Getting Access to Toxbase for Doctors in the Avon and Wiltshire Partnership

Doctors working in mental health often review patients who have taken an overdose. Having an evidence based resource which has information regarding the toxic doses of the drug taken enables informed discussions with senior doctors and decision making about whether to admit the patient to hospital. No site across the Avon and Wiltshire Partnership (AWP) Trust had access to TOXBASE, the Public Health England drug Toxicology database. A primary questionnaire (n= 39) found 97% of doctors thought that TOXBASE would be useful and 84.5% could not think of a better alternative. Through a series of Plan, Do, Study, Act cycles, TOXBASE access was gained for one site (Imber ward, Devizes) and following successful implementation this could be rolled out across all sites in the Trust. Doctors were surveyed and one month after the first site gained access, two out of seven doctors had used TOXBASE and found it useful. Further questionnaires were distributed following three months at three sites and then at six months to everyone. The final questionnaire showed that one third knew they had access and five doctors had used it in clinical context. Action was then taken by creating a TOXBASE on the Intranet site which directed doctors to their local inpatient unit for login details. By the end of the project access to TOXBASE was successfully gained at six out of the seven sites in the Trust. The surveys showed that access to the resource was highly regarded by doctors, and that it had enabled informed discussions with medical colleagues leading to reduced potentially lengthy transfers of patients to medical units. This has high cost implications of the transport of mental health patients, as well as reducing the distress caused to patients.