Spanish experts consensus on emergency psychiatric care in hospital emergency departments
Por:
Gordillo-Urbano, RM, Crespo-Facorro, B, Pérez-Solá, V, Cardoner, N, García-Ligero, E, Moreno, C, Ramos-Quiroga, JA, Ruiz-Veguilla, M, Vázquez-Vallejo, M, Prados-Ojeda, JL
Publicada:
4 jul 2024
Resumen:
BackgroundThe demand for urgent psychiatric care is increasing, but in Spain there are no clear recommendations for emergency departments (ED) on how to optimize care for patients with psychiatric emergencies. We aimed to provide expert consensus recommendations on the requirements for general hospitals emergency departments to treat patients with urgent psychiatric symptoms.MethodsWe used a modified Delphi technique. A scientific committee compiled 36 statements based on literature search and clinical experience. The statements covered the organizational model, facilities, staffing, safety, patient interventions, and staff training. A panel of 38 psychiatry specialists with expertise in psychiatric emergencies evaluated the questionnaire in two rounds.ResultsAfter two rounds of voting, 30 out of 36 proposed items (83%) were agreed upon. The panel agreed that psychiatric emergencies should be managed in a general hospital, with dedicated facilities for patient assessment, direct supervision of patients at risk, and an observation unit run by the psychiatric service. In addition to the psychiatrist, the ED should have specialist nurses and security staff available 24/7. Social workers should also be readily available. ED and consulting rooms should be designed to ensure patient and staff safety. A triage system should be established for patients with psychiatric symptoms, with medical evaluation preceding psychiatric evaluation. Guidance on supplies, equipment, and staff training is also provided.ConclusionAll ED in general hospitals should have adequate resources to handle any psychiatric emergency. This paper provides recommendations on the minimum requirements to achieve this goal.
Filiaciones:
Gordillo-Urbano, RM:
Hosp Infanta Margarita, Mental Hlth Clin Management Unit, South Hlth Management Area Cordoba, Unidad Gest Clin Salud Mental Area Gest Sanitaria, Cordoba, Spain
Crespo-Facorro, B:
Hosp Univ Virgen Rocio, Dept Mental Hlth, Seville, Spain
Univ Seville, Sch Med, Dept Psychiat, Seville, Spain
Inst Biomed Seville, IBiS, Seville, Spain
Inst Sauld Carlos III ISCIII, Hlth Inst Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Spanish Natl Network Res Mental Hlth, Madrid, Spain
Pérez-Solá, V:
Inst Sauld Carlos III ISCIII, Hlth Inst Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Spanish Natl Network Res Mental Hlth, Madrid, Spain
Hosp Mar, Mental Hlth Inst, Barcelona, Spain
Hosp Mar Med Res Inst, Barcelona, Spain
Univ Pompeu Fabra, Barcelona, Spain
Cardoner, N:
Inst Sauld Carlos III ISCIII, Hlth Inst Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Spanish Natl Network Res Mental Hlth, Madrid, Spain
UAB, Hosp Sant Creu I Sant Pau, Sant Pau Biomed Res Inst, Psychiat & Legal Med, Barcelona, Spain
Univ Autonoma Barcelona, Sch Med, Dept Psychiat & Forens Med, Barcelona, Spain
García-Ligero, E:
Hosp Univ Virgen Rocio, Dept Mental Hlth, Seville, Spain
Moreno, C:
Univ Complutense, Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth,Sch Med, Dept Child & Adolescent Psychiat,CIBERSAM,IiSGM,IS, Madrid, Spain
Ramos-Quiroga, JA:
Inst Sauld Carlos III ISCIII, Hlth Inst Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Spanish Natl Network Res Mental Hlth, Madrid, Spain
Hosp Universitari Vall dHebron, Dept Mental Hlth, Barcelona, Spain
Vall dHebron Inst Recerca VHIR, Grp Psychiat Mental Hlth & Addict, Barcelona, Spain
Univ Autonoma Barcelona, Dept Psychiat & Forens Med, Barcelona, Spain
Ruiz-Veguilla, M:
Hosp Univ Virgen Rocio, Dept Mental Hlth, Seville, Spain
Univ Seville, Sch Med, Dept Psychiat, Seville, Spain
Inst Biomed Seville, IBiS, Seville, Spain
Inst Sauld Carlos III ISCIII, Hlth Inst Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Spanish Natl Network Res Mental Hlth, Madrid, Spain
Vázquez-Vallejo, M:
Hosp Clin Barcelona, Serv Psychiat & Psychol, Barcelona, Spain
Prados-Ojeda, JL:
Hosp Univ Reina Sofia, Dept Mental Hlth, Cordoba, Spain
Univ Cordoba, Sch Med, Morphol & Socio Sanitary Sci Dept, Cordoba, Spain
Inst Maimonides Invest Biomed Cordoba IMIBIC, Maimonides Biomed Res Inst Cordoba, Cordoba, Spain
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