Inpatient Wards Research Articles

Causes, Diagnostic Testing, and Treatments Related to Clinical Deterioration Events Among High-Risk Ward Patients.

Timely intervention for clinically deteriorating ward patients requires that care teams accurately diagnose and treat their underlying medical conditions. However, the most common diagnoses leading to deterioration and the relevant therapies provided are poorly characterized. We aimed to determine the diagnoses responsible for clinical deterioration, the relevant diagnostic tests ordered, and the treatments administered among high-risk ward patients using manual chart review. This was a multicenter retrospective observational study in inpatient medical-surgical wards at four health systems from 2006 to 2020. Randomly selected patients (1000 from each health system) with clinical deterioration, defined by reaching the 95th percentile of a validated early warning score, electronic Cardiac Arrest Risk Triage, were included. Clinical deterioration was confirmed by a trained reviewer or marked as a false alarm if no deterioration occurred for each patient. For true deterioration events, the condition causing deterioration, relevant diagnostic tests ordered, and treatments provided were collected. Of the 4000 included patients, 2484 (62%) had clinical deterioration confirmed by chart review. Sepsis was the most common cause of deterioration (41%; n = 1021), followed by arrhythmia (19%; n = 473), while liver failure had the highest in-hospital mortality (41%). The most common diagnostic tests ordered were complete blood counts (47% of events), followed by chest radiographs (42%) and cultures (40%), while the most common medication orders were antimicrobials (46%), followed by fluid boluses (34%) and antiarrhythmics (19%). We found that sepsis was the most common cause of deterioration, while liver failure had the highest mortality. Complete blood counts and chest radiographs were the most common diagnostic tests ordered, and antimicrobials and fluid boluses were the most common medication interventions. These results provide important insights for clinical decision-making at the bedside, training of rapid response teams, and the development of institutional treatment pathways for clinical deterioration.

Experience of a tertiary acute care hospital in Southeast Asia in initiating patient engagement with the aid of digital solutions.

With the goal of patient engagement, an initiative was formulated to equip each patient in the general wards with a tablet whereby they can access their health information and patient education materials and communicate with their healthcare team. This paper presented the methodology of the implementation efforts as well as an evaluation of the preliminary outcomes. The process of hospital-wide implementation was shared using the implementation research logic model. The bedside tablets were rolled out hospital-wide in a step-wedge manner over 12 months. Barriers and facilitators to this implementation were discussed together with strategies to optimize the situation. Preliminary outcomes of the implementation were evaluated using the RE-AIM framework. The initial adoption rate for the bedside tablet was low. Additional strategies, such as survey audits and provision of feedback, development of education materials for patients, facilitation, and purposefully re-examining the implementation strategies, were used to improve adoption. The trend of adoption increased over the course of 2 years from the start of implementation. The initial lower adoption rates may reflect Singapore's paternalistic healthcare culture. While this implementation was driven by the need to move away from paternalism and toward patient engagement, more time is required for significant cultural change.

Development and validation of predictive models for mortality of cases with COVID-19 (Omicron BA.5.2.48 and B.7.14): a retrospective study

ObjectivesWith the emergence of new COVID-19 variants (Omicron BA.5.2.48 and B.7.14), predicting the mortality of infected patients has become increasingly challenging due to the continuous mutation of the virus. Existing...

Efficacy of air cleaning units for preventing SARS-CoV-2 and other hospital-acquired infections on medicine for older people wards: a quasi-experimental controlled before-and-after study

Nosocomial infections are costly and airborne transmission is increasingly recognised as important for spread. Air Cleaning Units (ACUs) may reduce transmission but little research has focused on their effectiveness on open wards. Assess whether ACUs reduce nosocomial SARS-CoV-2, or other, infections on older adult inpatient wards. Quasi-experimental before-after study on two intervention-control ward pairs in a UK teaching hospital. Infections were identified using routinely collected electronic health records data during one year of ACU implementation and the preceding year ("core study period"). Extended analyses included 6 months additional data from one ward pair following ACU removal. Hazard ratios (HR) were estimated through Cox regression controlling for age, sex, ward and background infection risk. Time the ACUs were switched on was also recorded for intervention ward 2. ACUs were initially feasible but compliance reduced towards the end of the study (average operation in first vs second half of ACU time on intervention ward 2: 77% vs 53%). 8171 admissions >48hrs (6112 patients, median age 85yrs) were included. Overall, incidence of ward-acquired SARS-CoV-2 was 3.8%. ACU implementation was associated with a non-significant trend of lower hazard for SARS-CoV-2 infection (HR core study period 0.90, 95% CI 0.53, 1.52; extended study period 0.78, 95% CI 0.53, 1.14). Only 1.5% of admissions resulted in other notable ward-acquired infections. ACUs may reduce SARS-CoV-2 infection to a clinically-meaningfully degree. Larger studies could reduce uncertainty, perhaps using a cross-over design, and factors influencing acceptability to staff and patients should be further explored.

