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Reynolds, Lisa. "Risk assessment and management in mental health nursing." Health, Risk & Society 13, no. 6 (September 2011): 599–600. http://dx.doi.org/10.1080/13698575.2011.615575.
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Crowe, Marie, and Dave Carlyle. "Deconstructing risk assessment and management in mental health nursing." Journal of Advanced Nursing 43, no. 1 (June 11, 2003): 19–27. http://dx.doi.org/10.1046/j.1365-2648.2003.02669.x.
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Dickens, G. L. "Re-focusing risk assessment in forensic mental health nursing." Journal of Psychiatric and Mental Health Nursing 22, no. 7 (August 2, 2015): 461–62. http://dx.doi.org/10.1111/jpm.12256.
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Crouche, S. "Risk Assessment in Mental Health: Introducing a Traffic Light System in a Community Mental Health Team." Open Nursing Journal 7, no. 1 (May 29, 2013): 0. http://dx.doi.org/10.2174/1874434620130516004.
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Crouche, S., and Graham R. Williamson. "Risk Assessment in Mental Health: Introducing a Traffic Light System in a Community Mental Health Team." Open Nursing Journal 7 (May 14, 2013): 82–88. http://dx.doi.org/10.2174/1874434620130529004.
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Harwood, Paul, and David Yeomans. "Inconsistencies in risk assessment." Psychiatric Bulletin 22, no. 7 (July 1998): 446–49. http://dx.doi.org/10.1192/pb.22.7.446.
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An audit of case notes and a survey of in-patients was carried out to evaluate risk assessment on an in-patient ward. We found considerable inconsistencies between the risk assessment records in medical and nursing notes. A systematic survey found higher levels of risk than either set of notes, but combining the notes improved the quality of risk assessment compared to the survey. We suggest three key areas for action to improve risk assessment.
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McConachie, Susan, and Ross Cheape. "An audit of maternal mental health assessments in the perinatal period using a new risk assessment document developed by a Scottish health board." British Journal of Mental Health Nursing 9, no. 3 (August 2, 2020): 1–10. http://dx.doi.org/10.12968/bjmh.2019.0024.
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The UK and Scottish Governments are pledging investment for maternal and infant mental health services. Nurses taking on advanced nursing roles within these developing services need to be aware of the specific risks that pertain to the perinatal period. A plethora of professional reports and women's lived experience have identified a lack of understanding to their needs and poor communication between health professionals, highlighting the need for robust risk assessments. New documentation was developed by NHS Forth Valley, with an embedded risk assessment to be used by all mental health services. An audit of 50 cases in perinatal services using the new documentation was measured against the standards for risk assessment set by the Royal College of Psychiatrists. Just under half of the women who were assessed did not have risks identified and for those who did, the majority of risks scored as low. The free text clinical notes of the risks on the new documentation identified specific risks to the mother, unborn child/infant and others.
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Delaney, Kathleen R., and Frances Belmonte-Mann. "Identifying the Mental Health Needs of Preschool Children." Journal of School Nursing 17, no. 4 (August 2001): 222–26. http://dx.doi.org/10.1177/10598405010170041001.
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The city of Chicago offers publicly funded preschool education to 20,000 3- and 4-year-olds through its State Pre-Kindergarten program. The students attend some 300 schools, and their health needs are monitored by 11 nurses and 8 aides. In the last several years, the nursing coordinator recognized the need to improve the mental health assessment skills of the school nurses. To that end, a relationship was developed with a child psychiatric nurse who had expertise in assessing young children’s behaviors, particularly in the context of the classroom milieu. The collaboration of the school nurse and mental health nurse-consultant was structured as one-on-one sessions, each focusing on a particular child. A case is presented to illustrate the assessment method and accompanying suggestions for early intervention strategies. The case also points out how school nurses can structure assessments of at-risk children that lead to classroom-based interventions.
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Murphy, Elizabeth, Navneet Kapur, Roger Webb, and Jayne Cooper. "Risk assessment following self-harm: comparison of mental health nurses and psychiatrists." Journal of Advanced Nursing 67, no. 1 (October 25, 2010): 127–39. http://dx.doi.org/10.1111/j.1365-2648.2010.05484.x.
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Garand, Linda, Ann M. Mitchell, Ann Dietrick, Sophia P. Hijjawi, and Di Pan. "SUICIDE IN OLDER ADULTS: NURSING ASSESSMENT OF SUICIDE RISK." Issues in Mental Health Nursing 27, no. 4 (January 2006): 355–70. http://dx.doi.org/10.1080/01612840600569633.
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Masson, Neil, Ashley Liew, John Taylor, and Frank McGuigan. "Risk assessment of psychiatric in-patients: audit of completion of a risk assessment tool." Psychiatric Bulletin 32, no. 1 (January 2008): 13–14. http://dx.doi.org/10.1192/pb.bp.107.015008.
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Aims and MethodTwo complete audit cycles were used to assess the completion of a bespoke risk assessment tool and whether an educational intervention, and subsequently the introduction of a standardised admission pack, led to improvements in completion rates.ResultsThe total rate of completion of forms improved from 60% to 81% following a brief educational intervention in the form of a lecture and email about the audit. The subsequent introduction of a standardised admission pack containing the tool maintained completion rates.Clinical ImplicationsAudit coupled with a simple educational intervention can improve the completion of risk assessment forms by medical and nursing staff.
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Ayhan, Fatma, and Besti Üstün. "Examination of risk assessment tools developed to evaluate risks in mental health areas: A systematic review." Nursing Forum 56, no. 2 (February 3, 2021): 330–40. http://dx.doi.org/10.1111/nuf.12557.
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Handa, Nikhita. "Assessing the quality of risk assessment conducted for new psychiatry inpatients." BJPsych Open 7, S1 (June 2021): S80. http://dx.doi.org/10.1192/bjo.2021.251.
