Reeves R R, Pinkofsky H B, Stevens L
Department of Psychiatry, Overton Brooks Veterans Affairs Medical Center, Louisiana State University, Shreveport, School of Medicine, 71101-4295, USA.
Am J Emerg Med. 1998 Nov;16(7):631-3. doi: 10.1016/s0735-6757(98)90162-0.
To determine the effectiveness of emergency department (ED) physicians properly and correctly completing documents required for emergency confinement of psychiatric patients, 1,000 Physician Emergency Certificates filed by ED physicians in the Shreveport, Louisiana, region were reviewed for appropriateness and for correctness of completion based on the applicable state law. Of the Physician Emergency Certificates reviewed 4.2% were incomplete or inappropriate. The most significant sources of error involved incomplete documentation of the mental status examination and not documenting the specific reason (dangerous to self, dangerous to others, or gravely disabled) for the patient meeting requirements for involuntary confinement. Other errors included confinement for reasons not appropriate for a psychiatric unit. This study suggests that ED physicians should be more cautious and thorough in completing the documents required for emergency confinement of psychiatric patients, so that the physician is less likely to be sued for malpractice or charged with the false imprisonment of such patients, and the patient's civil liberties are protected.
为确定急诊科医生正确无误地填写精神科患者紧急禁闭所需文件的有效性，对路易斯安那州什里夫波特地区急诊科医生提交的1000份医生紧急证明书进行了审查，以根据适用的州法律判断其是否恰当及填写是否正确。在所审查的医生紧急证明书中，4.2%不完整或不恰当。最主要的错误来源包括精神状态检查记录不完整，以及未记录患者符合非自愿禁闭要求的具体原因（对自己有危险、对他人有危险或严重残疾）。其他错误包括因不适合精神科病房的原因进行禁闭。这项研究表明，急诊科医生在填写精神科患者紧急禁闭所需文件时应更加谨慎和全面，这样医生被起诉医疗事故或被指控非法拘禁此类患者的可能性就会降低，同时患者的公民自由也能得到保护。