Patient factors influencing nutritional intake in post-intensive care and general ward patients

Patient factors influencing nutritional intake in post-intensive care and general ward patients

Hubungan Fungsi Kepala Ruangan dengan Kinerja Perawat Pelaksana di Ruangan Rawat Inap RSUD Palangka Raya

One of the critical elements affecting nurse performance and impacting the quality of nursing services is the implementation of the head nurse's functions. This role must be effectively integrated into the healthcare system to motivate nurses to provide optimal patient care, thereby improving community health quality. This study aims to analyze the relationship between the head nurse's functions and the performance of bedside nurses in the inpatient wards at RSUD Palangka Raya. Method: This study employed a quantitative method with a correlational research type and a cross-sectional approach. The sampling technique used was total sampling, involving 34 respondents. Data collection was performed using a questionnaire, and statistical analysis was conducted using the Spearman Rank Correlation test. Results:The results of the Spearman Rank statistical test showed a significance value (2-tailed) of p = 0.00 with a level of significance of p < 0.05, indicating a relationship between the head nurse's functions and the performance of bedside nurses. The correlation coefficient was 0.685, reflecting a high or strong correlation. This positive relationship indicates that as the function of the head nurse improves, the performance of bedside nurses also increases. Therefore, the alternative hypothesis (Ha) is accepted, meaning there is a relationship between the head nurse's functions and the performance of bedside nurses. Conclusion: There is a significant relationship between the head nurse's functions and the performance of bedside nurses. It is recommended that the hospital provide training for head nurses on management functions.

Clinical Symptoms of Patients with Early-Stage and Advanced-Stage Ovarian Cancer

Background: Ovarian cancer is a malignant neoplasm originating from ovarian cells with different histological types depending on the subtype. It can affect women of all ages. Ovarian cancer ranks third in terms of incidence among diagnosed female cancer patients, following breast and cervical cancer. Ovarian cancer often doesn’t present specific/clear symptoms. As a result, only a small number of patients are diagnosed at an early stage (20%). The study aimed to analyze the clinical complaints experienced by ovarian cancer patients, both in early and advanced stages before diagnosis. Methods: This descriptive cross-sectional study analyzes clinical complaints before the diagnosis of early and advanced-stage ovarian cancer patients. The study was conducted in the Gynecology-Oncology inpatient ward at Dr. Soetomo Regional General Hospital in 2021, utilizing medical record data. Results: A total of 98 patients (21 patients with early-stage, and 77 patients with advanced-stage) were analyzed. The majority of the patients are aged 45-58 years (49%), work as homemakers (32.7%), and are married (63.3%). The three most common complaints experienced by subjects with early-stage ovarian cancer were abdominal/pelvic pain (23.8%), abdominal/pelvic pressure (28.6%), and abdominal distension (42.9%), while in patients with advanced-stage ovarian cancer were abdominal/ pelvic pain (32.7%), abdominal distension (42.9%), and abdominal discomfort (bloating, early satiety, feeling of fullness, frequent belching, heartburn, nausea and vomiting) (44.2%). Conclusions: The three most common clinical complaints among patients before being diagnosed with early and advanced-stage ovarian cancer in the inpatient ward of Dr. Soetomo Regional General Hospital Surabaya in 2021 were similar. The recognition of these complaints and several risk factors are expected to assist in the earlier diagnosis of ovarian cancer.

