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Psychiatric Unit (psychiatric + unit)
Kinds of Psychiatric Unit Selected AbstractsGeriatric Patients Improve as Much as Younger Patients from Hospitalization on General Psychiatric UnitsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Mark B. Snowden MD Objectives: To determine whether geriatric patients aged 65 and older on general adult psychiatric units improve as much as younger patients, over what duration their improvement occurs, and their risk of readmission. Design: Cohort study. Setting: Inpatient psychiatric unit of an urban, university-affiliated, county hospital from January 1993 through August 1999. Participants: A total of 5,929 inpatients. Measurements: Standardized, routine assessments by attending psychiatrists included the Psychiatric Symptom Assessment Scale (PSAS) on admission and discharge. Discharge scores, length of stay (LOS), and risk of readmission within 1 year were modeled for the groups using multiple regression analyses. Results: Geriatric patients constituted 5% (n=299) of the 5,929 admissions. In multivariate analysis, geriatric status was not associated with discharge PSAS scores. Median LOS was longer for geriatric patients (16 days) than younger patients (10 days, P<.001), especially in older women (14 days) and geriatric patients with mild medical illness severity (13 days vs 11 days in those with moderate-to-severe medical illness). Geriatric patients were as likely to be readmitted within 1 year of discharge as younger patients. Conclusion: Geriatric patients on general inpatient psychiatry units improved as much as younger patients. Their longer LOS was associated with milder medical illness severity. There may be a role for more specialized care of elderly women or geriatric patients with mild to moderate medical illness to improve the efficiency of their care. [source] Completed suicide among psychiatric in-patients with depression in an Australian mental hospitalINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2000Ajit Shah Abstract Up to 45% of completed psychiatric in-patient suicides have a diagnosis of depression. Twenty-two completed psychiatric in-patient suicides with depression, over a 21-year period, in a large psychiatric hospital in Melbourne, Australia, were examined. The characteristics, including demographic and clinical data, for the completed suicides with depression were compared with a comparison group of ,alive' in-patients with depression. Completed suicide among psychiatric in-patients with depression was associated with male sex, suicidal thoughts during admission, and fluctuating suicidal ideation or continuous absence of suicidal ideation. Over 40% of completed suicides occurred whilst on approved leave and over 20% after absconding from the hospital. Violent methods (including jumping in front of trains, trams and road traffic, jumping of buildings, hanging and drowning) were used in over 65% of completed suicides. Psychiatric units should be developed away from readily available methods of suicide. In-patients with suicidal thoughts during the admission and unstable suicidal ideation should be carefully observed to avoid absconding and suicide, and should be carefully assessed prior to granting of leave. Copyright © 2000 Whurr Publishers Ltd. [source] Frontal lobe syndrome or adolescent-onset schizophrenia?ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2006A case report Objective:, To highlight the difficulties that abound in making a clinical distinction between early-onset schizophrenia (EOS) and juvenile frontal dementia early in the course of illness. Method:, Clinical information and data from investigations in single case was collated and reviewed. Results:, A 15-year-old girl was admitted to our psychiatric unit because of cognitive decline and formal thought disorder with echopraxia, echolalia and palilalia, and a lack of flexibility in the use of cognitive and motor strategies that culminated in psychosis. A single photon emission computerized tomography scan showed marked frontal lobe hypoperfusion; however, on proton spectroscopy there was no differential in N -acetyl aspartate levels. Conclusion:, Hypofrontality in EOS is well established and the association of frontal functional alterations, neuropsychological impairment and psychotic symptomatology is suggestive of frontal lobe prodrome that precedes the onset of psychosis. [source] Premorbid performance IQ deficit in schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2000G. P. Amminger Objective: Performance IQ (PIQ) is often lower than verbal IQ (VIQ) in schizophrenic patients. Whether PIQ Geriatric Patients Improve as Much as Younger Patients from Hospitalization on General Psychiatric UnitsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Mark B. Snowden MD Objectives: To determine whether geriatric patients aged 65 and older on general adult psychiatric units improve as much as younger patients, over what duration their improvement occurs, and their risk of readmission. Design: Cohort study. Setting: Inpatient psychiatric unit of an urban, university-affiliated, county hospital from January 1993 through August 1999. Participants: A total of 5,929 inpatients. Measurements: Standardized, routine assessments by attending