Clinical Re-audit of NICE Guideline CG120: Psychosis and co-existing substance misuse

First published: 10/05/2019 | Last updated: May 20th, 2019

Aims
Research has shown that patients with schizophrenia have a higher tendency to abuse substances than the average population. This can lead to an increase in severity of symptoms, a poorer response to treatment and increased risk of suicide. Following recommendations of the previous audit, the aim of this re-audit is to establish any improvements of information gathering in psychotic patients with co-existing substance misuse according to NICE guidelines CG120.

Method
The audit was performed between 1st of August and 1st October 2015 in Cedar ward, Harrogate Hospital. The information was collected from PARIS using a designated audit tool which covered areas regarding identification of the substance used, details of usage, withdrawals and` urine drug sampling. A standard of 100% was set for each criterion. A total number of 4 patients with an ICD-10 diagnosis between F20-F29 were identified. The data  collected were transferred to spreadsheet for data analysis.

Results
Comparing the results with previous audit, there has been a general increase in the standards by an average of 24%. Out of the 4 patients identified, all of them (100%) were questioned about alcohol and illicit drug use. In contrast, none of the patients were questioned about the route of administration and quantity of substance used.

Conclusion
As a comparison to previous work done, it is clear that there is an improvement in the standards. Some areas are yet to reach their 100% target and using recommendations made by this project, will be the subject of further re-audits.

Co-Authors

PROJECT LEAD- DR FATIMA ABUBAKAR- CT1 PSYCHIATRY PROJECT TEAM- DR HANY EL-SAYEH -CONSULTANT PSYCHIATRIST PROJECT LEAD OF PREVIOUS AUDIT- DR DANIEL WHITNEY -CT1 PSYCHIATRY TEAM MEMBER OF PREVIOUS AUDIT- RACHAEL DUNNILL – MEDICAL STUDENT

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Dr Fatima Abubakar