Responding to Sexual Activity on the Inpatient Psychiatric Unit

Topics: Assault | Capacity | Consensual | Consent | Debriefing | Hospital policy | hypersexual behaviors | post-exposure prophylaxis | pregnancy testing | reporting requirements | Risk Management | sexual intercourse | STI screening

We know sexual attraction occurs among individuals staying together in a psychiatric inpatient unit. The prevalence of sexual activity on acute units is as high as 5%—and up to 70% among chronically ill patients in long-term residence in state hospitals (Ford E et al, Psychiatr Serv 2003;54(3):346–350; Wright ER et al, Journal of Ethics in Mental He

The “Z-Drugs”: Safety Issues and Misuse Potential

Topics: Anxiety | Clinical practice | Deprescribing | Free Articles | Pharmacology | polypharmacy | prescribing patterns | Risk Management | Sleep | Sleep Disorders

Originally marketed as safer alternatives to benzodiazepines, the Z-drugs—eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien)—were considered devoid of misuse potential. But recent data and FDA warnings suggest we’ve been hitting the snooze on them for too long. Here, we review their risks and discuss safe prescribing. Medical risks

Muscle Relaxants: Sedatives Often Under the Radar

Topics: Clinical practice | Deprescribing | Opioids | Pain | Pharmacology | polypharmacy | prescribing patterns | Risk Management

Muscle relaxants are a diverse group of medications with varying mechanisms of action (see Commonly Prescribed Muscle Relaxants table below). They are indicated for short-term treatment (2–3 weeks) of acute, painful muscle spasms, as well as some chronic neurologic conditions associated with spasticity. However, many patients with chronic pain are on

Electronic Communication with Patients: Advantages and Risks

Topics: Risk Management

Do you use email to communicate with your patients? Chances are good that you don’t. One recent survey of psychiatrists found that just 5% routinely and 25% sometimes used email with patients (Koh S et al, J Psychiatr Pract 2013;19(3):254–263). This means that there is a significant disconnect between what we do and what patients want, as over 70% o

Assessing Suicide Risk and Documenting Your Care

Topics: Risk Management

Botox Injections Work as Antidepressant

Topics: Research Update | Risk Management

Debate Rages On Over ‘Black Box’ Warning on Antidepressants

Topics: Antidepressants | News of Note | Risk Management

Family-School Intervention Can Reduce Adolescent Alcohol Use

Topics: Risk Management | Substance Abuse