Module 2: Psychiatric Mental Health Nursing in Acute Care and Community Settings Flashcards
Criteria for admission to inpatient care
- imminent danger or harming themselves
- imminent danger or harming others
unable to care of basic needs and rendering them in danger of harming themselves
Admission options:
- direct admission
- hospital emergency department
Voluntary or Involuntary
- involuntary admissions may be contested under the review process established legislation
Describe the Mental health Act of Alberta and how it outlines actions when a patient with a mental disorder refuses to seek help
- it protects individuals who are admitted both in an involuntary basis as well as voluntary basis
If you refuse treatment:
• the health care team may try to work with you to make a treatment plan you are willing to try;
• your doctor may decide to respect your decision and not order treatment. He or she will decide if the certificates should be cancelled and if you should be discharged from hospital;
• or your doctor may request a Treatment Order (Form 15) from the Review Panel that allows for you to be treated against your will.
If you are considered incompetent (not able to make treatment decisions), a substitute decision-maker such as your agent (if you have chosen one), your guardian (if you have one), your nearest relative, or the Public Guardian will be asked to consent to treatment on your behalf.
Explain the importance of monitoring and methods of ensuring patient safety during hospitalization
- tracking patients’ whereabouts and activities, done periodically or continuously depending on the patient risk for a health crisis or self harm
- ## many psychiatric units are locked since some patients are hospitalized involuntarily and elopement must be prevented in a way that doesnt feel like imprisonment as it may bring forth aggression and agitation
Describe the role of the nurse as advocate and provider of care for the psychiatric mental health patient (page 40-41)
- admission assessment
- physical assessment
- milieu management
- structured group activities
- documentation
- medication administration
- crisis management
- discharge management
Describe the different types of treatment programs and settings for patients with mental health issues
- therapeutic milieu: surroundings and physical environment, managing behavioural crisis, safety, suicide risk
- structured group activities
- talk therapy
- a calm setting away from triggers
Describe the approach and use of Alberta’s Community Treatment Orders (CTO)
a community treatment order (CTO) is a tool intended to assist patients in maintaining compliance with treatment while in the community; thereby breaking the cycle of involuntary hospitalization, decompensation and rehospitalization
Who determines who will be on a CTO?
two physicians and one must be a psychiatrist
Who can be on a CTO?
- CTO’s are intended for individuals with mental illness who would otherwise decompensate in the community, be likely to cause harm to themselves or others, or suffer substantial mental or physical deterioration or serious physical impairment. These individuals are often subsequently admitted to the hospital for psychiatric treatment; however with appropriate support and supervision they can remain in the community. A CTO can be written while a person is a formal or voluntary inpatient preparing for discharge or while the person is living.
Multidisciplinary Treatment Team
- members of each discipline are responsible for gathering data and participating in the planning of care
- patients care plans provide a goldmine for patients’ care during hospital stay
Primary prevention
- adult and youth recreational or cultural centres
- schools and day care centres
- churches, temples, synagogues, mosques
- disaster preparedness teams
Secondary Prevention
- crisis enters, telephone crisis care, and shelters
- correctional community facilities
- youth residential treatment centres
- partial hospitalization programs
- chemical dependant programs
- nursing homes and hospices
- industry/work sites
- early intervention psychosis programs
- street outreach
Tertiary Prevention
- community mental health centres
- psychosocial rehabilitation programs
