Psychiatric nursing quality guide lines , by hatem a. aziz banjar.ppt [compatibility mode]


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Psychiatric nursing quality guide lines , by hatem a. aziz banjar.ppt [compatibility mode]

  1. 1. Psychiatric Nursing Quality Guide lines By: Hatim AbdulAziz Banjar (Nursing quality coordinator and hospital risk officer) Al-Amal Hospital (Jeddah) Al- Mob. 00966 540572716 2/11/2009 11/ Hatim Banjar 1
  2. 2. Introduction Mental health problems are an international and national concern. More than 30% of adults are estimated to experience at least one form of mental ill health during any one year. There is a lack of understanding of the role and value of the psychiatric nurse among health practitioners. there is lack of competent qualified nurses in psychiatric area and young people are not willing to educate themselves for the field of mental health care. 2/11/2009 11/ Hatim Banjar 2
  3. 3. The main goal Providing data that will hopefully help in mapping the road to achieving high performance levels in psychiatric nursing practice and in giving an understanding to the role and value of the psychiatric nurse. The method Collection of multiple data from multiple sources that discuses points in quality of psychiatric nursing. Emphasis on the special points of psychiatric nursing. 2/11/2009 11/ Hatim Banjar 3
  4. 4. What is psychiatric nursing? It is the specialty of nursing practice employing theories of human behavior as its science and purposeful use of self as its art. Nurses in this area receive additional training in building a therapeutic alliance, psychosocial therapy, dealing with challenging behavior and the administration of psychiatric medication. 2/11/2009 11/ Hatim Banjar 4
  5. 5. Basic scope of service Therapeutic relationship Physical and biological interventions Psychosocial interventions: ( helping the patient and family in dealing with each other and with the society) Spiritual interventions: (focus on developing a sense of meaning, purpose and hope for the person in their current life experience) 2/11/2009 11/ Hatim Banjar 5
  6. 6. What are the trends of a psychiatric nurse? Clear insight with high self-understanding self- (Stigmatization and ethical dilemmas are high in psychiatric nursing) Psychiatric and medical-surgical nursing skills medical- and knowledge Good and affective communication skills (a therapeutic relation can only be billed with affective communication) Competent, punctual, cooperative and calm 2/11/2009 11/ Hatim Banjar 6
  7. 7. High since of moral values ( many psychiatric patients are easy to be taken advantage of) Psychological and physical stamina Good judgment and critical thinking (situations explodes with in moments with psychiatric patients) Highly observant (many small behavioral changes of the patient that can be considered normal by others have a dramatic effect on the nursing care plan) 2/11/2009 11/ Hatim Banjar 7
  8. 8. What are the elements needed for nursing quality? NURSING ETHICS: Many elements of the nursing code of ethics have been involved with the psychiatric nursing care as methods of treatment: confidentiality- confidentiality-(Breaking confidentiality can be if there is a well-defined reason to share information: well- Benefit outweighs harm. This is an ethical dilemma ) veracity- veracity-(The only way to deal with patients with hallucinations is to confront them with the truth) fidelity- fidelity-(psychiatric treatment depends trust and maintaining therapeutic alliance) non malfeasances-(many psychiatric patients are malfeasances- easy to take advantage of) 2/11/2009 11/ Hatim Banjar 8
  9. 9. Knowledge and skills. Utilization of the nursing care plan and the nursing process: assessment- assessment-(the main dependence is on objective data) nursing Diagnosis-(many symptoms of the Diagnosis- psychiatric illness is hard do defined and many of them are not present all of the time) Healthy and safe working environment. Good retention plan (psychiatric nurses are among the rears and highest paid in the world) Standard policies and procedures. 2/11/2009 11/ Hatim Banjar 9
  10. 10. How is nursing Quality measured? Competency Effectiveness Respect and Caring Safety Appropriateness Timing 2/11/2009 11/ Hatim Banjar 10
  11. 11. How is patient safety cared for ? Protecting the patient from harming himself : That is done by monitoring patients with tendency to comet suicide or to cause harm to themselves and placing them under clues observation, exploring their thought content and try to distract them away from such ideas and try to occupy their time with different activities and give them a since of hope in life and place them in a safe environment in the wards away from any external stimulators for such ideas and away from any harmful object that he might use to cause harm to him self . Protecting the patient from case prognoses. 2/11/2009 11/ Hatim Banjar 11