psychiatrists included the Psychiatric Symptom Assessment Scale (PSAS) on admission and discharge. Discharge scores, length of stay (LOS), and risk of readmission within 1 year were modeled for the groups using multiple regression analyses. Results: Geriatric patients constituted 5% (n=299) of the 5,929 admissions. In multivariate analysis, geriatric status was not associated with discharge PSAS scores. Median LOS was longer for geriatric patients (16 days) than younger patients (10 days, P<.001), especially in older women (14 days) and geriatric patients with mild medical illness severity (13 days vs 11 days in those with moderate-to-severe medical illness). Geriatric patients were as likely to be readmitted within 1 year of discharge as younger patients. Conclusion: Geriatric patients on general inpatient psychiatry units improved as much as younger patients. Their longer LOS was associated with milder medical illness severity. There may be a role for more specialized care of elderly women or geriatric patients with mild to moderate medical illness to improve the efficiency of their care. [source] A structured observation of the interaction between nurses and patients during the administration of medication in an acute mental health unitJOURNAL OF CLINICAL NURSING, Issue 17-18 2010Joy A Duxbury Aims., This aims of this study are to describe current practice in the administration of medication in an acute psychiatric unit and explore factors that influence nurses' decisions regarding the administration of medication during ,rounds'. Background., Medication ,rounds' form part of the ward routine in many inpatient mental health settings. Nurses make several clinical decisions about administrating medication; yet, concerns have been raised about the poor assessment of patients' needs and the quality of the information exchanged. Design., A structured non-participant observational design was used for this research. Method., This study involved the observation of 20 medication ,rounds' over three months. The Ward Administration of Medication Schedule was used to report on the interactions between nurses and patients and aspects of their communication during each round. Results., From the rounds observed nurses appeared adept at communicating a positive interpersonal style but less so in demonstrating skills portraying collaboration and information giving. For example whilst nurses communicated warmth in 97% of cases, using non-verbal behaviours such as good eye contact, the provision of information was only initiated in 46% of cases. Enquiries regarding the patient's general health and medication taking (35% and 17% respectively) were less commonly observed. Verbal consent was sought in only 25% of cases. Procedural matters were adhered to overall. Conclusions., Findings suggest limited collaboration between nurses and patients and the poor monitoring of health status and medication effects. Information exchange could be improved; however, this may be related to medication procedures that make it difficult to explore sensitive information with patients, rather than nursing skills and behaviour. Relevance to clinical practice., The Ward Administration of Medication Schedule can be used as a clinical or educational tool in the administration of medication. In both instances, it may be self-administered and used to reflect on personal skills or employed as an observational tool during peer review and audit. [source] Psychiatric inpatient care for adults with intellectual disabilities: generic or specialist units?JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2004K. Xenitidis Abstract Background When adults with intellectual disabilities (ID) require a psychiatric admission, general adult mental health units are often used. Specialist units have emerged recently as a care option but there is only limited evidence of their effectiveness. Thus this study aims to describe and evaluate the effectiveness of a specialist inpatient unit and report on the utilization of generic and specialist inpatient services. Method All patients admitted to a specialist ID psychiatric unit were evaluated on admission and immediately after discharge on a number of outcome measures. In addition, they were compared with those admitted to general adult mental health units covering the same catchment area. Results Significant improvements were demonstrated within the specialist unit cohort on measures including psychopathology, global level of functioning, behavioural impairment and severity of mental illness. The specialist unit patients had a longer length of inpatient stay but were less likely to be discharged to out-of-area residential placement. Conclusions Specialist units are an effective care option for this group of people. [source] A prospective study of patients absconding from a general hospital psychiatry unit in a developing countryJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2008N. KHISTY Characteristics of patients absconding from an open psychiatry ward in a developing country may be different from both those in developed countries and a mental hospital setting. The aim of this paper is to study the incidence and characteristics of patients absconding from an open psychiatric ward in a general hospital-based psychiatric unit