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Are national standards really national? A survey of seven PICUs
Published online by Cambridge University Press: 22 December 2009
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.
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