با سلام خدمت کاربران در صورتی که با خطای سیستم پرداخت بانکی مواجه شدید از طریق کارت به کارت (6037997535328901 بانک ملی ناصر خنجری ) مقاله خود را دریافت کنید (تا مشکل رفع گردد).
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Psychotropic medication profile in a community youth mental health service in Australia
نقش داروهای روان گردان در سلامت روانی جوانان جامعه در استرالیا-2018 Aim
There has been a rise in the use of psychotropic medication in young people, despite limited risk-benefit profile of psychotropic medication for this population. Given their side effect profile, the use of psychotropic medications should occur with caution. This study investigated psychotropic prescribing pattern in a public youth community mental health service and gives an estimate of general level of psychotropic medication use in this setting.
Methods
A retrospective file review was undertaken of all young people aged 12–17 who received care from the service in 2016 (N = 189) for a range of mental health problems, excluding psychosis. Files were reviewed for demographical information (age, gender), diagnosis/presenting issues, prescribed medications, indications of medications, and prescriber type (e.g. psychiatrist, general practitioners (GPs), paediatrician). The data was analysed descriptively.
Results
Over 60% (60.8%, n = 115) of young people were prescribed psychotropic medications. Over half of the entire sample were on antidepressants (51.32%, n = 97), nearly a quarter (n = 46, 24%) on antipsychotics, 6% on ADHD medications (6.35%, n = 12), and a fifth (19.58%, n = 37) on polypharmacy. Antidepressants and antipsychotics were mostly used off-label, prescribed by public psychiatric staff. Quetiapine was the most prescribed antipsychotic predominantly for insomnia. Fluoxetine and fluvoxamine were the most prescribed antidepressants predominantly for anxiety disorders. Girls are more likely to be prescribed psychotropic medications than boys, specifically antipsychotic medication.
Conclusions
A high proportion of young people were prescribed psychotropic medication, including antipsychotic medication, mostly for the treatment of anxiety and depressive disorders. There is little evidence around how psychotropic medication is used in youth mental health settings, and this study contributes to this gap.
keywords: Psychotropic medication |Adolescent mental health |Prescribing patterns |Antidepressants |Antipsychotics |
مقاله انگلیسی |
2 |
Application of the SEIPS Model to Analyze Medication Safety in a Crisis Residential Center
کاربرد مدل SEIPS برای تحلیل ایمنی دارو در یک بحران مرکز مسکونی-2018 Purpose: Medication safety and error reduction has been studied in acute and long-term care settings, but little
research is found in the literature regarding mental health settings. Because mental health settings are complex,
medication administration is vulnerable to a variety of errors from transcription to administration. The purpose
of this study was to analyze critical factors related to a mental health work system structure and processes that
threaten safe medication administration practices.
Background: The Systems Engineering Initiative for Patient Safety (SEIPS) model provides a framework to
analyze factors affecting medication safety. The model approach analyzes the work system concepts of tech
nology, tasks, persons, environment, and organization to guide the collection of data.
Methods: In the study, the Lean methodology tools were used to identify vulnerabilities in the system that could
be targeted later for improvement activities. The project director completed face-to-face interviews, asked nurses
to record disruptions in a log, and administered a questionnaire to nursing staff. The project director also
conducted medication chart reviews and recorded medication errors using a standardized taxonomy for errors
that allowed categorization of the prevalent types of medication errors.
Results: Results of the study revealed disruptions during the medication process, pharmacology training needs,
and documentation processes as the primary opportunities for improvement. The project engaged nurses to
identify sustainable quality improvement strategies to improve patient safety.
Conclusion: The mental health setting carries challenges for safe medication administration practices. Through
analysis of the structure, process, and outcomes of medication administration, opportunities for quality im
provement and sustainable interventions were identified, including minimizing the number of distractions
during medication administration, training nurses on psychotropic medications, and improving the doc
umentation system. A task force was created to analyze the descriptive data and to establish objectives aimed at
improving efficiency of the work system and care process involved in medication administration at the end of the
project.
Keywords: Medication administration ، Mental health ، Process improvement ، SEIPS model ، Drug administration ، Medication errors and control ، Quality improvement |
مقاله انگلیسی |