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Audit on nursing notes in a psychiatry in-patient setting
- Kavinda Gunathillaka, Mariam Timbo, Stephen Ginn
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S189
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- Article
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Aims
We aimed to assess the accessibility and informativeness of the content of daily nursing notes through an audit, and improve deficiencies identified.
BackgroundNursing notes are an important source of observation findings, of in-ward psychiatry patients.
There can be variations in the quality of the notes as well as information contained within.
A basic level of clarity and information within all notes will be helpful in using these to inform the management of patients.
MethodAn audit was carried-out in a ward treating working-age patients for psychiatric illnesses.
Setting standards - standard required of a daily progress note was decided after discussion in multi-disciplinary team meeting (MDT). Clear language and information on; mental-state, medication, meals, physical health, personal care, activities, risks and use of leave, were identified as requirements.
Retrospective audit - First audit cycle was carried-out by assessing the notes two weeks retrospectively. The assessment instrument used a qualitative measurement of the readability of the notes as well as quantitative assessment of the contents.
Intervention - The standards set during the MDT, as well as a suggested format for recording notes, were communicated to the staff through email. Follow-up meetings with individual staff members and MDT, to evaluate staff satisfaction and new suggestions to improve the format were held. Difficulties staff encountered when implementing the format were discussed and resolved.
Second audit cycle - Following implementation of the intervention, the notes were again assessed using the same instrument.
ConclusionDifficulty in accessing information from the notes was noted in the first audit cycle. The average score for accessibility of information when scored on Likert scale + 3 to -3, was 1. Use of language scored 2 on average. On the second audit cycle, accessibility had increased to 3 on average while language score remained 2.
Quantitative measurement was done for presence of information on; mental state, medication, meals, physical health, personal care, activities, risks and use of time away from ward. All of these parameters showed an increase in the post-intervention second audit cycle. Information on taking meals, medication, and physical health was present 100% of the time in the second cycle. Most improvement was in information on personal care which showed a five-fold increase, from 17% to 89%
In conclusion, standard for nursing notes arrived via discussion and consensus in MDT, has been successful in improving the accessibility and information within nursing notes.
Validation of the internet addiction test (IAT) to Sinhalese and assessment of internet addiction among school children in Sri Lanka
- Kavinda Gunathillaka, Chamara Wijesinghe, Trivon Gunasekera, Bhagye Premathilake, Asiri Rodrigo, Arunasalam Pathmeswaran, Lalith Kuruppuarachchi
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S27
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- Article
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Aims
To translate Young's Internet Addiction Test (IAT) to Sinhalese and validate for use in a Sri Lankan population. Following validation of the questionnaire, to use the validated questionnaire to assess the prevalence of internet addiction in a school going population in the Western province of Sri Lanka and identify characteristics of those addicted to the internet.
BackgroundThe internet is widely used across the world and in Sri Lanka. Though essential for everyday life there are many negative aspects of internet use. Addiction to the internet is one such problem and identified to exist among the general population and students in other countries. The most common tool used to measure internet addiction is Young's internet addiction test. The phenomena of internet addiction has not been scientifically studied in Sri Lanka according to our knowledge.
MethodA school-based cross-sectional analytical study conducted in two stages among students aged 15 to 19 years. In stage 1 of the study, 200 students were administered the Sinhalese translation of the IAT and internal consistency and test retest validity assessed. Once validation of the scale was established the translated scale was used on a sample of 2800 students to assess presence of internet addiction.
ResultThe Sinhala translation of the Internet addiction test showed good reliability and validity The Chrohnbach's alpha value was 0.78 and Pearson correlation coefficient of 0.85 and therefore suitable to use in a Sinhalese speaking population in Sri Lanka.
Internet addiction was identified among the study population. 8% of the entire study sample and 12.6% among those using the internet showed features of internet addiction. The majority of cases of internet addiction identified were mild 8.2% followed by moderate internet addiction in 3.6% and only 0.9 % having severe internet addiction. There were no significant demographic or internet use related features identified among those with internet users and those not addicted to the internet.
ConclusionThis study demonstrated that the Sinhala translation of Young's IAT is suitable to assess internet addiction in Sri Lanka. It also identified that there are students in Sri Lanka who are addicted to the internet. This will possibly impact negatively on their lives at a crucial stage of development and have immediate as well as long term detrimental effects. More studies are required to identify characteristics of those who are addicted to the internet and to plan interventions.