Pattern of Mortality among Patients Admitted in Medical Wards in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

Introduction: Most developing regions of the world are undergoing gradual epidemiological transition resulting in high burden of both communicable and noncommunicable diseases. Morbidity and mortality pattern is a reflection of disease burden. Detailed assessment of these parameters tends to aid in formulating pivotal aspects of in-hospital policies, standards of care and so consequently promoting efficient work systems. The aim of this study is to identify the pattern of mortalities in medical wards in a tertiary care hospital.Methods: This retrospective descriptive cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital focusing on all patients admitted to the medical wards (General Medical, Hepatology, Nephrology, Neurology, Endocrinology, Pulmonology, Cardiology and Gastrology) between January 1 to December 31, 2023 after obtaining ethical approval from Institutional Review Committee (Reference Number: 390/2080/81). Total population sampling was done. Data were analyzed using Microsoft Excel and SPSS.Results: Among 10124 admitted patients in medical wards, mortality was reported in 732 (7.22%). The number of deaths seen in general medical ward was 389 (53.14%) and in liver ward was 85 (11.61%). Systemic cause of death due to respiratory diseases was 157 (21.5%) and liver disease was 143 (19.6%).Conclusions: The respiratory disease is responsible for a higher proportion of deaths among admitted patients. However, the deaths due to liver disease are increasing because of the rise in cirrhosis of the liver in the younger age group.

Nurse Managers' Experiences in Managing Inpatient Wards During a Crisis: Lessons from the COVID-19 Pandemic

The COVID-19 pandemic has provided valuable lessons for all parties, including nursing services in hospitals. To date, literature has been lacking on the role of nurse managers in managing inpatient wards for COVID-19 patients, especially in Indonesia. This study aims to explore the experiences of, and the challenges encountered by nurse managers in managing inpatient wards during the crisis. This is a qualitative study with a phenomenology design. The study used a purposive sampling technique involving four nurse managers from several hospitals in South Sulawesi Province, Indonesia. Data were obtained through semi-structured interviews and were analyzed using thematic analysis. This study yielded three themes and nine sub-themes. Nurse managers experienced panic and fear but carried out inpatient management immediately. There was also a solid commitment to protect the fellow nurses from infection. Valuable lessons include the availability of human resources, strong commitment from all lines, management support, and teamwork. Meanwhile, nurse managers encountered challenges such as the lack of personal protective equipment, frequently changing service procedures and the psychological needs of nurses. Nurse managers obtained numerous lessons from the COVID-19 pandemic related to their capabilities in managing inpatient wards. The findings suggest the adaptability of nurse managers to similar challenging crisis encounters in the future by analysing the effects of frequent workflow changes on care quality and staff adaptation, examining the long-term psychological impact of pandemic work on nurses developing strategies to enhance organizational support for nurses including coping mechanisms and well-being related trainings and services, and to build dynamics of effective teamwork during crisis.

Remote Healthcare: Development of a Centralized Patient Monitoring System for Ward Patients.

Patient monitoring is an essential practice in healthcare settings to assess well-being and medical conditions. This study proposes a central patient monitoring system enabling healthcare personnel to have a comprehensive perspective of multiple patients' health state from a central location. The proposed prototype enables healthcare providers to detect and respond to changes in patients' condition efficiently. The project contains multiple patient monitoring units with each measuring temperature, ECG, SpO2, and heart rate along with a display on a centralized screen. The hardware of monitors is placed at each patient bed connected with all the patients and the result of each patient can be seen from the general ward counter. Different sensors are used to design monitoring units and are connected with node MCU through different pin connections. Node MCU sends the information gathered from sensors to the Raspberry pi unit using Wi-Fi. The real-time data of patients are being displayed and saved using server “thing speak”. There are different options on the server window to switch between different patients’ real time results to monitor them. The proposed prototype uses computer technology to monitor the vital signs of multiple patients on a single monitor from a centralized location using internet which may eventually reduce the time and workload of medical staff leading to improved patient care.

The Goldilocks Effect Of Hydration For Patients In A Sub-Acute Rehabilitation Setting: Too Warm, Too Cold Or Simply Not Nice

Abstract Background Older adults are considered at risk of becoming dehydrated. Risk of dehydration is increased during a hospital stay. Offering a range of preferred drinks frequently during the day can improve total fluid intake and minimise the risk of low intake dehydration. A survey of patient access to and consumption of water on an inpatient ward for older adult rehabilitation was undertaken. Methods A point prevalence survey was conducted on each patient on an inpatient ward for the following six situations: Results All inpatients (n=26, 15 female and 11 male) completed the survey for each of the six situations. 85% of patients surveyed had access to water (n=22). 85% of patients (n=22) surveyed were able to reach the water and 85% (n=22) could pour the water independently. 15% of patients surveyed (n=4) required assistance to drink (modified consistency (n=2) or physical assistance (n=2). Only 35% of patients (n=9) reported drinking the available water. Of the 17 patients who reported not drinking the water accessible to them, 59% (n=10) reported the water was too warm and 29% of patients (n=5) reported the water didn’t taste nice. Conclusion Low intake dehydration is associated with adverse outcomes in older adults. The root causes of low fluid intake need to be established in order to minimise the risk of dehydration during a period of hospitalisation. Further research is required to establish the root causes of low intake dehydration and development of quality improvement initiatives to minimise low intake dehydration in a hospital setting.

