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Research and Audit • de Dois, Consuelo, Ezquiaga et al. Usefulness of the Spanish version of the Mood Disorder Questionnaire for screening for bipolar disorder in routine clinical practice in outpatients with major depression. Clinical Practice and Epidemiology in Mental Health, May 2008; 4:1745-0179. • Field A. Discovering Statistics using SPSS, Sage Publications Limited, 2009. • Hirschfeld RM. The Mood Disorder Questionnaire: A simple, patient-rated screening instrument for bipolar disorder. Primary care companion to the Journal of Clinical Psychiatry, February 2002; 4(1):9-11. • Hunter R, Fraser K, Martin M, Hudson S. Bipolar disorder – aetiology and pathophysiology. Hospital Pharmacist, 2004; 11: 129-32. • Kasper S. Issues in the treatment of bipolar disorder. European Neuropsychopharmacology, 2003; 13(Suppl 2): S37-42. • Kessler RC, McGonagle KA, Zhao S et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 1994; 51: 8-19. • Menzin J, Sussman M, Tafesse E et al. A model of the economic impact of a bipolar disorder screening program in primary care. Journal of Clinical Psychiatry, September 2009; 70(9):1230-6. • Perry A, Tarrier N, Morriss R et al. Randomized controlled trial of efficacy of teaching patients with bipolar disorder to recognized early symptoms of relapse and obtain treatment. BMJ, 16 January 1999;318:149-153. • Sachs GS. Unmet clinical needs in bipolar disorder. Journal of Clinical Psychopharmacology, 2003; 23: S2-8. • Simon S. An introduction to diagnostic tests. The Children’s Mercy Hospital 2007. • Stang P, Frank C, Ulcickas Yood M, et al. Impact of bipolar disorder: Results from a screening study. Primary care companion to the Journal of clinical psychiatry, 2007; vol/is 9/1(142-47), 1523-5998. • Twiss J, Jones S, Anderson I. Validation of the Mood Disorder Questionnaire for screening for bipolar disorder in a UK sample. Journal of affective disorders, September 2008; 110(1-2):180-4. • Wehr TA, Goodwin FK. Can antidepressants cause mania and worse the course of affective illness? American Journal of Psychiatry, 1987; 144: 1403-11. • Weissman MM, Leaf PJ, Tischler GL et al. Affective disorders in five United States communities. Psychol Med 1988; 18: 147-53. • World Health Organization. The ICD- 10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO, 1992. 16 Surrey and Borders Online Journal www.sabp.nhs.uk/journal
Audit of risk assessment documentation in adult in-patients - adherence to Trust guidelines and how to improve performance in this area By Abigail Crutchlow Acknowledgements: Many thanks to Dr L Church for his help in finalising this document Background Current local policy for SABP NHS Foundation Trust states that all adult patients admitted to an in-patient unit within the Trust should have a standardised risk assessment form completed on admission and this should be updated regularly at every ward round or if a significant change in risk occurs. The aim of this audit is to provide an overview of performance and whether these guidelines are being met and, if not, to implement methods to improve performance. Through re-audit, the benefit and impact of such interventions and their role in the future will also be assessed. Formal ethical approval was not required for this audit as all data were anonymous and patients were not directly approached or involved in the audit. The audit was registered and approved by the Trust audit department. Method Initial audit The initial audit included all current adult in-patients on general adult wards at the Abraham Cowley Unit, Chertsey. The PICU unit was not included due to altered level of risk for these patients. Their notes were identified and their risk assessment on admission and its subsequent updates examined. The following questions were asked: 1. Was a complete risk assessment recorded on admission? • This included a completed comprehensive risk assessment within 24h of admission 2. Has the risk assessment been updated regularly /at each ward round? • Occasional or irregular updates were not considered satisfactory • If the patient had been an in-patient for a very short time and not yet been seen on a ward round (meaning regular updates may not yet have commenced) then this was noted and they were excluded from question 2 3. Is the risk assessment accessible to staff? • Information needed to be clearly visible in the appropriate section of the notes It was recorded whether all, some or none of these three criteria were met for each set of notes reviewed. The length of stay, regularity with which the patient was seen on a consultant ward round and the team they were under were also recorded, as these were identified as possible factors that could influence the results. In order to meet the standard guidelines, all three criteria needed to be met. The data was then analysed and results identified as below. Research and Audit Surrey and Borders Online Journal www.sabp.nhs.uk/journal 17
Page 1 and 2: Issue 1 Summer 2010 Surrey and Bord
Page 3 and 4: Do you ever wonder why you agree to
Page 5 and 6: We are not so aware of the hidden f
Page 7 and 8: esorting too soon to complex statis
Page 9 and 10: Bipolar Disorder: how effective is
Page 11 and 12: Research Method The study was condu
Page 13 and 14: Screened for Hypomania Yes No Total
Page 15: In our sample the GPs screening met
Page 19 and 20: Fig. 2 Re-audit May 2009 - distribu
Page 21 and 22: An evolving service - results of a
Page 23 and 24: having clinical responsibility for
Page 25 and 26: school exposure to psychiatry as an
Page 27 and 28: The measures outlined above will ho
Page 29 and 30: Interview with Fiona Edwards, Chief
Page 31 and 32: Q. Very topical to that is the appo

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