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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 2007

1st December 2007

1st April 2008

1st August 2008

1st December 2008

1st April 2009

1st August 2009

1st December 2009

1st April 2010

1st August 2010

1st December 2010

1st April 2011

1st August 2011

1st December 2011

1st April 2012

1st August 2012

1st December 2012

Show Results Over Time

Results

 
Date Patients Measured Results Standard Regional avg.
01st December 2010 Patients attaneding ED following overdose or self-harm episode Management according of patient to criteria If diminished capacity/mental illness established, patient referred for urgent mental health assessment 100 % 91.43 %
Appropriate follow-up arranged and documented for patients who leave after triage and prior to assessment, and GP informed 100 % 90.63 %
Patients offered preliminary psychosocial assessment at triage 100 % 97.5 %
Psychosocial assessment by ED personnel prior to referral or discharge from the ED 100 % 92.5 %

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Record created on 1st May 2011 by