Determination of the effect of the pre-surgery COVID-19 fear level and hygiene behaviours of the patients on the personal protective clinical measures developed after the surgery: Across-sectional study.

This study aims to examine patients' preoperative COVID-19 fear levels, hygiene behaviours, postoperative personal protective clinical measures, and their correlations with each other. This research is a cross-sectional type of study. The study sample consisted of 131 patients hospitalized in the general surgery inpatient ward of a hospital in Turkey. The sample was determined by G-Power analysis. The data were collected in two stages in a research hospital between 1 April 2021 and 1 March 2022. Sociodemographic and Clinical Information Form, COVID-19 Fear Scale, COVID-19 Hygiene Scale were used before surgery; COVID-19 personal protective clinical measures questionnaire was used after surgery. Descriptive statistics, independent t-test, ANOVA test, Wilcoxon test and Spearman correlation analysis were used to evaluate the data. It was determined that preoperative COVID-19 fear levels, hygiene behaviours, and the personal protective clinical measures developed after the surgery were above moderate. A statistically significant and positive correlation was found between the COVID-19 Fear Scale and the preoperative COVID-19 Hygiene Scale and postoperative COVID-19 personal protective clinical prevention questionnaire total score and sub-dimension score averages. Patients' COVID-19 fears, preoperative and postoperative hygiene behaviours are statistically significantly associated with each other at a low level; postoperative clinical precautions and preoperative hygiene behaviours are statistically significantly associated with each other at a high level. The results of this study show that patients are terrified of COVID-19 while they are hospitalized due to surgical intervention during the pandemic process, and they increase their hygiene measures. It is thought that the results of the study will guide the regulation of clinical measures, patient education, and nursing care to be developed for patients during pandemic periods. No patient or public contribution.

Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit

Unplanned transfers from the General Ward to Critical Care Units occur due to a deterioration in the patient's clinical status. They are of great interest because of their negative impact, associated with longer hospital stays and higher mortality. To report the frequency at which these transfers occur, characteristics of these patients and causes of the transfer. Identify shortcomings in the care process that may allow improvement strategies. cross-sectional study. Cases were considered those who, during the first 24 hours of hospitalization in the General Ward, required transfer to the ICU between January - December 2022 in a high-complexity hospital in Buenos Aires. Results: Of 8317 admissions, 124 were transferred to the ICU, with a rate of 14 per 1000 and an average of 70 years. The most frequent comorbidities were high blood pressure, heart failure, cancer and overweight-obesity. The main causes of hospitalization were respiratory and gastrointestinal symptoms. 67% had non-alarming results in the NEWS score prior to transfer to the ICU. The most frequent causes were respiratory failure, hemodynamic instability and requirement for monitoring. Average hospital stay was 10 days and in-hospital mortality was 26%. Respiratory decompensation in elderly male patients was the most common cause of transfer to a Closed Unit. One of the shortcomings of the care process seems to be the NEWS score, where in 67% of cases it did not warn about the high requirement of patient monitoring.

The effect of Qigong exercise on state anxiety levels of inpatients in psychiatric wards: A randomized controlled study

BackgroundQigong is a mind-body exercise that originated in China and is often described as a form of meditation or movement therapy. While the existing literature has investigated the impact of Qigong exercises on trait anxiety in outpatients, there is limited research on their influence on state anxiety in inpatients. This study examined the effect of Qigong exercise on state anxiety levels of inpatients in psychiatric wards. MethodsThis study was a single-blind, randomized controlled trial. Patients were randomly assigned to either the intervention or control group. Seventy inpatients participated in the study, with 35 in each group. In the intervention group, the STAI-I form was used to assess state anxiety levels before (Test 1) and after (Test 2) a single 40-minute session of Qigong. ResultsThe mean post-test scores of the intervention group (27.20±5.57) were significantly lower than those of the control group (39.72±10.84). Additionally, a statistically significant difference was observed between the mean test-1 (38.42±9.7) and test-2 scores (27.2 ± 5.57) within the intervention group. ConclusionA single 40-minute Qigong exercise session reduced state anxiety levels in psychiatric inpatients and reduced the risk of potential adverse outcomes associated with state anxiety. Practitioners may consider the use of Qigong exercise in the management of state anxiety in clinical practice, when making clinical decisions.

