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Psychiatric Inpatient Units (psychiatric + inpatient_unit)
Selected AbstractsAn examination of frequent nursing interventions and outcomes in an adolescent psychiatric inpatient unitINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 5 2009Candace Bobier ABSTRACT:, Little is known about which nursing interventions used in adolescent psychiatric inpatient treatment demonstrate improvements in outcome in the ,real world' setting, despite an increase in external outcomes reporting requirements. This paper examines nursing and other multidisciplinary interventions commonly used at the Youth Inpatient Unit, Christchurch, New Zealand, in relation to improvements in outcomes as measured by the Health of the Nation Outcome Scales for Children and Adolescents, utilizing data gathered prospectively as part of an ongoing quality assurance and outcomes project. We found the majority of interventions investigated were utilized equally across diagnostic groups, although stress management and problem-solving education was used more for patients with mixed affective disorders. Further, the results contribute to growing evidence toward the value of providing medication and problem-solving education to this population. Mental health nurses working with children and adolescents should be supported to utilize and develop their unique skill set to offer targeted interventions and to examine their practice to identify the most valuable interventions for their patients within this developmental context. [source] Occupational violence and assault in mental health nursing: A scoping project for a Victorian Mental Health ServiceINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2008Brett McKinnon ABSTRACT:, The present study aimed to examine the prevalence of occupational assault against nurses at a Victorian Mental Health Service, including inpatient units and community teams. The results of this study will assist in developing strategies to minimize the occurrence of occupational assault and, more importantly, its impact for nursing staff. A survey methodology was used. All nurses from two adult acute psychiatric inpatient units as well as those from the community-based teams were invited to participate in a single survey (n = 90). The sample group for this research included all nursing staff from both inpatient units and community services. High levels of occupational violence against nurses overall and in the past year, underreporting of incidents, and high levels of staff fear are prominent findings of this study. There needs to be a total review of all policy relating to occupational violence with special focus given to the results of this study. The areas of risk management, training, sanctioning, and incident reporting should head the list, as well as addressing staff culture. Universally adopting a zero tolerance approach to occupational violence suggests that it is far from being part of the job. Further, management should consider a comprehensive orientation package that informs patients and their significant others about the role of the treating team. Communicating adequately with patients and their significant others is needed to clarify expectations and to avoid frustration and angry outbursts. [source] Staff gender ratio and aggression in a forensic psychiatric hospitalINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2006Michael Daffern ABSTRACT:, Gender balance in acute psychiatric inpatient units remains a contentious issue. In terms of maintaining staff and patient safety, ,balance' is often considered by ensuring there are ,sufficient' male nurses present on each shift. In an ongoing programme of research into aggression, the authors investigated reported incidents of patient aggression and examined the gender ratio on each shift over a 6-month period. Contrary to the popular notion that a particular gender ratio might have some relationship with the likelihood of aggressive incidents, there was no statistically significant difference in the proportion of male staff working on the shifts when there was an aggressive incident compared with the shifts when there was no aggressive incident. Further, when an incident did occur, the severity of the incident bore no relationship with the proportion of male staff working on the shift. Nor did the gender of the shift leader have an impact on the decision to seclude the patient or the likelihood of completing an incident form following an aggressive incident. Staff confidence in managing aggression may be influenced by the presence of male staff. Further, aspects of prevention and management may be influenced by staff gender. However, results suggest there is no evidence that the frequency or severity of aggression is influenced by staff gender ratio. [source] Trauma for all: a pilot study of the subjective experience of physical restraint for mental health inpatients and staff in the UKJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2002G. Bonner Violence and aggression is common in psychiatric inpatient units. Despite the near universal prevalence of restraint, there is very little published research on either the efficacy or the subjective effects of restraint on staff or patients. In this pilot study, semistructured interviews were given to the patients and staff involved in six untoward incidents in which the patient participant had been subject to manual physical restraint. Participants were interviewed as soon as possible after the occurrence of the incidents. The interviews asked the patient and staff participants to identify and discuss the factors that they found helpful and unhelpful during and in the immediate aftermath of these incidents. The incidents generated strong emotions for all concerned. The patients valued staff time and attention but felt that they received too little attention. Both nurses and patients discriminated between permanent and temporary staff. Patients reported feeling upset, distressed and ignored prior to the incidents and isolated and ashamed afterwards. Postincident debriefing was valued by all but was patchy for staff and rarer still for patients. Patients feared the possibility of being restrained. Half of the patients and several staff members reported that the incidents had reawakened distressing memories of previous traumatic events. Further research on the subjective effects of restraint is urgently needed. [source] Formal observations and engagement: a discussion paperJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2002N. Bowles rmn ba(hons) ma Formal observation of patients at risk is extremely common in acute psychiatric facilities. Effectively a form of physical containment, observation is resource-intensive, makes significant personal demands upon staff and skews the focus of nursing care towards the small group of patients judged to be most at risk. For patients, the experience of being observed is often less than therapeutic and, in some cases, counter productive. In this paper, the authors draw upon a variety of perspectives, including that of a psychiatrist and a service user. It is argued that the practice of formal observation is ineffective and may actually contribute to the poor state of UK acute psychiatric inpatient units, in terms of direct patient care, clinical decision-making and appropriate risk management. In a recent ,commentary' within this journal, the authors offered ,engagement' as an alternative to observation. In this paper, the meaning of engagement is refined and presented as a process of emotional and psychological containment of distress. The paper concludes that inappropriate over-use of formal observation as a custodial and defensive practice can contribute to a sense of dehumanization and isolation within acute psychiatric patients; engagement may provide a genuine (i.e. not just linguistic) alternative. [source] HOVIS , The Hertfordshire/Oxfordshire Violent Incident StudyJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2002K. Spokes msc bsc(hons) Violence in psychiatric inpatient units is a major and growing problem. Research interest has primarily focussed on patient characteristics. The role of staff factors and the antecedents of violent incidents has been neglected, despite the fact that staff factors and behaviour may be more readily amenable to change than patient characteristics. The HOVIS study sought to obtain the views of a sample of mental health nurses in current clinical practice about staff-related factors, which they perceive to contribute to, or protect against, the occurrence of violent incidents. A total of 108 nurses working in psychiatric acute admission, intensive care and low secure units, in two NHS Trusts were interviewed using a specially designed semistructured interview schedule. These nurses identified a variety of behaviours, clinical skills, personal characteristics and interpersonal skills that they believe impact on the occurrence of violent incidents. These findings are discussed in relation to their possible training and managerial implications. [source] | ||||||||||