Abstract

Aims and MethodAn audit in a general hospital accident and emergency (A&E) department and the subsequent development of a triage process for people presenting with self-harm is described. A random sample of 103 people attending with self-harm were selected and their treatment audited against standards derived from NICE guidelines.ResultsThe service provided by the A&E department was sub-standard. Of particular concern was the lack of processes addressing risk assessment and safe discharge. A pro forma was designed with the aim of improving assessment of self-harm. A repeat audit 3 months after introduction of the pro forma showed an improvement in the recording of relevant information underpinning risk assessment.Clinical ImplicationsProcedures for those presenting to A&E departments with self-harm may not meet recommended guidelines. The use of a pro forma with staff training can improve risk assessment.

Highlights

  • The service provided by the A&E department was sub-standard

  • A repeat audit 3 months after introduction of the pro forma showed an improvement in the recording of relevant information underpinning risk assessment

  • All staff working in the A&E department received a written training package, including a presentation on basic mental health assessment, psychiatric terminology and some information on capacity to consent, prior to the pro forma being introduced

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Summary

AIMS AND METHOD

A random sample of 103 people attending with self-harm were selected and their treatment audited against standards derived from NICE guidelines

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