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Start Over Author "Patrick Keown" Journal bjpsych bulletin
3 results on '"Patrick Keown"'

1. Development and evaluation of a personalised sleep care plan on child and adolescent in-patient mental health wards

Author

Kirstie N. Anderson, Rod Bowles, Christine Fyfe, Ron Weddle, and Patrick Keown

Subjects
Education and training, sleep–wake disorders, risk assessment, psychiatric nursing, mental health services, Psychiatry, RC435-571
Abstract

Aims and method The study evaluated a package of measures to improve sleep on psychiatric wards admitting patients from children and young people's services (CYPS). Sleep disturbance has significant impact on adolescent mental health, and in-patient wards can directly cause sleep disturbance, independent of the problem that led to admission. We developed a CYPS-specific package (TeenSleepWell) that promoted a better sleep environment, enhanced staff education about sleep, screened for sleep disorders, and raised awareness of benefits and side-effects of hypnotics. This included personalised sleep care plans that allowed a protected 8 h sleep period when safe. Results Evaluation over 2 years showed enhanced in-patient care: 57% of patients were able to have a protected sleep period. There was no increase in adverse events and there was a decrease in hypnotics issued. Clinical implications Improving sleep during in-patient CYPS admissions is possible and personalised sleep care plan should be a care standard.

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2. Mental health clustering and diagnosis in psychiatric in-patients

Author

Patrick Keown, Jon Painter, and Liam Trevithick

Subjects
Psychosis, medicine.medical_specialty, education.field_of_study, business.industry, Population, medicine.disease, Mental health, Personality disorders, Original Papers, 030227 psychiatry, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Mood disorders, medicine, 030212 general & internal medicine, Medical diagnosis, Psychiatry, business, education, Anxiety disorder, Superclass
Abstract

Aims and methodThis paper investigates the relationship between cluster (Mental Health Clustering Tool, MHCT) and diagnosis in an in-patient population. We analysed the diagnostic make-up of each cluster and the clinical utility of the diagnostic advice in the Department of Health's Mental Health Clustering Booklet. In-patients discharged from working-age adult and older people's services of a National Health Service trust over 1 year were included. Cluster on admission was compared with primary diagnosis on discharge.ResultsOrganic, schizophreniform, anxiety disorder and personality disorders aligned to one superclass cluster. Alcohol and substance misuse, and mood disorders distributed evenly across psychosis and non-psychosis superclass clusters. Two-thirds of diagnoses fell within the MHCT ‘likely’ group and a tenth into the ‘unlikely’ group.Clinical implicationsCluster and diagnosis are best viewed as complimentary systems to describe an individual's needs. Improvements are suggested to the MHCT diagnostic advice in in-patient settings. Substance misuse and affective disorders have a more complex distribution between superclass clusters than all other broad diagnostic groups.

Published
2015

3. Feasibility and utility of enhanced sleep management on in-patient psychiatry wards

Author

Rosie Locke, Kirstie N. Anderson, Stuart Watson, Emma Packer, Patrick Keown, Alastair Paterson, Chloe Novak, and Ambrina Roshi

Subjects
Sleep disorder, medicine.medical_specialty, obstructive sleep apnoea, medicine.drug_class, business.industry, nursing observations, Sleep management, medicine.disease, Mental health, Original Papers, Hypnotic, Psychiatry and Mental health, psychiatric nursing, medicine, Insomnia, In patient, Sleep (system call), medicine.symptom, Adverse effect, business, Psychiatry, Sleep, in-patient treatment
Abstract

Aims and methodSleep disturbance is common in psychiatry wards despite poor sleep worsening mental health. Contributory factors include the ward environment, frequent nightly checks on patients and sleep disorders including sleep apnoea. We evaluated the safety and feasibility of a package of measures to improve sleep across a mental health trust, including removing hourly checks when safe, sleep disorder screening and improving the ward environment.ResultsDuring the pilot there were no serious adverse events; 50% of in-patients were able to have protected overnight sleep. Hypnotic issuing decreased, and feedback from patients and staff was positive. It was possible to offer cognitive–behavioural therapy for insomnia to selected patients.Clinical implicationsMany psychiatry wards perform standardised, overnight checks, which are one cause of sleep disruption. A protected sleep period was safe and well-tolerated alongside education about sleep disturbance and mental health. Future research should evaluate personalised care rather than blanket observation policies.

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