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PSYCHIATRIC NURSING UNIT.
BY, RADHA V.DEOSTHALEE
BHA 1ST YEAR.
INTRODUCTION:
 Nursing care of Psychiatric patients requires
knowledge of their various behavioural patterns.
 The Psychiatric hospitals of the past more closely
resembled maximum security prisons. Hence, the
patients were locked inside the rooms and apart from
one another. Rooms were depressing.
 But today the things have changed and treatments are
based on widely accepted principles all over the world.
 In the new step the psychiatric hospitals are not
prisons. The patients are not locked instead they are in
a free & pleasant environment. Today the hospitals
have developed social and recreational activities for
the mentally disturbed ones.
 Psychiatric medication and Psychotherapy has
become the most common method of
psychiatric treatment.
 The psychiatric patients can be in-patients or
outpatients. The patients who have a normal
mental stress etc can be treated in the OPD,
whereas, the patients who have to undergo a
mental surgery are kept under observation in
the IPD.
FUNCTIONS:
 The basic functions of a Psychiatric unit are to
provide:
1) Diagnostic and Treatment Services.
2) Full or partial Hospitalization.
3) Consultation for Physicians.
4) Education for staff, patients and
members of public.
LOCATION:
 The Psychiatric Unit should be located on a
floor that has separate entrance from the rest of
the hospital.
 As the occupants have no contact with the rest
of the hospital population.
PLANNING & DESIGNING:
 As we know “ Planning & Designing should be based on
the functions”, similarly the planning and designing of
the Psychiatric nursing unit is based on its functions.
 The unit should be designed as an open type ward. It
should provide a safe environment for patients and staff.
 Light, Paints, Décor, etc. should be chosen correctly
since these factors affect the mind and attitudes of the
psychiatric patients.
 There should be a different unit for the psychiatric
therapies that will be used for patients.
 In some cases, the relatives who have brought the
patients do not remain with the patients during the
time of need. In such situations it becomes
incumbent for the staff and it becomes difficult for
the staff to continually keep the patients under
observation.
 Hence the staff should give enough knowledge to the
patient attendant about keeping watch on the
patients needs.
 Also there should be a Single Exit, Tamper-Proof
fittings, precautions against suicide and escape, and
24-hour security.
 Another differentiation is made about the patients i.e,
1) Acutely disturbed patients who require temporary
physical and chemical treatments.
2) Chronic, deteriorated a-motivated patients &
3) The patients who have come for diagnosis or for a
relapse.
 For the 1st group, specific isolation rooms are needed with
a provision to physically restrain them and to prevent the
risk of suicide, Self-harm or homicide.
DIVISION OF PSYCHIATRIC UNIT:
 The psychiatric unit has 4 sub units-
1) The Treatment- Consultation area composed of staff
offices for individual or family care sessions and for
administrative purposes.
2) The conference-Therapy area for group therapy
sessions & for observation of these sessions by staff.
3) Inpatient department to accommodate hospitalized
patients.
4) Area for therapeutic activities such as Occupational
Therapy, Recreational Therapy, etc.
 The design of the unit should provide space for various
functions, similarly the subunits should be flexible to
share as many common facilities as possible.
 The inpatient area should be located farthest away from
the main entrance to the facility, adjacent to the conference
room and the administrative area.
 Ideally, the psychiatric nursing unit should have 20 to 30
beds. This provides for close observation for the medical
and nursing staff. It is also good as per the therapeutic
point of view.
 Private and Semi-Private accommodations are desirable.
Experts recommend 20 rooms for 30 patients divided to
two units of single and double rooms.
 The Psychiatric nursing unit should have one or 2 seclusion
rooms for the patients who require security and protection or
for managing the acute behavioural disturbances of patients.
 These rooms are mean for the short term occupancy by
patients who have become violent and suicidal, should be
specially designed to prevent escape, injury or suicide.
 They should have padded beds, high ceilings, tamper-proof
fittings, shatter proof glass for doors and windows and
absence of objects like knife, glass, rope, etc.
 There should be 2 rooms for physically ill patients or patients
receiving treatment requiring bed rest or skilled nursing care.
These should be adjacent to the nurses station so as to permit
close observation of the patients.
 The unit should also have day rooms.
FACILTIES & SPACE REQUIREMENTS:
 Windows should be operable by keys or some such
devices that are under control of staff. Safety glazing or
other appropriate security features are to be used so as to
inhibit any possible escape or suicide.
 Drug cabinet should have security against unauthorized
access.
 A separate charting area i.e. the medical records
department so that patients do not see there reports.
 Space for storage of wheelchair and stretchers should be
outside the unit. They should be readily available.
 Interview rooms for the therapist so that he can work up
and see the patient. Here acoustical privacy i.e. speech
privacy is necessary.
 Space for group therapy- recreational and occupational
therapy-(both indoors and outdoors)
should be provided, particularly for a-motivated and
chronically ill patients. Indoor activity area should be used
for group discussions, family interaction session and other
group sessions.
 Medical examination and procedure room or rooms close to
the nurses station.
 Consultation rooms: There should be at least 1
consultation room for every 30 psychiatric beds. Rooms
should be designed to provide both visual and acoustical
privacy.
 Visiting area for family members.
 Toilets and bathrooms.
 Patient Laundry Facilities.
CONCLUSION:
 By studying the psychiatric unit we know
various facilities which are provided to the
patients and with modern aspects. The
comparison between the past and the present
psychiatric ward gives us a clear picture of the
change of hospital behaviour towards the
mentally disturbed ones. Here the patients
require more attention and observation and a
strain free environment of the hospital. Hence
the healthcare and hospital operations promote
for the suitable and peaceful atmosphere for the
patients as they require.