Socio-Demographic and Clinical Profile of Admitted Patients for Psychiatric Illness in a Tertiary Care Military Hospital in Bangladesh

Background: Mental health problems are becoming a public health issue in all countries around the world. It’s often ignored and unnoticed by patients, their relatives and society as well. Treatments for all these disorders are as available as efficacious. The purpose of this study was to assess the socio-demographic and clinical profile of admitted patients for psychiatric illness in a tertiary care military hospital. Materials and methods: This hospital based retrospective study was performed by analyzing the medical records of admitted psychiatric patients, carried out in the Department of Psychiatry at Combined Military Hospital (CMH), Chattogram from 01 July 2022 to 31 December 2022. For this purpose, 41admitted patients in psychiatry ward of CMH Chattogram were enrolled in the study. Psychiatric diagnoses of the patients were assigned by the consultant psychiatrist as per International Classification of Diseases (ICD) 10th Revision diagnostic criteria. Statistical analyses were carried out by using the Statistical Package for Social Sciences (SPSS)-version 16. The quantitative observations were indicated by frequencies and percentages. Ethical issues were maintained all through the study. Results: The results showed that more than half of (56.09%) patients were in 19-35 years of age with male preponderance (63.41%) and most of the cases reported from urban area (58.53%). The most common psychiatric morbidity among the patients were major depressive disorder (26.82%) followed by Anxiety disorder (17.07%) and Obsessive- compulsive disorders (17.07%). In this study majority of patients stayed 15-28 days (80.48%) on an average of 21.5 days. Conclusion: Neurotic cases were predominant in psychiatric admission. Results of this study may help in the planning for better mental health service integrated with primary healthcare system of our country. Findings of this study will also act as an eye-opener for psychiatrists regarding a wide range of psychiatric diagnoses as well future research in psychiatric fraternity. IAHS Medical Journal Vol 6(2), December 2023; 19-23

Exploring the Perceptions of Families and Nurses After Signing a Do-Not-Resuscitate Order for Patients in Respiratory Care Wards.

Introduction: This study aimed to explore the perceptions and experiences of family caregivers and nurses after the signing of a do-not-resuscitate (DNR) order for patients in respiratory care wards (RCWs). The goal was to facilitate nurses' preparedness for responding to family reactions and feelings in future DNR situations. Methods: The study employed semi-structured interviews with ventilator-dependent patients' families and nurses recruited from RCWs in regional and district hospitals in New Taipei City. It explored the feelings, motivations, and decision-making processes concerning DNR orders. Thematic analysis identified key themes and patterns. Results: Twenty-two family members and 12 nurses, caring for 22 patients, participated in the interviews, resulting in 44 interview transcripts. The majority of family members were male (54.5%), whereas all nurses were female. Family caregivers and nurses had nuanced perceptions and showed emotional responses after the signing of DNR orders. Family caregivers grappled with feelings of guilt, uncertainty, and the weight of decision-making, while nurses navigated ethical dilemmas and sought to support families through the process. Common themes included the desire to minimize the patient's suffering, concerns about quality of life, and the need for clear communication and support. Conclusion: The understanding of family caregivers' and nurses' perceptions of DNR orders for patients in RCWs illuminates complex end-of-life care challenges. A key gap in the study was its limited generalizability due to focusing on specific RCWs. Nonetheless, the insights gained may enable health care providers to tailor support, facilitate informed decision-making, and promote compassionate care for ventilator-dependent patients and their families.

Appraising motivation as a predictor of independence in individual activities of daily living in patients with subacute stroke: a retrospective study

ABSTRACT Objectives This study aimed to evaluate the impact of motivation on independence in activities of daily living, such as eating, getting up, and rehabilitation, in subacute stroke patients. Materials and Methods We retrospectively assessed the data of 191 first-stroke patients in a rehabilitation hospital ward. Motivation was examined using the following five elements of the Vitality Index: waking pattern, communication, feeding, on and off toilet, and rehabilitation and other activities. As an outcome measure, independence in activities of daily living, such as eating and dressing, was assessed using the Barthel Index. Logistic regression analysis was performed using the independence of each activities of daily living, as determined by the Barthel Index at discharge, as a dependent variable and each of the Vitality Index item scores as the independent variable. Results Motivation to get up item of the Vitality Index was significantly associated with independence in grooming and dressing, whereas motivation to communicate item was significantly associated with independence in transferring (p < 0.05). Furthermore, motivation to eat item was significantly associated with independence in feeding, grooming, dressing, and transferring, whereas motivation to engage in rehabilitation and activities was significantly associated with independence in dressing, transferring, and toileting (p < 0.05). Conclusions Our results suggest that the motivation to eat, get up, communicate, and participate in rehabilitation and activities is associated with independence in different activities of daily living. The present study provides useful insights into the significance and interpretation of assessing motivation on independence in activities of daily living.

