Book contents
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- 73 Alcohol withdrawal: management
- 74 Anticholinesterase inhibitors: monitoring of cardiac side-effects
- 75 Anticholinesterase inhibitors: prescribing
- 76 Antimuscarinic medications
- 77 Antipsychotics: combined and high dose
- 78 Antipsychotics: prescribing
- 79 Antipsychotics: use in dementia
- 80 Attention-deficit hyperactivity disorder: prescribing
- 81 Atypical antipsychotics: monitoring
- 82 Behavioural problems in adults with intellectual disabilities: medication management
- 83 Benzodiazepines in old age psychiatry
- 84 Covert administration of medication
- 85 Depot antipsychotics: side-effects
- 86 Diazepam as rescue medication in epilepsy
- 87 Electroconvulsive therapy: facilities
- 88 Electroconvulsive therapy: indications
- 89 Hypnotics
- 90 Lithium: monitoring
- 91 Medicines reconciliation
- 92 Mood stabilisers: monitoring
- 93 Nurses’ administration of medication
- 94 Prescribing: British National Formulary limits
- 95 Prescribing: Mental Capacity Act
- 96 Prescribing: p.r.n. medication
- 97 Prescription charts
- 98 Psychological therapies
- 99 Psychotherapy re-referrals
- 100 Psychotropic prescriptions in dual diagnosis
- 101 Rapid tranquillisation
- Appendices
95 - Prescribing: Mental Capacity Act
from VII - Treatment
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- 73 Alcohol withdrawal: management
- 74 Anticholinesterase inhibitors: monitoring of cardiac side-effects
- 75 Anticholinesterase inhibitors: prescribing
- 76 Antimuscarinic medications
- 77 Antipsychotics: combined and high dose
- 78 Antipsychotics: prescribing
- 79 Antipsychotics: use in dementia
- 80 Attention-deficit hyperactivity disorder: prescribing
- 81 Atypical antipsychotics: monitoring
- 82 Behavioural problems in adults with intellectual disabilities: medication management
- 83 Benzodiazepines in old age psychiatry
- 84 Covert administration of medication
- 85 Depot antipsychotics: side-effects
- 86 Diazepam as rescue medication in epilepsy
- 87 Electroconvulsive therapy: facilities
- 88 Electroconvulsive therapy: indications
- 89 Hypnotics
- 90 Lithium: monitoring
- 91 Medicines reconciliation
- 92 Mood stabilisers: monitoring
- 93 Nurses’ administration of medication
- 94 Prescribing: British National Formulary limits
- 95 Prescribing: Mental Capacity Act
- 96 Prescribing: p.r.n. medication
- 97 Prescription charts
- 98 Psychological therapies
- 99 Psychotherapy re-referrals
- 100 Psychotropic prescriptions in dual diagnosis
- 101 Rapid tranquillisation
- Appendices
Summary
Setting
This audit is appropriate for all psychiatric in-patient settings in England and Wales (with patients over 16 years of age). It is designed to be carried out in conjunction with the audits of nurses’ administration of medication (audit 93, p. 217) and of the British National Formulary limits (audit 94, p. 219).
Background
The Mental Capacity Act 2005 provides a framework for people over the age of 16 years who lack capacity to make decisions for themselves, or who have capacity and want to make advance decisions in preparation for a time when they may lack capacity in the future. It sets out who can make decisions, and when and how they should go about this.
Standards
A code of practice (Department for Constitutional Affairs, 2007) has been produced to offer guidance on the Mental Capacity Act 2005.
The standard procedure for assessing capacity involves determination of the following:
ᐅ Does the person have an impairment of, or a disturbance in the functioning of, their mind or brain? If so:
ᐅ Does the person understand information about the decision to be made?
ᐅ Can they retain that information in their mind?
ᐅ Can they use or weigh that information as part of the decision-making process?
ᐅ Can they communicate their decision (by talking, using sign language or any other means)?
Professionals should carry out an assessment of a person's capacity to make particular decisions and record the findings. It is important to review capacity from time to time, as a person's decision-making capabilities can change. Capacity should always be reviewed when decisions need to be made (e.g. for new medications).
Decisions may be made in the best interests of the person who lacks capacity to make those decisions for themselves (in the absence of an advance decision to refuse treatment by the person while having capacity). A record should be kept of best interests decisions for each relevant decision. This record should include:
ᐅ how the best interests decision was reached
ᐅ what the reasons for reaching the decision were
ᐅ who was consulted
ᐅ what factors were taken into account.
- Type
- Chapter
- Information
- 101 Recipes for Audit in Psychiatry , pp. 221 - 222Publisher: Royal College of PsychiatristsPrint publication year: 2011