Blood Tests in Psychiatric Patients-Evaluation and Improving the Process

AIMS/BACKGROUND: The aim of this project is to assess which specific laboratory tests where being requested to psychiatric patients in our trust prior to developing a new local guideline to help standardise the blood testing to improve quality of patient care and reduce wastage in NHS due to inappropriate blood tests. It also assessed financial implication of unnecessary blood tests. To identify medical conditions that might be causing or contributing to a psychiatric presentation. Provide baseline for safer initiation of psychotropic medication that can cause adverse effects. To screen for medical problems who are less likely to attend primary care. Requesting blood tests is a clinical responsibility .Currently there is no formal guidance on which specific lab tests should be ordered for psychiatric patients and was felt a new local guideline was essential to rationalise blood testing. METHODS: A survey was circulated to all wards and community mental health teams within our trust to get a clear insight about current practice. Place of work? What is included in routine blood tests list? Who created and approved the blood list? Where is the blood list kept? When was it reviewed? RESULTS: : Significant variation in blood test requesting within our trust emphasising need for standardization using evidence based methods. Unnecessary repetition of blood tests like thyroid function and vitamin D levels against guidelines. Unwarranted blood test request when clinically not indicated like including Troponin and Creatine kinase in routine tests. The results were shared to all staff through meetings. CONCLUSION: Recommendations were drawn to improve optimisation of resource use, communication between health professionals and the need for standardisation in requesting blood tests.