Quality Statements - Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard
The standard contains eight quality statements that describe the health care that people of all ages with cognitive disability or impairment should receive to ensure the safe and appropriate use of psychotropic medicines.
Quality statements
The quality statements describe the expected standard for key components of patient care. By describing what each statement means, they support:
- Consumers to know what care may be offered by their healthcare system, and to make informed treatment decisions in partnership with their clinician
- Clinicians to make decisions about appropriate care
- Healthcare services to understand the policies, procedures and organisational factors that can enable the delivery of high-quality care.
Some quality statements are linked to indicators to support monitoring of quality improvement.
Goal
This clinical care standard aims to ensure the safe and appropriate use of psychotropic medicines in people with cognitive disability or impairment and to uphold their rights, dignity, health and quality of life.
Scope
This clinical care standard relates to the health care that people of all ages including children and adolescents with cognitive disability or impairment should receive to optimise the prescribing and use of psychotropic medicines. It is relevant to people with cognitive disability or impairment who are:
- Living independently and may have visiting support workers
- Living with family and may have visiting support workers
- Living in aged care homes
- Living in specialist disability accommodation
- Receiving care in acute healthcare facilities.
The standard relates to the care provided to people with cognitive disability or impairment when psychotropic medicines are prescribed for one or more of the following reasons:
- In response to behaviours of concern
- For treating diagnosed mental health or neurological conditions, or sleep disorders
- For treating diagnosed physical illnesses or conditions
The standard recognises existing legislation that identifies use of psychotropic medicines for the primary purpose of influencing a person’s behaviour – rather than treating a mental health condition – as a restrictive practice, and the regulatory roles of the Aged Care Quality and Safety Commission and the NDIS Quality and Safeguards Commission. It does not replace the regulations and requirements of these two Commissions. Similarly, in healthcare services where state or territory mental health legislation applies, the standard should be considered within the requirements of the relevant mental health Act.
This clinical care standard provides guidance that can be applied across diverse settings and to people of different ages with different types of types of cognitive impairment and disability. When implementing this clinical care standard, clinicians and those governing the provision of healthcare, aged care and disability services should consider the context in which health care is delivered and the specific relevant jurisdictional and regulatory requirements that apply to the person and healthcare setting.
Healthcare settings
Health care is delivered in various settings. This clinical care standard applies to all settings where people living with cognitive disability or impairment receive health care. Examples of settings that are in scope for this clinical care standard include, but are not limited to:
- Hospital settings, both public and private, including subacute facilities, outpatient clinics, day procedure services and multipurpose services
- Community settings, both clinical and residence-based, including people’s homes, aged care homes, hostels, boarding houses, and supported accommodation (such as specialist disability accommodation services provided through the NDIS)
- Justice or forensic healthcare services.
Implementation of this clinical care standard should consider the context in which health care is provided (such as an aged care home versus an acute care hospital); local variations that indicate a need for improvement; and the quality improvement priorities of the individual healthcare service.
In rural and remote settings, implementation of the standard may require different strategies, such as telehealth consultations and hub‑and‑spoke models that integrate larger and smaller healthcare services.
Implementation should comply with jurisdictional requirements relevant to the healthcare service.