Assessment and documentation of substance abuse by crisis resolution home treatment team: A quality improvement project

Abstract

AIM: Substance abuse is associated with mental health crises, leading to increased attendance in A and E and hospital admissions. This quality improvement project (QIP) evaluated the assessment and documentation of substance abuse of patients admitted under the crisis resolution home treatment team (CRHT) as well as any change following a teaching session as an intervention.

METHODS: Data from 40 consecutive patients admitted under the CRHT from the 1st of September 2023 were collected. The CRHT uses the “Core Crisis Resolution Team Fidelity Scale” as the standard of practice and this was utilized as the benchmark for the QIP. A teaching session for nursing staff was conducted as an intervention. Following the teaching session, the second cycle of data was collected from 40 consecutive patients.

RESULTS: Substance abuse was documented by CRHT in 30% of patients (12/40). However, the proportion was 70% (28/40) when documentation by other secondary services, such as mental health liaison, community mental teams, and the sources of referral were considered. Following the educational session, CRHT documented substance abuse for 37.5% (15/40). When documentation by secondary services was checked, the percentage of patients with documented substance abuse was 67.5% (27/40).

CONCLUSION: The QIP suggested a minor improvement in the documentation of substance use after the educational session of the nurses. Multiple sessions of sessions, a longer period before reassessment to allow change of practice, and a prompt in the evaluation document might improve the assessment and documentation of substance use by the patients in CRHT.