9. Increases in the use Split in two The distinctions • – • physical and between these of restrictive practices. mechanical practices are Examples: use of restraint versus recognised. seclusion, use of PRN Splitting them, physical or mechanical medications. however, would restraint, increased use seem to create a level of of medications specificity/precision administered/taken as not afforded to needed (known as PRN other signs of medications), increased deterioration. This level of observation reasoning may be sufficient to keep them together. 10. Unresponsiveness Cluster name The examples are • • needs changing about treatment. Examples: to care. to reflect the unexpected signs better. 10. Unresponsiveness The examples • to treatment. seeking care, relate to Examples: unexpected unresponsiveness to rather treatment re-admission/return de-escalation attempts, than care more seeking treatment, generally. self-medication, not unresponsiveness to following expected de-escalation improvement attempts, pathway/trajectory not following expected improvement pathway/trajectory
9. Increases in the use of restrictive practices. Examples: use of seclusion, use of physical or mechanical restraint, increased use of medications administered/taken as needed (known as PRN medications), increased level of observation • Split in two – physical and mechanical restraint versus PRN medications. • The distinctions between these practices are recognised. Splitting them, however, would seem to create a level of specificity/precision not afforded to other signs of deterioration. This reasoning may be sufficient to keep them together. 10. Unresponsiveness to care. Examples: unexpected seeking care, unresponsiveness to de-escalation attempts, self-medication, not following expected improvement pathway/trajectory • Cluster name needs changing to reflect the signs better. • The examples relate to treatment rather than care more generally. • The examples are about treatment. 10. Unresponsiveness to treatment. Examples: unexpected re-admission/return seeking treatment, unresponsiveness to de-escalation attempts, not following expected improvement pathway/trajectory
Recognising-Signs-of-Deterioration-in-a-Persons-Mental-State.docx