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829 / Appropriate use of benzodiazepines and hypnotic drugs

IRELAND
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Medication / IV Fluids
Other There is no specified text here
Topic of the reported practice
Audit system
Aim and the benefit of the Patient Safety Practice
 
A comprehensive clinical audit benchmarking practice against standards contained in a number of best practice documents, including Benzodiazepines: Good Practice Guidelines For Clinicians (DoHC, 2002), the Maudsley Prescribing Guidelines, the NICE (National Institute for Clinical Excellence, UK) Guidelines and other international best practice guidelines was undertaken in January 2011. This project was undertaken by a sub-committee of the Drugs & Therapeutics Committee and overseen by the Clinical Governance Committee. The results and conclusions arising from the audit of appropriate use of benzodiazepine and hypnotics were presented to the Clinical Governance Committee in September 2011 and implemented throughout the organisation.
Description of the Patient Safety Practice
 
Method: Clinical Audit Cycle of Benzodiazepine Prescribing Practice
Implementation: The Clinical Governance Committee has led the introduction of a number of practical prescribing changes. These include:

1.    The Drugs and Therapeutics Committee should be tasked with developing and implementing a Benzodiazepine Prescribing Policy (see Appendix 3).
2.    Hospital Policy was changed so that Registrars are prohibited from prescribing PRN (as necessary) Benzodiazepines and should they ignore this prohibition the Pharmacist is authorised to discontinue this prescription.
3.    Hospital Policy was also changed to allow for when a Registrar is asked to prescribe a Benzodiazepine that they must do so as a stat (once only) prescription or they may only prescribe Benzodiazepines on a regular basis.
4.    Benzodiazepines that are prescribed on a regular basis need to be reviewed weekly by the Consultant Psychiatrist in conjunction with the multidisciplinary team.
5.    In the longer term SPUH / SEH should consider ways in which we can initiate good sleep hygiene practices throughout the organisation, perhaps through the work of a small project team.
6.    Multidisciplinary teams must recognise and record on the treatment plan the existence of Benzodiazepine dependence.

Evaluation: Re-audit showed significant reduction in the prescription of benzodiazepines.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Mental health care
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Pharmacists
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Regular data feed back to involved staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Steve Douglas
Country: IRELAND
Organisation: St. Patrick's University Hospital
E-mail: sdouglas@stpatsmail.com
Phone: 00 353 1 249 3439
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