NEW LONG-STAY PATIENTS ON ACUTE PSYCHIATRIC UNITS - DOES AUDIT CHANGEPRACTICE

Patients who have prolonged stays on acute psychiatric wards are a fea ture of many modern community psychiatric services. The present study aimed to determine if the care delivered to these patients could be im proved by reflecting back to practitioners easily auditable components of the patients' care, The subjects comprised patients resident on th e acute psychiatric units in Sheffield for more than six months. These patients were surveyed in April 1995 and again in February 1996, Afte r the first survey, clinicians received a presentation and feedback re garding aspects of their patients' care. The results demonstrated ther e had been little change in the percentage of acute bed capacity occup ied by patients with inpatient stays in excess of six months, despite improvement in many of the audit standards. The main reason for prolon ged inpatient treatment was continued mental state or behavioural dist urbance. The mean length of stay of patients in this category actually increased. The results suggest that a simple audit exercise can impro ve the quality of care delivered to this group of patients, but that t hey will continue to occupy a substantial proportion of acute bed capa city in the absence of suitable alternative treatment settings.