Improving the treatment of patients with dual diagnosis in emergency departments.

Emergency Nurse : the Journal of the RCN Accident and Emergency Nursing Association
Thomas Johann Willmann

Abstract

Dual diagnosis involves the co-occurrence of severe mental illness and substance misuse. Recent guidance has sought to improve the initial identification of dual diagnosis and the ongoing management of patients with confirmed dual diagnoses. However, service provision between mental health teams and emergency departments (EDs) can be disjointed, resulting in suboptimal care. This article explores the care of patients who present at EDs with symptoms arising from a combination of severe mental illness and substance misuse. The author aims to alter the approach of multidisciplinary teams by applying change management theory, resulting in patients being treated by multiple healthcare disciplines in a more coordinated way. This will be demonstrated through a case study that follows a patient with dual diagnosis on the journey through an emergency department. Guidelines identifying best practice will be referred to and care failings in the patient's journey will be analysed. The author also provides an overview of how change management theory can be used to implement a new protocol for managing the treatment of patients with a dual diagnosis.

References

Mar 3, 2007·The American Journal of Psychiatry·Alan I GreenDouglas L Noordsy
May 29, 2014·The Western Journal of Emergency Medicine·Benjamin GoodGregory Moore
Sep 16, 2014·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Giuseppe CarràMassimo Clerici
Oct 11, 2017·Alcohol and Alcoholism : International Journal of the Medical Council on Alcoholism·A ZambonI Giorgi
Oct 17, 2017·Psychiatric Services : a Journal of the American Psychiatric Association·Ish P Bhalla, Robert A Rosenheck
Sep 21, 2018·Leadership in Health Services·Kevin Wing Ki Chu, Lenis Lai Wan Cheung

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