  12. 12. Protecting the patient from being harmed by others: That is done by monitoring aggressive and provoking behaviors so physical contact ( fights) don't happen among patients, delusions and wrong beliefs are also monitored to prevent patients from causing harm to each other due to the delusions or beliefs and in case of any physical contact among patients nurses must interfere as quickly as possible using the right manner of intervention also patients of deferent age groups and genders must be separated to prevent sexual assault ( male – female ) ( adult – teenagers - children ) . Protecting the patient from any medical or nursing errors. 2/11/2009 Hatim Banjar 12
  13. 13. Protecting the patient from the physical surrounding: That is done by making sure that the patient is placed in a save place and free from any harmful objects that might injure the patient or be used to cause harm for him e.g. ( only plastic food utilities can be used in the ward , no sharp objects are allowed in the ward ) The patients consciousness level must be monitored to prevent any possible danger of falling down, for patients that are endangered of falling down during sleep precautions like sidereal, placing patients in beds clause to the door, decreasing bed height must be taken. 2/11/2009 11/ Hatim Banjar 13
  14. 14. Patient safety during restrain episodes That is done by following the correct and safe steps to administer restrains : never use restrains with out a medical order. never use retrains as a punishment method or for personal revenge. always tell the patient the reason from restraining him. make sure that restrains do not block the blood circulation . chick on patient and take vital signs every 15min. 15min. make sure room temperature is appropriate . always restrain the patient in a supine position. make sure that the patient's physical needs are met. do not apply restrains to cases of resent ophthalmic surgery, spinal surgery, harts conditions, chest and respiratory problems. the restrain room physical surrounding must be appropriate and equipped with a monitoring camera. patient should be on monitors through all the restraining time . 2/11/2009 11/ Hatim Banjar 14
  15. 15. Patient safety during seclusion episodes That is done by following the correct safety measures: never use seclusion with out a medical order. never use seclusion as punishment or for personal revenge. always tell the patient the reason of putting him in seclusion. chick on patient every 15 min. make sure that the room is harm free. make sure that the room physical surrounding is appropriate and equipped with a monitoring camera. make sure that the patient physical needs are met. seclusion should not be done to cases in risk of self harm, autism, cardiac and respiratory disorders and phobic patients. 2/11/2009 11/ Hatim Banjar 15
  16. 16. Nurses safety during P.T encounter Never face an aggressive P.T on your own. Always be calm and use an appropriate voice tone. Never turn your back to the patient. Always keep eye contact. Always keep an arm space between the nurse and the patient during confrontation. When trying to physically control the patient approach him from the back and sides. 2/11/2009 11/ Hatim Banjar 16
  17. 17. A final statement Psychiatry dose not have much luxury when it comes to diagnostic lab tests and helping diagnostic aids and many symptoms of the psychiatric illness is hard do defined and many of them are not present all of the time so the psychiatrist depends mostly on his observations and on the extra eye that he has ( the nurse and his/her observations) to confirm diagnoses and to set the correct treatment plan. That makes the qualified plan. psychiatric nurse a valuable and rear commodity in today's nursing world and the way to perfection in psychiatric nursing starts with understanding of the important role of the psychiatric nurse and improving the psychiatric educational level, observation skills and documentation skills of the psychiatric nurse. nurse. 2/11/2009 11/ Hatim Banjar 17
  18. 18. References Psychiatric Mental Health Nursing (6th addition) 2009. 2009. “Toward Improved Quality – Developing Nurse’s Continuing Vocational Training In Hospitals And Inpatient Units”. Units”. 2006 – 2007 By: Välimäki M, Scott A, Lahti M & Chambers M (eds.) Lippincott’s Manual Of Psychiatric Nursing Care Plans, Plans, 8th Edition 2009By: Lippincott Williams & Wilkins. 2009By: Al-amal Hospital In Jeddah Policies And Procedures Al- Manual, 2009, Jeddah. Manual, 2009, Jeddah. Essentials Of Psychiatric Mental Health Nursing, Nursing, Collaboratively Developed by ISPN and APNA, (2007- 2007- 2008) 2008). 2/11/2009 11/ Hatim Banjar 18