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An audit of clinical practice in an ACT team against NICE guidelines in schizophrenia

Published online by Cambridge University Press:  01 July 2007

Rob Macpherson ,
Nicola Hovey ,
Krishen Ranganath ,
Amjad Uppal  and
Andrew Thompson
Rob Macpherson*
Affiliation:
Consultant Psychiatrist, Wotton Lawn Hospital, Gloucester
Nicola Hovey
Affiliation:
Audit Manager, Gloucestershire NHS Partnership Trust, Rikenel, Montpellier, Gloucester
Krishen Ranganath
Affiliation:
Senior House Officer in Psychiatry, Wotton Lawn Hospital
Amjad Uppal
Affiliation:
Senior House Officer in Psychiatry, Wotton Lawn Hospital
Andrew Thompson
Affiliation:
Psychiatrist, ORYGEN Youth Health, Parkville, Melbourne, Australia
*
Correspondence to: Rob Macpherson, Wotton Lawn Hospital, Horton Road, Gloucester GL1 3WL. E-mail: rob.macpherson@glos.nhs.uk
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Abstract

Aims and method: We audited the caseload of an Assertive Community Treatment (ACT) team against National Institute of Clinical Excellence (NICE) guidelines in the treatment of schizophrenia. Care coordinators rated the work carried out by the team on an audit tool. Results were compared to a case note audit completed 2 years earlier.

Results: 61 patients had a primary diagnosis of schizophrenia. Rates of compliance with NICE guidelines varied from 0% (provision of advance directive) to 85% (written information given, no antipsychotic polypharmacy). Compliance was greater than in the earlier audit.

Discussion: When refusal, lack of capacity or indication were taken account of, guidelines were generally adhered to. Although a useful benchmarking process and an opportunity to identify skill deficits in the team, our findings raised concerns about simplistic notions of guideline implementation, as a means to improve practice. Patient choice is an important consideration.

Keywords

AuditACTNICE schizophrenia guidelines
Type
Original Article
Information
Journal of Psychiatric Intensive Care , Volume 3 , Issue 2 , July 2007 , pp. 113 - 117
Copyright
Copyright © NAPICU 2007

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