursing colleagues, some advisory guidelines were produced on different types of scenarios with guides on which drugs to use, including dose range and method of administration. These were generally agreed and distributed to all medical staff and all wards in July 1994 (copies of guidelines can be obtained from NH). In 1995, an audit was undertaken to review practice in the management of acute behaviour al disturbance during 1994 and to see whether the guidelines had any effect on prescribing practice
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