[Management of violent behaviour and rapid tranquillisation during acute psychotic episode: discrepancy between routine practice and evidence. The SIEP-DIRECT'S Project].
OBJECTIVE
To evaluate the quality of acute psychiatric care concerning the management of violent behaviour and rapid tranquilization.


METHODS
Data concerning 13 indicators, drawn from NICE recommendations, were collected in 19 Departments of Mental Health, in the frame of the SIEP-DIRECT'S Project, to evaluate the implementation of NICE recommendations in Italian Mental Health Services.


RESULTS
In about two thirds of Departments of Mental Health (DMHs) professionals were trained in the management of violent behaviour, while written procedures existed only in one fourth of DMHs. About a half of the professionals working in Psychiatric Wards in General Hospital were trained in rapid tranquilization, while procedures on this topic are practically absent and specific care for monitoring intensively the heavily sedated patient was not frequent.


CONCLUSIONS
Management of violent behaviour and rapid tranquilization are two critical areas in the care performed by Psychiatric Wards in General Hospital. Training on these topics is more frequent than implementation of procedures. NICE recommendations and SIEP indicators are useful tools for improving the quality of acute psychiatric care.
Lora
Antonio
A
Dipartimento di Salute Mentale, Azienda Ospedaliera di Vimercate, Vimercate, Milano. antoniolora@virgilio.it
Morganti
Carla
C
Erlicher
Arcadio
A
Burti
Lorenzo
L
Buscaglia
Giacinto
G
Pegoraro
Marco
M
Davide
Jacchetti
J
Cristofalo
Doriana
D
Ruggeri
Mirella
M
Domenico
Semisa
S
D000208:Acute Disease; D003156:Community Mental Health Services / Q000592:standards*; D006801:Humans; D007558:Italy; D017410:Practice Guidelines as Topic / Q000592:standards*; D011618:Psychotic Disorders / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy*; D012955:Societies, Medical; D013997:Time Factors; D014149:Tranquilizing Agents / Q000627:therapeutic use*; D014754:Violence
D014149:Tranquilizing Agents