ADMIN/NON MEDICINE
DAMA
PromptImportant considerations when patient wanting to DAMA
ResponseCompetence/Capacity
Presence of life threatening illness/injury
Presence of life threatening illness/injury
PromptWays to manipulate patients into staying without using MHA
ResponseCultural specific
- Offer male/female doctor
- Avoid direct contact
- Utilise interpreter
- Recruit family/friends
- Utilise ALO
- Non medical conversation (where are you from, hows the fam, etc.)
- Explore concerns
- Why wants to leave
- Provide reassurance
- Meet patient needs – phone, food, cigarettes
- Use simple language
- Anxiolysis - ?diazepam
PromptPatient missing from bedspace – actions
ResponseLook for patient outside ED/other spaces
Contact patient, encouraged to return/see GP
Update GP/community clinic
Phone phamily/NOK
Contact police if significant clinical concern/lacking capacity
Contact patient, encouraged to return/see GP
Update GP/community clinic
Phone phamily/NOK
Contact police if significant clinical concern/lacking capacity
PromptMedicolegal requirements necessary for competence to DAMA
ResponseCognitive capacity: understand the condition, treatment options, potential outcomes, likelihood
Able to accept/retain/paraphrase info, explain consequences, reasons for their decision
Mental state: not altered by medical conditions+ Not impaired by alcohol/drugs + MMSE>20
Age : adult – given in stem
Able to accept/retain/paraphrase info, explain consequences, reasons for their decision
Mental state: not altered by medical conditions+ Not impaired by alcohol/drugs + MMSE>20
Age : adult – given in stem
Prompt16 F wanting to DAMA - competence assessment
ResponseChoice - ability to maintain and communicate a choice
Comprehension - understand relevant information
Belief - appreciate situation and its consequences
Weighing - Ability to weigh information in rational fashion
Comprehension - understand relevant information
Belief - appreciate situation and its consequences
Weighing - Ability to weigh information in rational fashion