LIGATURE RECORD: improved capture of risk information in CAMHS PICU using a mnemonic-style documentation aid
Abstract
Psychiatric risks associated with ligature-tying present significant management challenges for inpatient multidisciplinary teams (MDT). Accurate and detailed clinical information capture following incidents involving ligatures is necessary to inform future risk management. A documentation tool is presented which has been demonstrated to improve the accuracy of recording of clinical risk information following inpatient ligature incidents in the child and adolescent mental health service (CAMHS) psychiatric intensive care unit (PICU) setting. The LIGATURE RECORD tool provides a highly useable prompt for information capture of 14 important data elements identified as relevant to MDT risk formulation.
The effectiveness of the LIGATURE RECORD tool was audited following its introduction in PICU in May 2020. Contemporaneous incident reports and progress note entries were examined with an improvement in the frequency of reporting of all 14 domains seen, with near-100% completeness where the prompt was used directly as a template. Particular improvements were seen in recording of non-narrative elements such as circumstantial information and important negative reports. Formal and informal feedback from clinical staff indicated good usability and high rates of adoption of the tool.
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Date
2021
Type
Subject
Child psychiatry, Child health services, Risk assessment, Psychiatric intensive care unit, Ligature
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Citation
Meggison, N., Anyameluhor, F., El-Ahmar, H. & Morley, L. (2021). LIGATURE RECORD: improved capture of risk information in CAMHS PICU using a mnemonic-style documentation aid. Journal of Psychiatric Intensive Care, 17(2), pp. 113-122.