1661 – Effects Of a Basic Protocol To Manage Patients With Personality Disorders In The General Hospital

Abstract

Introduction

Patients presenting Personality Disorders and specially Borderline Personality Disorder are often admitted to Psychiatry Units in General Hospitals. Their impulsivity, affective disregulation and difficulties in interpersonal relations complicate the therapeutic atmosphere and cause problematic interactions with staff and other patients. We have developed a basic protocol to manage behavioural problems of those patients in the general hospital.

Objectives

To study the effect of the protocol on the unit's work. Aims. To know the effect of the protocol on some specific variables related to the admission and specifically the use of mechanical restraint. Methods. Prospectively, we compare data on all patients admitted during 2010 (876 total, 87 PD) before establishing the protocol and all those admitted during 2011 (870 total, 112 PD) when the protocol was in use.

Results

The proportion of patients with PD who experienced at least one mechanical restraint intervention went down from 43.7% in 2010 to only 2.7% in 2011 (p= 0.000). In the total group, figures also decreased from 17.3% in 2010 to 3.4% in 2011 (p= 0.000).

Conclusions

The use of mechanical restraints with PD patients in General Hospital Psychiatric Units can be drastically reduced using a protocol guiding the staff to better manage behavioural problems of the patients.