Re-Audit of Physical Examination and Blood Tests Completed Within 24 Hours of Admission to Psychiatric Ward

Abstract

Aims

To establish if the creation of a checklist of examination and investigations required within 24 hours of admission to Psychiatric ward had improved practice and patient care.

Methods

This was a snapshot audit. On 7th August 2022 I carried out a retrospective review of the case notes & results on electronic recording system to ascertain which investigations had been completed for all current in-patients on Ward 4, Dr Gray's Hospital, Elgin. I noted how soon after admission these tests had been completed.

I compared these data with results from a previous audit in January 2022 which had highlighted failings in meeting the standards recommended by Royal College of Psychiatrists. The initial audit led to the creation of an Admission checklist to improve practice. The results from August 2022 demonstrated the impact of the checklist.

Results

On 7th August 2022, there were 18 inpatients in Ward 4. Duration of admission varied from 1 day to 1,259 days.

The 3 routine investigations of Physical Examination, ECG and Bloods were completed within 24 hours of admission much more reliably than the initial audit.

Bloods were completed in 100% of cases compared to 52.9% in January 2022. Physical Examination was completed in 94.4% compared to 76.4% in January 2022. ECG was also completed in 94.4% compared to 58.8% in previous audit.

Conclusion

There was a marked improvement in completion of examination, investigations and recording of the results since creation of a checklist. This could be due to increased awareness of the requirements aided by the visible prompt of the checklist on the ward.

Staff are recognizing that mental health cannot be viewed in isolation from physical health which improves the quality of care patients receive during admission. Any health needs can be identified early allowing time for referral if required.