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dc.contributor.authorKENNEDY, HARRYen
dc.date.accessioned2016-06-23T11:16:43Z
dc.date.available2016-06-23T11:16:43Z
dc.date.issued2015en
dc.date.submitted2015en
dc.identifier.citationDavoren, M., Byrne, O., O'Connell, P., O'Neill, H., O'Reilly, K., Kennedy, H.G., Factors affecting length of stay in forensic hospital setting: Need for therapeutic security and course of admission, BMC Psychiatry, 2015en
dc.identifier.otherYen
dc.identifier.urihttp://hdl.handle.net/2262/76625
dc.descriptionPUBLISHEDen
dc.description.abstractBACKGROUND: Patients admitted to a secure forensic hospital are at risk of a long hospital stay. Forensic hospital beds are a scarce and expensive resource and ability to identify the factors predicting length of stay at time of admission would be beneficial. The DUNDRUM-1 triage security scale and DUNDRUM-2 triage urgency scale are designed to assess need for therapeutic security and urgency of that need while the HCR-20 predicts risk of violence. We hypothesized that items on the DUNDRUM-1 and DUNDRUM-2 scales, rated at the time of pre-admission assessment, would predict length of stay in a medium secure forensic hospital setting. METHODS: This is a prospective study. All admissions to a medium secure forensic hospital setting were collated over a 54 month period (n = 279) and followed up for a total of 66 months. Each patient was rated using the DUNDRUM-1 triage security scale and DUNDRUM-2 triage urgency scale as part of a pre-admission assessment (n = 279) and HCR-20 within 2 weeks of admission (n = 187). Episodes of harm to self, harm to others and episodes of seclusion whilst an in-patient were collated. Date of discharge was noted for each individual. RESULTS: Diagnosis at the time of pre-admission assessment (adjustment disorder v other diagnosis), predicted legal status (sentenced v mental health order) and items on the DUNDRUM-1 triage security scale and the DUNDRUM-2 triage urgency scale, also rated at the time of pre-admission assessment, predicted length of stay in the forensic hospital setting. Need for seclusion following admission also predicted length of stay. CONCLUSIONS: These findings may form the basis for a structured professional judgment instrument, rated prior to or at time of admission, to assist in estimating length of stay for forensic patients. Such a tool would be useful to clinicians, service planners and commissioners given the high cost of secure psychiatric care.en
dc.relation.ispartofseriesBMC Psychiatryen
dc.rightsYen
dc.subjectPsychiatryen
dc.titleFactors affecting length of stay in forensic hospital setting: Need for therapeutic security and course of admissionen
dc.typeJournal Articleen
dc.type.supercollectionscholarly_publicationsen
dc.type.supercollectionrefereed_publicationsen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/kennedhen
dc.identifier.rssinternalid111560en
dc.rights.ecaccessrightsopenAccess
dc.identifier.orcid_id0000-0003-3174-3272en


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