in India. We studied patients consecutively admitted to an open psychiatric ward over a 2-month period. We compared those who absconded with those who did not. Out of 231 patients admitted, 33 absconded. Among those who absconded, 15 had bipolar disorder, 11 had schizophrenia and five had substance-related disorders. Nine had indicated their intention to do so at admission. Ten patients had absconded by the second day. The treatment cost was the likely influencing factor for seven patients who absconded after deemed fit for discharge on clinical grounds. Only 10 patients were readmitted to the hospital within 2 weeks of absconding. The risk of absconding is highest in the early days following. Absconding patients did not differ significantly from others in many socio-demographic and clinical features. Treatment costs are an important consideration in India. [source] Supplementary prescribing: relationships between nurses and psychiatrists on hospital psychiatric wardsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2006A. JONES phd bn (hons) rmn The purpose of this study was to explore some of the issues for the implementation of supplementary prescribing for acute hospital care. The study design was the use of focus group methodology. In total, 19 nurses and 7 psychiatrists joined 1 of 6 focus groups held on the psychiatric unit. The data were analyzed using a modified grounded theory technique. In the study to be reported here, nurses and psychiatrists described the potential for different ways of working to emerge on acute psychiatric wards. Two major themes were identified: supplementary prescribing bringing about different ways of influencing decisions and controlling professional work; nurses and psychiatrists developing different types of relationships. Findings suggest an overall positive acceptance for supplementary prescribing, but for greater attention to be placed on the nature of relationships between nurses and psychiatrists. Implications for practice include the impact on new roles for nurses and psychiatrists and how this new form of relationship can best serve patients. [source] Caring for people in the ,virtual ward': the practical ramifications for acute nursing workJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2003M. DEACON, ba (hons) m.phil rmn srn enb(810) This paper discusses an aspect of data analysis arising from an ethnographic study of acute mental health nursing conducted in an inner city psychiatric unit. The data were collected in the form of field notes. These were made during and following episodes of participant observation on one acute ward and on a psychiatric intensive care unit over a period of 20 months. Acute wards have been subject to continuing criticism as both sites of care and treatment for mentally ill people and of nursing work. However, the practical operations of this social world remain largely unexamined. It is argued that without this understanding, mundane work methods will always be regarded as an impediment to work that is regarded as ,therapeutic' and therefore, of importance. The focus will be on phenomena named the ,virtual ward'. The research has demonstrated that the boundaries of nurses' responsibility reach far beyond the ward's spatial environment, both physically and communicatively. The complexity of the work that takes place within the virtual ward and the skills required for its successful completion are taken for granted, but are also a practical source of frustration. Anonymized examples from the practice site studied are used to illuminate the discussion. Working within the virtual ward is part of the messy reality of nurses' work. It is argued that understanding and respecting this reality is necessary if we are to be seriously and consistently ambitious about practice development. [source] Review article: recognition and treatment of eating disorders in primary and secondary careALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2000Robinson Eating disorders are serious illnesses affecting 1,2% of young women. Patients may present to any doctor, sometimes atypically (e.g. unexplained weight loss, food allergy, infertility, diarrhoea), delaying diagnosis and leading to needless investigation. The cardinal signs are weight loss, amenorrhoea, bingeing with vomiting and other compensatory behaviours, and disturbances in body image with an exaggeration of the importance of slimness. When other causes have been excluded, useful investigations are serum potassium, bone mineral density scanning and pelvic ultrasound. In emaciated patients multiple systems may fail with pancytopaenia, neuromyopathy and heart failure. Clinical assessment of muscle power is used to monitor physical risk. Treatment may involve individual, group or family sessions, using cognitive-behavioural, psychodynamic and family approaches. More severe or intractable illness is treated with day care, with in-patient care in a medical or specialist psychiatric unit reserved for the most severely ill patients. Antidepressants have a place in the treatment of bulimia nervosa unresponsive to psychological approaches, and when severe depressive symptoms develop. The children of people with eating disorders may have an increased risk of difficulties. Support for the patient and family, and