'I Think the First Priority is Physically Safe First, Before You Can Actually Get Psychologically Safe': Staff Perspectives on Psychological Safety in Inpatient Mental Health Settings.

While the concept of psychological safety has been gaining momentum, research concerning psychological safety in inpatient mental health wards is lacking. To investigate how psychological safety is conceptualised by healthcare staff in inpatient mental health units, and what barriers and facilitators exist. Reflexive Thematic Analysis was used to analyse 12 interviews. Participants conceptualised psychological safety as feeling safe from physical harm, being able to develop meaningful relationships and feeling valued at work. Participants often did not feel physically safe at work, which led them to feel psychologically unsafe. Barriers to psychological safety were reliance on agency workers, punitive management approaches and the inherent risk in working with mental health inpatients. Facilitators included appropriate staffing ratios and skill mix, being able to form meaningful relationships and having access to support. The emphasis on the physical safety element within psychological safety means that existing definitions of psychological safety require extension for the mental healthcare context. However, large-scale research is needed to further understand experiences of psychological safety in this group. A better understanding of the dimensions of psychological safety in inpatient mental health settings could support the development of tools to investigate psychological safety interventions. Organisations could support psychological safety through regular staff supervision and improved staffing ratios and skill mix.

The Relationship Between The Accuracy of Filling Out The Early Warning Score System Form and Nurse Decision Making

&lt;p&gt;&lt;em&gt;Early Warning Score System plays an important role in monitoring and tracking patient deterioration through vital signs and physical condition. Nursing decision making is a complex process that has the potential to influence the quality of care provided. Clinical decision making requires critical thinking skills for nurses. This study aims to analyze the relationship between the accuracy of filling out the Early Warning Score System form and nurses' decision making. The type of research used is quantitative research using a retrospective descriptive research design with a cross sectional descriptive research design. The sampling technique is purposive sampling. The respondents of this study were nurses in integrated inpatient rooms A and B at the Haji Adam Malik Central General Hospital, Medan. This research was carried out in the integrated inpatient ward at the Haji Adam Malik Central General Hospital, Medan. The sample consisted of 148 respondents in the inpatient ward. The instruments used were the standardized Early Warning Score System monitoring form at Haji Adam Malik Hospital and nurse decision making adopted from the Ekwantoro questionnaire. The data were analyzed using the Spearman rank test to obtain a correlation coefficient of +0.470 with a significant p-value = 0.000. The conclusion is that there is a relationship between the accuracy of filling in the Early Warning Score System formula and nurse decision making which is quite strong and in the same direction. It is recommended that nurses increase their in-depth understanding of filling out the Early Warning Score System form in order to make appropriate decisions in providing nursing care.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: Accuracy of filling, Decision making, ERWSS&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Characterising the nature of psychiatric disorders and patterns of antipsychotic medications prescribed in a psychiatric ward in a public hospital in Tasmania.

We present an evaluation of antipsychotic prescribing in an inpatient psychiatry ward in Hobart, Tasmania, to establish pattern of use, alignment with other psychiatric wards orcentres and the recommendations in the Royal Australian and New Zealand College of Psychiatry Clinical Practice Guidelines, and to determine predictors of polypharmacy. A descriptive cross-sectional survey design was used. Data from 118 patients discharged from the Royal Hobart Hospital (RHH) Mental Health Inpatient Unit between 01/02/2021 to 01/08/2021 were evaluated. Antipsychotic polypharmacy (APP) was observed in 40% of patients. When low doses of adjunctive ('PRN') use of olanzapine and quetiapine were excluded, the APP proportion was 35%. APP was predicted by age and by a schizophrenia diagnosis. Long-acting injections (LAIs) were used in 46% of the patients. The most common LAI was risperidone (52%). Average daily dose of antipsychotic at the time of discharge was 529mg chlorpromazine (CPZ) equivalents. High dose antipsychotics (more than 1000mg CPZ equivalents per day) was observed in 13% of the patients. The observed prescribing practice is consistent with other clinical settings. Antipsychotic prescribing practice should, however, continue to be monitored to ensure adherence to best practice guidelines.