ABSTRACT
OBJECTIVES: Specialist Perinatal Mental Health Services (SPMHS) are a new development in Ireland. This service evaluation examined the impact of the introduction of a SPMHS multidisciplinary team (MDT) on prescribing practices and treatment pathways in an Irish maternity hospital. METHODS: Clinical charts were reviewed to collect data on all referrals, diagnoses, pharmacological and non-pharmacological interventions delivered in a SPMHS over a 3-week period in 2019. The findings were compared to the same 3-week period in 2020 following the expansion of the SPMHS MDT. RESULTS: In 2019 (n = 32) and 2020 (n = 47), most (75 and 79%, respectively) assessments were antenatal. The proportion of patients prescribed psychotropic medication within the SPMHS was not significantly different from 2019 (31%) to 2020 (23%), though more patients were already prescribed psychotropic medications at the time of referral (22% in 2019 v. 36% in 2020). There was an increase in MDT interventions in 2020 with more input from psychology, clinical nurse specialist (CNS), and social work intervention. Adherence to prescribing standards improved from 2019 to 2020. CONCLUSION: Prescribing patterns remained unchanged between 2019 and 2020. Improvement was observed in adherence to prescribing standards and there was increased provision of MDT interventions in 2020. Broader diagnostic categories were also used in 2020, possibly suggesting that the service is now providing more individualized care.
Subject(s)
Hospitals, Maternity , Mental Health Services , Pregnancy , Female , Humans , Universities , Psychotropic Drugs , Referral and ConsultationABSTRACT
Of 834 children who had appendicectomy for appendicitis 77 (9.2%) had developed an appendix mass when first seen. Under 6 years of age 25% of appendicitis patients had an appendix mass at presentation and almost 60% of the masses seen were in patients under six years of age. Forty three of the 77 masses (55%) were palpable only under anaesthesia. The masses were all initially managed conservatively by bed rest, intravenous fluids and intravenous antibiotics. All but eight (10%) of the 77 patients responded to this form of treatment. Interval appendicectomy was planned for a date 4 weeks following discharge. The overall total average bed stay including interval appendicectomy was 16 days. There were no late complications or relaparotomies.
Subject(s)
Appendicitis/complications , Appendix , Cecal Diseases/therapy , Abscess/surgery , Adolescent , Anti-Bacterial Agents/therapeutic use , Appendectomy , Appendicitis/therapy , Bed Rest , Cecal Diseases/etiology , Child , Child, Preschool , Drainage , Fluid Therapy , Humans , Infant , Length of Stay , PalpationABSTRACT
A commintment to the concept of total patient care requires consideration of the social and emotional, as well as the physical, problems of the patient. Assessing the quality of the social work service--including adequate attention to problem evaluation, social treatment, and outcome--can help to assure that patients will return to as high a level of social functioning as possible.
