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Are national standards really national? A survey of seven PICUs

Published online by Cambridge University Press:  22 December 2009

Stephen Dye*
Affiliation:
Consultant Psychiatrist, Suffolk Mental Health Partnership NHS Trust
Navjyoat Chhina
Affiliation:
Consultant Psychiatrist, Cumbria Partnership NHS Foundation Trust
Steve Brown
Affiliation:
Consultant Psychiatrist, Hampshire Partnership NHS Trust
*
Correspondence to: Dr Stephen Dye, Suffolk Mental Health Partnership NHS Trust, St Clement’s Hospital, Foxhall Rd, Ipswich, IP3 8LS UK. E-mail: stephen.dye@smhp.nhs.uk
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Abstract

Background: Psychiatric intensive care units (PICUs) initially developed in a haphazard fashion. In the UK, in an attempt to standardise quality of services, guidance for PICUs was published in 2002. Subsequently there has been a paucity of information outlining compliance with standards within different units.

Aims: To describe adherence to a subset of national standards in the care of 332 patients admitted consecutively to seven English PICUs.

Methods: Prospective, multi-centre patient case note analysis and staff questionnaire for each patient admitted.

Results: There was significant variation in different PICUs’ compliance with standards. Seventeen percent of patients were deemed not to meet basic criteria for admission to PICU. Pre-admission assessment and identification of treatment aims were poorly adhered to. Inappropriate mix of gender within patients occurred following 33% of admissions.

Conclusions: Implementation of national standards varies between different PICUs according to local policy and interface between acute wards and PICUs. This highlights the importance of, and challenge for, a national accreditation scheme.

Type
Original Article
Copyright
Copyright © NAPICU 2010

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