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Overdose and Self-Harm CPI
Clinical scenario
Patients who present with SH are at high risk of further self-harm and suicide. The government published guidelines on the management of self-harm in 1984 which recommended that all those seen in the emergency department (ED) following an episode of SH be given a psychosocial assessment prior to discharge by a member of staff trained for the task. The initial assessment of self-harm patients in most hospitals remains the responsibility of medical staff in the ED.
Audit question
Are patients presenting with overdose and/or self-harm managed appropriately according to best practice guidelines?
Method
Retrospective audit
Sample: 30-50 Emergency Department patient records
Criteria
Inclusions: All patients 16 years old and over attending with self-harm (whether physical or pharmacological)
Exclusions: None
Audits
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1st August 2011
Results
| Date | Patients | Measured | Results | Standard | Regional avg. |
|---|---|---|---|---|---|
| 01st August 2011 | Patients attending ED following overdose or self-harm episode | Management of patient according to criteria | If diminished capacity/mental illness established, patient referred for urgent mental health assessment | 100 % | 90.48 % |
| Appropriate follow-up arranged and documented for patients who leave after triage and prior to assessment, and GP informed | 100 % | 33.33 % | |||
| Patients offered preliminary psychosocial assessment at triage | 100 % | 61.29 % | |||
| Psychosocial assessment by ED personnel prior to referral or discharge from the ED | 100 % | 87.1 % |
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