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Blood Tests in Psychiatric Patients-Evaluation and Improving the Process

Published online by Cambridge University Press:  07 July 2023

Mehr Usman  and
Daniel Afloarei
Mehr Usman*
Affiliation:
North Staffordshire Combined Healthcare NHS Trust, Stoke On Trent, United Kingdom
Daniel Afloarei
Affiliation:
North Staffordshire Combined Healthcare NHS Trust, Stoke On Trent, United Kingdom
*
*Corresponding author.
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Abstract

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Aims/background

The aim of this project is to assess which specific laboratory tests where being requested to psychiatric patients in our trust prior to developing a new local guideline to help standardise the blood testing to improve quality of patient care and reduce wastage in NHS due to inappropriate blood tests. It also assessed financial implication of unnecessary blood tests.

There are several reasons for the purpose of blood tests:

  • • To identify medical conditions that might be causing or contributing to a psychiatric presentation

  • • Provide baseline for safer initiation of psychotropic medication that can cause adverse effects

  • • To screen for medical problems who are less likely to attend primary care. Requesting blood tests is a clinical responsibility .Currently there is no formal guidance on which specific lab tests should be ordered for psychiatric patients and was felt a new local guideline was essential to rationalise blood testing

Methods

A survey was circulated to all wards and community mental health teams within our trust to get a clear insight about current practice.

The survey questions included:

  • • Place of work?

  • • What is included in routine blood tests list?

  • • Who created and approved the blood list?

  • • Where is the blood list kept?

  • • When was it reviewed?

Results

Results showed

  • • Significant variation in blood test requesting within our trust emphasising need for standardization using evidence based methods.

  • • Unnecessary repetition of blood tests like thyroid function and vitamin D levels against guidelines

  • • Unwarranted blood test request when clinically not indicated like including Troponin and Creatine kinase in routine tests. The results were shared to all staff through meetings.

Conclusion

Recommendations were drawn to improve optimisation of resource use, communication between health professionals and the need for standardisation in requesting blood tests.

Type
Quality Improvement
Information
BJPsych Open , Volume 9 , Supplement S1: Abstracts from the RCPsych International Congress 2023, 10–13 July , July 2023 , pp. S115
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NC
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Footnotes

Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.

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