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Assessement of Antipsychotic Side-Effects Monitoring in Learning Disability Patients in a Medium Secure Hospital
- Indu Surendran, Johannes Cronje
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S183-S184
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- Article
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- Open access
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Aims
Learning Disability population has increased neuroleptic sensitivity which predisposes to development of side-effects at even lower doses of antipsychotics. STOMP practices (Stopping OverMedication of People with a learning disability, autism or both psychotropic medications) advocate regular review of psychotropic medications, providing information about non-pharmacological therapy and involvement of patients and families about medications. Our audit aimed to understand how the side-effects in the Learning Disability patients who are on antipsychotics in a Medium Secure Hospital were being monitored in a 12-month period. The objectives were to assess whether the side-effects were being monitored regularly, whether a scale (Liverpool University Neuroleptic Side-Effect Rating Scale or LUNSERS) was being used or not, the grade of staff conducting the assessment and whether the outcomes being scored and reviewed adequately in Multi-Disciplinary Team meetings or Care Programme Approach meetings.
Methods• It was a retrospective, cross-sectional audit involving inpatients on the Learning Disability Wards of Rowan View (Medium Secure Hospital under Merseycare) in the time period 01/06/21 to 31/05/22
• No patients were excluded
• Data pertaining to assessment of side-effects to antipsychotics were collected from electronic database PACIS, the computer database used in Rowan View using Microsoft excel tool created by author
• Descriptive statistics were used to analyse data
ResultsThere were 27 patients included in the study from four different learning disability wards in Rowan View Hospital. In all but one (96.3%), side-effects to antipsychotics were assessed at least once in 12 months, but formal assessment using a rating scale was conducted in only 88.5%. In majority of patients, only one assessment was done in 12 months (43.8%) whilst the maximum was 3 assessments in a year in 34.8%. None of the assessments had the grade of staff noted whilst only 8.7% assessments were scored despite 91.3% being calculated and only 26.1% assessments even reviewed further. All patients reported side-effects to some extent.
ConclusionThe modality and frequency of reviewing side-effects to antipsychotics in this neuro-sensitive patient population was noted to be inadequate. The practice of using LUNSERS appears to be completed only superficially with questionable delivery and review of results. There is no formal guideline available nation-wide for basing this assessment of side-effects despite STOMP actions (other than suggestions) and a real deficit was identified. A creation of a formal guideline for monitoring side-effects in patients with Learning Disability is needed and is currently being addressed by Rowan View Patient Safety Team.
3 - Real learning in virtual environments
- from Part I - Literacies in the digital age
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- By Johannes Cronjé, Professor of Computers in Education and Training University of Pretoria, South Africa
- Edited by Allan Martin, Dan Madigan
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- Book:
- Digital Literacies for Learning
- Published by:
- Facet
- Published online:
- 08 June 2018
- Print publication:
- 30 September 2006, pp 34-41
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Summary
Abstract
Virtual learning environments mirror their physical counterparts in many ways, using metaphorical representations to enable students to understand the interface. Digital campuses share the architectural features exhibited by physical institutions: an entrance, administration block, lecture halls, library, ancillary services and recreation areas. Lectures are replaced by learning tasks that require learners to interact, promoting a feeling of community. Co-operative learning allows us to compensate for the absence of interactivity in web-based learning. While computer literacy is taken for granted, students in digital learning environments require three specific literacies: visual, co-operative and academic literacy.
Introduction
E-learning courses show a distinct advantage over conventional distance education because in a digital environment e-mail and bulletin boards have made it easier and cheaper for messages to be exchanged within a cost-effective learning environment (Woods and Baker, 2004). Nevertheless they lack the personal dimension of contact education. In most cases an instructor cannot see the body language of a student or hear their expressions of joy or disappointment. Neither can you feel the oppressive heat in a desert classroom, or smell the stink bomb from a naughty learner. So, how does one get a taste for e-learning?
The answer seems to lie in the creation of learning communities by using metaphor and collaborative learning tasks. Functioning in online learning communities requires students to be able to decode the metaphors, interact with their peers, and take responsibility for their own learning. Three literacies are required: visual literacy, co-operative literacy and academic literacy.
While McInnerney and Roberts (2004) highlight the importance of social context in determining the success or failure of learning, Jones (1997) shows the relationship between an online community and the internet when he distinguishes between ‘a virtual community's cyber-place and the virtual community itself. A virtual community's cyber-place will be termed a virtual settlement.’ This chapter considers the architecture and functioning of virtual settlements where communities learn – virtual learning environments and portals – and compares them metaphorically with physical campuses.
Real or virtual
Now that the internet and digital technology have reached into just about every home in the developed world, and even the wealthier parts of the poorest of developing countries, it becomes hard to talk of the internet as a virtual environment. To many users it has become the primary actual means of communication.