Intro to psych nursing
Nursing 4206
Mental Health vs. Mental Illness
Mental Health
Mental Health Problems
Mental Illness/Mental Disorder
DSM-IV-TR Diagnostic Axes
Axis I- Clinical Disorder and other conditions
Axis II- Personality Disorders and Mental Retardation
Axis III- General Medical Conditions
Axis IV- Psychosocial and Environmental Problems
Axis V- Global Assessment of Functioning
Evidence-based nursing practice
The focus of nursing care today
Involves defining clinical questions, finding and analyzing evidence, applying research
and evaluation outcomes.
Based on critical analysis of all the research studies related to a specific area.
Patient’s Rights
Patient’s Bill of Rights
Self-Determination
Informed Consent/competence
Patient’s Rights
Treatment- Voluntary vs. Involuntary
Right to Least Restrictive Environment
Mandate to Inform
Internal Rights Protection System
Community Mental Health Care
Primary Goal
Types of Care in a Continuum
Crisis intervention
Acute inpatient care
Partial Hospitalization
Residential services
In-home services
Outpatient care
After care
Frameworks, Ethics and Standards of Psychiatric Nursing
Bio-psycho-social framework
Biologic domain
Psychological domain
Social domain
Scope of Psychiatric Nursing
Box 5.2, page 48
A wide range of mental health problems and disorders
Actual and potential problems
Standards of Care-Psychiatric Nursing
Organized around the nursing process
Standard I
Assessment
Patient Interview
Biologic domain
Current and past health status
Physical exam
Physical functioning
Pharmacology
Psychological domain
Response to mental health problems
Mental status exam
Standards of Nursing Care-Psychiatric Nursing
Assessment
Mental Status Exam
General observations
Orientation
Mood
Affect
Speech
Thought processes
Cognition
Insight and Judgment
Standard I
Assessment
Behavior
Self-concept
Body image
Self-esteem
Personal identity
Suicidal ideation
Assaultive or homicidal ideation
Standard I
Assessment
Social Domain
Social systems
Family assessment
Cultural
assessment
Community Support and Resources
Spiritual assessment
Standard II- Diagnosis
Data collected during the assessment are used to formulate nursing diagnoses
Nursing Diagnoses are clinical judgments based on the needs and problems identified
during the assessment
Cluster Data
Standard III-Outcome Identification
Outcome- patient’s response to care; the result of a process, treatment or a nursing
intervention
Purpose- to assure quality of care
Standard IV- Planning
Develops a plan of care that prescribes interventions to attain expected outcomes
Standard V-Implementation
Biologic Interventions
Promotion of self-care
Activity and exercise
Sleep
Nutrition
Relaxation
Hydration
Pain Management
Medication Management
Psychological Interventions
Counseling
Conflict resolution
Reminiscence
Behavior therapy-behavior modification
Token economy
Psychoeducation
Cognitive Interventions
Cognitive Interventions
Cognitive behavioral therapy
Rational emotive behavior therapy
Solution-focused brief therapy
Uses in psychiatric nursing
Social Interventions
Milieu Therapy
Therapeutic environment
Responsibility of nurse in collaboration with patient and other health care providers
Milieu Therapy
Containment
Validation
Structured Interaction
Open Communication
Standard V
Promotion of Patient Safety
Observation
De-escalation
Seclusion
Restraints
Home Visits
Standard VI-Evaluation
The PMH nurse evaluated the patient’s progress in attaining expected outcomes