THANK YOU.

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Psychiatric nursing unit

  • 1. PSYCHIATRIC NURSING UNIT. BY, RADHA V.DEOSTHALEE BHA 1ST YEAR.
  • 2. INTRODUCTION:  Nursing care of Psychiatric patients requires knowledge of their various behavioural patterns.  The Psychiatric hospitals of the past more closely resembled maximum security prisons. Hence, the patients were locked inside the rooms and apart from one another. Rooms were depressing.  But today the things have changed and treatments are based on widely accepted principles all over the world.  In the new step the psychiatric hospitals are not prisons. The patients are not locked instead they are in a free & pleasant environment. Today the hospitals have developed social and recreational activities for the mentally disturbed ones.
  • 3.  Psychiatric medication and Psychotherapy has become the most common method of psychiatric treatment.  The psychiatric patients can be in-patients or outpatients. The patients who have a normal mental stress etc can be treated in the OPD, whereas, the patients who have to undergo a mental surgery are kept under observation in the IPD.
  • 4. FUNCTIONS:  The basic functions of a Psychiatric unit are to provide: 1) Diagnostic and Treatment Services. 2) Full or partial Hospitalization. 3) Consultation for Physicians. 4) Education for staff, patients and members of public.
  • 5. LOCATION:  The Psychiatric Unit should be located on a floor that has separate entrance from the rest of the hospital.  As the occupants have no contact with the rest of the hospital population.
  • 6.
  • 7. PLANNING & DESIGNING:  As we know “ Planning & Designing should be based on the functions”, similarly the planning and designing of the Psychiatric nursing unit is based on its functions.  The unit should be designed as an open type ward. It should provide a safe environment for patients and staff.  Light, Paints, Décor, etc. should be chosen correctly since these factors affect the mind and attitudes of the psychiatric patients.  There should be a different unit for the psychiatric therapies that will be used for patients.
  • 8.  In some cases, the relatives who have brought the patients do not remain with the patients during the time of need. In such situations it becomes incumbent for the staff and it becomes difficult for the staff to continually keep the patients under observation.  Hence the staff should give enough knowledge to the patient attendant about keeping watch on the patients needs.  Also there should be a Single Exit, Tamper-Proof fittings, precautions against suicide and escape, and 24-hour security.
  • 9.  Another differentiation is made about the patients i.e, 1) Acutely disturbed patients who require temporary physical and chemical treatments. 2) Chronic, deteriorated a-motivated patients & 3) The patients who have come for diagnosis or for a relapse.  For the 1st group, specific isolation rooms are needed with a provision to physically restrain them and to prevent the risk of suicide, Self-harm or homicide.
  • 10. DIVISION OF PSYCHIATRIC UNIT:  The psychiatric unit has 4 sub units- 1) The Treatment- Consultation area composed of staff offices for individual or family care sessions and for administrative purposes. 2) The conference-Therapy area for group therapy sessions & for observation of these sessions by staff. 3) Inpatient department to accommodate hospitalized patients. 4) Area for therapeutic activities such as Occupational Therapy, Recreational Therapy, etc.
  • 11.  The design of the unit should provide space for various functions, similarly the subunits should be flexible to share as many common facilities as possible.  The inpatient area should be located farthest away from the main entrance to the facility, adjacent to the conference room and the administrative area.  Ideally, the psychiatric nursing unit should have 20 to 30 beds. This provides for close observation for the medical and nursing staff. It is also good as per the therapeutic point of view.  Private and Semi-Private accommodations are desirable. Experts recommend 20 rooms for 30 patients divided to two units of single and double rooms.
  • 12.  The Psychiatric nursing unit should have one or 2 seclusion rooms for the patients who require security and protection or for managing the acute behavioural disturbances of patients.  These rooms are mean for the short term occupancy by patients who have become violent and suicidal, should be specially designed to prevent escape, injury or suicide.  They should have padded beds, high ceilings, tamper-proof fittings, shatter proof glass for doors and windows and absence of objects like knife, glass, rope, etc.  There should be 2 rooms for physically ill patients or patients receiving treatment requiring bed rest or skilled nursing care. These should be adjacent to the nurses station so as to permit close observation of the patients.  The unit should also have day rooms.
  • 13. FACILTIES & SPACE REQUIREMENTS:  Windows should be operable by keys or some such devices that are under control of staff. Safety glazing or other appropriate security features are to be used so as to inhibit any possible escape or suicide.  Drug cabinet should have security against unauthorized access.  A separate charting area i.e. the medical records department so that patients do not see there reports.  Space for storage of wheelchair and stretchers should be outside the unit. They should be readily available.  Interview rooms for the therapist so that he can work up and see the patient. Here acoustical privacy i.e. speech privacy is necessary.
  • 14.  Space for group therapy- recreational and occupational therapy-(both indoors and outdoors) should be provided, particularly for a-motivated and chronically ill patients. Indoor activity area should be used for group discussions, family interaction session and other group sessions.  Medical examination and procedure room or rooms close to the nurses station.  Consultation rooms: There should be at least 1 consultation room for every 30 psychiatric beds. Rooms should be designed to provide both visual and acoustical privacy.  Visiting area for family members.  Toilets and bathrooms.  Patient Laundry Facilities.
  • 15. CONCLUSION:  By studying the psychiatric unit we know various facilities which are provided to the patients and with modern aspects. The comparison between the past and the present psychiatric ward gives us a clear picture of the change of hospital behaviour towards the mentally disturbed ones. Here the patients require more attention and observation and a strain free environment of the hospital. Hence the healthcare and hospital operations promote for the suitable and peaceful atmosphere for the patients as they require.