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Evaluation of Psychiatric Intensive Care Unit (PICU) Admissions in Comparison to NAPICU Guidelines on Admissions Criteria

Published online by Cambridge University Press:  07 July 2023

Francis Felix*
Affiliation:
Kent and Medway NHS and Social Care Partnership Trust, Kent, United Kingdom
*
*Corresponding author.
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Abstract

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Aims

Ward 1 at The Newsam Centre, Seacroft Hospital is a 12 bedded PICU facility for the city of Leeds, United Kingdom (UK). Our average length of stay was between 3 and 4 weeks. This project aimed to evaluate our admissions in comparison to the National Association of Psychiatric Intensive Care Unite (NAPICU) guidelines on admission criteria and to describe the characteristics of our patient population. At the time of our evaluation, we operated without a specific admission criteria, and this was hypothesised to be a contributor to longer length of stay.

Methods

297 patients admitted over a period of 2 years were identified and their characteristics including age, sex, ethnicity, housing area, general practitioner (GP) practice, mental health diagnosis, and length of stay tallied. These were compared with NAPICU guidelines on admission criteria and 2 patient groups (NAPICU and Non-NAPICU) were identified, analysed, and compared using Microsoft Excel pivot table. We compared their length of stay corrected for outliers using the z-score calculation. We also looked at significant differences between the groups and looked in greater detail for the profile of the Non-NAPICU group to understand the reasons for their admission, and consider their impact on our length of stay.

Results

We found that our mean length of stay was 25.9 (1 – 215) days. When the NAPICU admission criteria were applied onto the sample, 9 patients were excluded (Non-NAPICU group) resulting in a reduction of our mean length of stay to 20.5 (1 – 83) days. When the Non-NAPICU group were looked at separately, their mean length of stay was 66.22 (7 – 152) days. When the Non-NAPICU group was looked at in greater detail, 2 patients had 2 separate recurrent admissions; one of which had a primary diagnosis of Learning Disability while the other had no clear Psychotic nor Depressive Disorder, and was complicated by Personality Disorder and criminality. 2/9 patients were detained using the forensic section 37/41. In addition, 2/9 patients were from the elderly population and 1/9 was from the younger population. There were no major differences in gender, ethnicity or age distribution.

Conclusion

Our evaluation suggested the potential reduction of our mean length of stay from 25.9 days to 20.5 days when the NAPICU admissions criteria were applied. We recommended a careful implementation of an admissions criteria for Ward 1 at The Newsam Centre PICU.

Type
Service Evaluation
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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