Physical health screening for people with severe mental disorders: a best practice implementation project.
Carlos Alberto Dos Santos Treichel, Ana Laura Salomé Lourencetti, Bruno Marinho da Silva and 2 others
PMID 41885738WHAT IT FOUND
In a Brazilian centre for people with severe mental disorders, documented physical exams rose from 9% to 47.1% when a nursing intake stamp and routine nursing assessments were added, and weight or height recording rose from 0% to 22.4%; blood tests and electrocardiograms remained absent.
Key findings
01At baseline, 9% of 278 users had a documented physical health examination at intake, and no records showed weight, height or body mass index in the past six months.
02At follow-up, 47.1% of 134 users had a documented physical examination at intake, and 22.4% had weight, height or body mass index recorded.
03At follow-up, health behavior history was documented in 4.5% of users, antipsychotic side effect monitoring was 6.1%, and no user had a documented fasting blood test or electrocardiogram.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The project was done at one centre, and the follow-up audit was compared only with the baseline audit. The follow-up audit included 134 users, and the baseline and follow-up groups were not fully paired because of service turnover. The audits were close in time, so the changes may reflect attention to the project rather than sustained practice. The team did not systematically record process measures, such as use of the stamp, adherence to documentation practices, or the number of feedback meetings. The evaluation relied only on medical record review, so actual changes in clinical practice may have been underestimated when documentation was incomplete or delayed. Several strategies, including coordination with primary care and laboratory services, were planned but not implemented during the reporting period.
Declared interests
FAPESP, the Brazilian Centre for Evidence-based Healthcare (JBI Brazil) and CNPq supported the study, with grant number 2023/18317-2. The article does not report author competing interests.
The easy way to misread this
Do not read the rise in documented physical exams as proof that the stamp alone improved care. The team also made routine nursing assessments part of every intake visit, and the follow-up audit measured documentation, not patient health.