Spanish experts consensus on emergency psychiatric care in hospital emergency departments
Gordillo-Urbano, Rafael Manuel (Hospital Infanta Margarita)
Crespo-Facorro, Benedicto (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Pérez-Solá, V. (Hospital del Mar (Barcelona, Catalunya))
Cardoner, Narcís (Institut de Recerca Sant Pau)
García-Ligero, Elena (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Moreno, C. (Hospital General Universitario Gregorio Marañón)
Ramos-Quiroga, Josep Antoni (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Ruiz-Veguilla, Miguel (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Vázquez-Vallejo, Mireia (Hospital Clínic i Provincial de Barcelona)
Prados Ojeda, Juan Luis (Hospital Universitario Reina Sofía (Còrdova, Espanya))

Fecha:	2024
Resumen:	Background: The demand for urgent psychiatric care is increasing, but in Spain there are no clear recommendations for emergency departments (ED) on how to optimize care for patients with psychiatric emergencies. We aimed to provide expert consensus recommendations on the requirements for general hospitals' emergency departments to treat patients with urgent psychiatric symptoms. Methods: We used a modified Delphi technique. A scientific committee compiled 36 statements based on literature search and clinical experience. The statements covered the organizational model, facilities, staffing, safety, patient interventions, and staff training. A panel of 38 psychiatry specialists with expertise in psychiatric emergencies evaluated the questionnaire in two rounds. Results: After two rounds of voting, 30 out of 36 proposed items (83%) were agreed upon. The panel agreed that psychiatric emergencies should be managed in a general hospital, with dedicated facilities for patient assessment, direct supervision of patients at risk, and an observation unit run by the psychiatric service. In addition to the psychiatrist, the ED should have specialist nurses and security staff available 24/7. Social workers should also be readily available. ED and consulting rooms should be designed to ensure patient and staff safety. A triage system should be established for patients with psychiatric symptoms, with medical evaluation preceding psychiatric evaluation. Guidance on supplies, equipment, and staff training is also provided. Conclusion: All ED in general hospitals should have adequate resources to handle any psychiatric emergency. This paper provides recommendations on the minimum requirements to achieve this goal.
Nota:	This work was funded by Janssen. The authors point out the absolute independence in the realization of this article.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	BMC Psychiatry, Vol. 24, Num. 1 (December 2024) , p. 489, ISSN 1471-244X

DOI: 10.1186/s12888-024-05939-1
PMID: 38965477

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