effective liaison between professionals, are essential in the treatment of severe eating disorders. [source] Hamartoma of the Breast in a Man: First Case ReportTHE BREAST JOURNAL, Issue 4 2001Keyvan Ravakhah MD Abstract: Mammary hamartomas were reported in 0.7% of all benign tumors of the female breast. Histologically breast hamartomas contain lobular breast tissue with various degrees of fibrous, fibrocystic, and adipose tissue. Rare types include muscular (myoid) and cartilage (chondroid) hamartomas. We report a case of muscular hamartoma in a man. A 36-year-old man was admitted to the psychiatric unit with the diagnosis of schizophrenia. The patient complained of a slowly growing mass in his left breast. He denied any discharge from the nipple, but he complained of itching. A 2 cm × 3 cm nontender mass was palpable. There was no evidence of axillary lymphadenopathy. A needle aspiration was nondiagnostic. The excisional biopsy specimen revealed fatty tissue which was edematous and hemorrhagic. Microscopically it showed multiple bundles of muscles organized randomly. Myoid hamartoma was the diagnosis. Mammary hamartoma is considered a female tumor exclusively. Myoid hamartoma has been reported previously in 25 women. We report a myoid hamartoma in a man and, to our knowledge, it is the first and only such case to be reported. [source] Six-month outcomes associated with a brief alcohol intervention for adult in-patients with psychiatric disordersDRUG AND ALCOHOL REVIEW, Issue 2 2002GARY K. HULSE Abstract The objective of this study was to evaluate the 6-month outcomes of a brief intervention to reduce alcohol consumption by psychiatric in-patients in the general hospital setting and following resolution of psychiatric morbidity. Patients from the psychiatric wards of three general hospitals were screened using the Alcohol Use Disorders Identification Test. Of 144 people approached who matched the study criteria, 120 (83%) people aged 18,64 years (mean 31.7) were recruited. Participants were randomized to either a brief motivational interview or an information package to reduce alcohol consumption. Alcohol consumption was assessed as total weekly consumption and categorized on Australian National Health and Medical Research Council (NH&MRC) criteria. We delivered 62 motivational interviews and 58 information packages. At the 6-month follow-up 83 (69%), participants were reassessed. Both groups had significantly reduced alcohol consumption. However, the motivation group had a significantly greater reduction in weekly consumption than the information group (F = 6.8, (1,65) p < 0.025) after controlling for age, sex, SCL-90-R GSI and alcohol dependence (and baseline alcohol consumption). A greater proportion of the motivation group compared to the information group also ,improved' in their classification on NH&MRC criteria (,2 = 7.3, df 1, p < 0.01). Brief interventions, especially motivational interviews, are effective in reducing alcohol use in persons with psychiatric disorders. They are effective across the mid-range of GSI severity scores for in-patients. Screening and brief interventions can and should be incorporated into the routine assessment and management in psychiatric units. [source] Close-observation areas in acute psychiatric units: A literature reviewINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2003Louise O'Brien ABSTRACT: Close-observation areas in Australian inpatient psychiatric units are locked areas usually within an open ward. Despite patient acuity, and the inherent difficulties in this area, little has been written that addresses either the processes or goals of containing patients, the role of nurses, or the skills involved. This paper examines the literature related to close-observation areas and argues that they are highly demanding of expert psychiatric nursing skills. Nurses need to advocate for humane, well-resourced areas, staffed with highly skilled nurses in order to fulfil the obligations of the national nursing and mental health service standards and to reduce the deleterious effects of hospitalization on patients. [source] Geriatric Patients Improve as Much as Younger Patients from Hospitalization on General Psychiatric UnitsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004Mark B. Snowden MD Objectives: To determine whether geriatric patients aged 65 and older on general adult psychiatric units improve as much as younger patients, over what duration their improvement occurs, and their risk of readmission. Design: Cohort study. Setting: Inpatient psychiatric unit of an urban, university-affiliated, county hospital from January 1993 through August 1999. Participants: A total of 5,929 inpatients. Measurements: Standardized, routine assessments by attending psychiatrists included the Psychiatric Symptom Assessment Scale (PSAS) on admission and discharge. Discharge scores, length of stay (LOS), and risk of readmission within 1 year were modeled for the groups using multiple regression analyses. Results: Geriatric patients constituted 5% (n=299) of the 5,929 admissions. In multivariate analysis, geriatric status was not associated with discharge PSAS scores. Median LOS was longer for geriatric patients (16 days) than younger patients (10 days, P<.001), especially in older women (14 days) and geriatric patients with mild medical illness severity (13 days vs 11 days in those with moderate-to-severe medical illness). Geriatric patients were as likely to be readmitted within 1 year of discharge as younger patients. Conclusion: Geriatric patients on general inpatient psychiatry units improved as much as younger patients. Their longer LOS was associated with milder medical illness severity. There may be a role for more specialized care of elderly women or geriatric patients with mild to moderate medical illness to improve the efficiency of their care. [source] Mental health professionals' attitudes towards consumer participation in inpatient unitsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2008T. V. MCCANN rmn rgn phd ma ba dipnurs (lond) rnt rcnt Consumer participation has been a major focus in mental health services in recent years, but the attitudes of mental health professionals towards this initiative remain variable. The purpose of this study was to describe mental health professionals' attitudes towards mental health consumer participation in inpatient psychiatric units. The Consumer Participation and Consultant Questionnaire was used with a non-probability sample of 47 mental health professionals from two adult inpatient psychiatric units situated in a large Australian public general hospital. Ethics approval was obtained from a university and a hospital ethics committee. Data were analysed using spss, Version 12. Overall, respondents had favourable attitudes towards consumer participation in management, care and treatment, and mental health planning. They were less supportive about matters that directly or indirectly related to their spheres of responsibility. The type of unit that the respondents worked in was not a factor in their beliefs about consumer participation. Recommendations are made about the development of guidelines for consumer participation in inpatient units, the educational preparation of mental health clinicians, and the need for mental health professionals to reflect on, and discuss their own beliefs and practices about, consumer participation. [source] Mental health clinicians' attitudes about consumer and consumer consultant participation in Australia: A cross-sectional survey designNURSING & HEALTH SCIENCES, Issue 2 2008Terence V. McCann rn Abstract The purpose of this study was to assess mental health clinicians' attitudes about mental health consumer participation in inpatient psychiatric units. A cross-sectional survey design was used with a non-probability sample of 47 clinicians in the psychiatric units of a large Australian hospital. The results showed that gender, length of time as a clinician, and how long the staff worked in the units influenced their attitudes about consumer involvement. Females were more likely than males to support consumer participation in management and consumer consultants. Less experienced staff showed greater support than more experienced staff for mental health consumer involvement in treatment-related matters and consumer consultants in units. New staff members were more likely to register agreement-to-uncertainty regarding consumer involvement in treatment-related issues, whereas established staff members were more likely to record uncertainty about this issue. The findings showed that although reports and policies promoted participation, some clinicians were reluctant to accept consumer and consultant involvement. [source] Governing the Captives: Forensic Psychiatric Nursing in CorrectionsPERSPECTIVES IN PSYCHIATRIC CARE, Issue 1 2005Dave Holmes RN TOPIC/PROBLEM:,Since 1978, the federal inmates of Canada serving time have had access to a full range of psychiatric care within the carceral system. Five psychiatric units are part of the Federal Correctional Services. Nursing practice in forensic psychiatry opens up new horizons in nursing. This complex professional nursing practice involves the coupling of two contradictory socio-professional mandates: to punish and to provide care. METHOD:,The purpose of this article is to present the results of a grounded theory doctoral study realized in a multi-level security psychiatric ward of the Canadian Federal Penitentiary System. The theoretical work of the late French philosopher, Michel Foucault, and those of sociologist, Erving Goffman, are used to illuminate the qualitative data that emerged from the author's fieldwork. FINDINGS:,A Foucauldian perspective allows us to understand the way forensic psychiatric nursing is involved in the governance of mentally ill criminals through a vast array of power techniques (sovereign, disciplinary, and pastoral) which posited nurses as "subjects of power". These nurses are also "objects of power" in that nursing practice is constrained by formal and informal regulations of the penitentiary context. CONCLUSION:,As an object of "governmental technologies", the nursing staff becomes the body onto which a process of conforming to the customs of the correctional milieu is dictated and inscribed. The results of this qualitative research, from a nursing perspective, are the first of their kind to be reported in Canada since the creation of the Regional Psychiatric Correctional Units in 1978. [source]
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