A study of factors influencing the duration of stay in forensic psychiatric ward patients

Background: Psychiatric patients who are admitted in to forensic psychiatric ward have frequent hospital admissions and prolonged length of hospital stay, may be due to the growing demands in health services and the limitation of resources of patients and their care takers. Aim and objectives: To study the mean duration of stay in psychiatric forensic wards and to study the socio demographic factors of the admitted patients and their clinical profile. Materials and methods: A total of 150 case records fulfilling criteria for study were taken. Semi - structured proforma for socio demographic and clinical variables were used and analyzed using SPSS. Results: Mean duration of hospital stay in closed ward patients was 92.47 and the mean duration of hospital stay was 21.9 days in patients whose reception order had a clear mention of free citizen and can be handed over to family members in comparison 38.9 days in “To be produced before the court”, 33.71 days in reception order having “Yet to be clarified”. Conclusion: Socio-demographic factors like educational level, clinical diagnosis, details of the reception order regarding discharge status, residential status after discharge are significant factors which influenced the duration of hospital stay in forensic ward patients. We also noticed that certain phrasings of the reception order have much significantly influenced the delay in the discharge.

Influenza A (H1N1) Outbreak at a Psychiatric Closed Ward and Infection Control / 신경정신의학

OBJECTIVES: In this study, we propose effective policies for preventing transmission in the closed ward of psychiatry department at the subject hospital. METHODS: 15 patients (9 in 2010, 3 in 2012, and 3 in 2013) infected by 2009 H1N1 Influenza A were treated with Tamiflu® (Roche), and preventive Tamiflu® was administered to patients without symptoms as well as healthcare workers. Infected patients were placed in cohorts or isolation rooms with droplet and contact precautions. The ward was cleaned daily with chloride. Influenza vaccinations were administered to immunosuppressed patients and long-term patients. In addition, respiratory etiquette posters were posted on the closed ward during the latter half of 2012. The 2013 outbreak involved the same controls as 2012. RESULTS: The incidence of outbreak among patients during the three outbreaks was 53%, 18%, and 19%. The incidence of infection among healthcare workers was 0% throughout the three periods, and there was no additional infection. CONCLUSION: In a closed ward of the psychiatry department, there is constant contact between healthcare workers and patients. Therefore, the possibility of influenza transmission is expected to be high. It is important to maintain constant inspection to detect outbreaks. Effective infection control should be applied to block the virus.

A Comparative Study on the Therapeutic Setting of the Open and the Closed Ward in Mental Hospital / 신경정신의학

OBJECTIVES: The treatment setting of mental hospital has a great influence on the outcome of treatment. The authors compared the characteristics of treatment setting of the open and the closed wards in a mental hospital and the attitudes of the staff and patients on each ward. METHODS: Total four wards two typical open wards and two typical closed wards were selected and each contained one male ward and one female ward. Ward Atmosphere Scale(WAS) was conducted to each and the mean scores of suscales of WAS were compared by using Student's t-test. RESULTS: 1) The closed ward was similar to the treatment setting of control-oriented program which stresses the stator control and the nile of ward and ignores the autonomy of patients and such a evaluation was perceived more by the patients than by the staff. 2) The open ward supported and encouraged the staff and patients and focused on solving the practical problems of the patients, and especially the staff perceived it as the treatment program the activated ward. 3) It was shown that the open ward was more therapeutic and while it focused on the autonomous problem solving, the closed ward pup enguasis on the protection of patients. In addition, the patients were more sensitive to the difference of setting between the two wards than the star. CONCLUSION: In conclusion, if various and realistic programs were offered to the patients in the ward, the open ward would be proposed as a desirable therapeutic form for the chronic psychiatric inpatients.