RANZCP guidelines for psychotropic drugs: application to hospital inpatients. Royal Australian and New Zealand College of Psychiatrists.

Abstract

The objective of this study was to monitor compliance with the Royal Australian and New Zealand College of Psychiatrists (RANZCP) guidelines for psychiatric drug use, in the forensic section of a psychiatric institution in Queensland. The author performed an audit of the charts and medical records of 65 patients in three forensic hospital wards at the John Oxley Memorial Hospital, a 73-bed forensic/secure section of the Wolston Park Hospital Complex. It was found that many patient records were lacking some relevant documentation. There was a higher rate of prescription for multiple psychotropic drugs than is recommended for patients at discharge from inpatient units. This quality assurance exercise has provided a basis for discussion to find ways to more closely comply with the RANZCP Guidelines for Psychotropic Drugs in Psychiatric Practice. No benchmarks are available for equivalent continuing inpatients in a similar setting. It has been shown that, for continuing inpatients in a forensic hospital, there is poor compliance with Draft Clinical Indicator No. 2.1 for Pilot Test (developed jointly by the RANZCP and the ACHS). Perhaps the threshold for this indicator needs to be raised in this clinical setting. The situation may be clarified when the proposed follow-up audit has taken place. There were no patients receiving doses in excess of currently-accepted limits, that is, Clinical Indicator (CI) No. 2.2 was 0, and there were 31 patients (47.7%) concurrently receiving two or more antipsychotic drugs and CI no.2.3 had a value of 31.