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AimsAn audit was conducted to assess if thorough risk assessments had been documented in electronic clinical record notes (ECR) clerking for new patients in two acute mental health wards. Risk assessment is a vital part of admission clerking and when done well it can prevent early incidents and aid the ward nursing team greatly. During induction, junior doctors are advised to document assessed risks when clerking a new patient. A screening of the risks on admission could help determine the levels of observations required to minimise the identified risks whilst the patient awaits their first ward review.MethodThe NHS numbers for the 30 current inpatients across male and female acute psychiatric wards were gathered at the time of the audit (February – March 2020). Admission clerking was analysed for a clear statement of patient risk to self, others or property. Within these categories quantitative results were obtained on how often the risk of self-harm, self-neglect, absconding, vulnerability or aggression was documented. The term ‘risk’ was used for each patient on their ECR notes to search for risk assessments in all entries other than admission clerking.Result12 out of the 30 patients had a junior doctor risk assessment documented in their clerking (40%). 14 patients had no mention of risk assessment on admission (47%) and their first formal risk assessment was documented only in their senior ward review. Of the 12 assessments completed in clerking; all assessed self harm/suicide risk and violent risk to others, 1 mentioned risk of absconding, 8 mentioned risk of illicit substance use and 8 mentioned vulnerability. It was unclear if the risks documented were based on current or historic presentation. Junior doctors were anonymously surveyed following this audit and reported they did not feel confident in how to document a risk assessment or whether to document negative findings.ConclusionClear documentation of risk assessment being performed was lacking in over half of junior doctor admission clerkings. When risks were assessed it was mainly violence/self harm risk documented not vulnerability and physical health risks. Based on these findings we have designed more comprehensive teaching on risk assessments and a template for how to complete a risk assessment. We feel the use of a template will ensure all elements of risk are clearly considered even if they are not present currently. This is being reaudited to assess if the changes have impacted the quality of risk assessment conducted.
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Grotto, Jessica, Adam Gerace, Deb O'Kane, Alan Simpson, Candice Oster, and Eimear Muir-Cochrane. "Risk assessment and absconding: perceptions, understandings and responses of mental health nurses." Journal of Clinical Nursing 24, no. 5-6 (September 11, 2014): 855–65. http://dx.doi.org/10.1111/jocn.12671.
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Abayomi, Julie, and Allan Hackett. "Assessment of malnutrition in mental health clients: nurses' judgement vs. a nutrition risk tool." Journal of Advanced Nursing 45, no. 4 (February 2004): 430–37. http://dx.doi.org/10.1046/j.1365-2648.2003.02926.x.
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Walker, Helen, Lindsay Tulloch, Karen Boa, Gordon Ritchie, and John Thompson. "A multi-site survey of forensic nursing assessment." Journal of Forensic Practice 21, no. 2 (May 13, 2019): 124–38. http://dx.doi.org/10.1108/jfp-11-2018-0045.
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Purpose A major difficulty identified many years ago in psychiatric care is the shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments which are behaviourally based and therefore appropriate for use in a variety of contexts. The aim of this project was to ascertain the utility of a forensic nursing risk assessment tool - Behavioural Status Index (BEST-Index). The paper aims to discuss these issues. Design/methodology/approach A multi-site cross-sectional survey was undertaken using mixed method design. Quantitative data was generated using BEST-Index to allow comparisons across three different levels of security (high, medium and low) in Scotland and Ireland. Qualitative data were gathered from patients and multi-disciplinary team (MDT) members using semi-structured interviews and questionnaire. Findings Measured over an 18-month period, there was a statistically significant improvement in behaviour, when comparing patients in high and medium secure hospitals. Two key themes emerged from patient and staff perspectives: “acceptance of the process” and “production and delivery of information”, respectively. The wider MDT acknowledge the value of nursing risk assessment, but require adequate information to enable them to interpret findings. Collaborating with patients to undertake risk assessments can enhance future care planning. Research limitations/implications Studies using cross-section can only provide information at fixed points in time. Practical implications The BEST-Index assessment tool is well established in clinical practice and has demonstrated good utility. Originality/value This project has served to highlight the unique contribution of BEST-Index to both staff and patients alike and confirm its robustness and versatility across differing levels of security in Scottish and Irish forensic mental health services.
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Hootman, Janis, Gail M. Houck, and Mary Catherine King. "A Program to Educate School Nurses About Mental Health Interventions." Journal of School Nursing 18, no. 4 (August 2002): 191–95. http://dx.doi.org/10.1177/10598405020180040401.
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Concerned with the increasing incidence of mental health problems in children and adolescents and the impact of these problems on students’ school success and predisposition to self- and other-directed violence, the Multnomah Education Service District Department of School Health Services determined to become proactive by providing preventive interventions for students experiencing actual or potential mental health problems. An educational program was designed to assist school nurses in the identification of potential mental health problems. In addition, information about appropriate interventions for students at risk for aggression, violence, and other mental health pathology was presented. The program involved education on mental health assessment and intervention, as well as expert psychiatric clinical support for the development of student support groups. School nurses were then challenged to develop practice improvement projects incorporating this knowledge for a group of students in their work setting. This introductory article describes the project’s general rationale and implementation process. The four articles following in this issue of The Journal of School Nursing describe the goals, implementation, and outcomes of the practice improvement projects developed for early intervention with students exhibiting attention disorders, school absenteeism, social withdrawal, and depression.
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Hootman, Janis, Gail M. Houck, and Mary Catherine King. "A Program to Educate School Nurses About Mental Health Interventions." Journal of School Nursing 18, no. 4 (August 2002): 191–95. http://dx.doi.org/10.1177/10598405020180040501.
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Concerned with the increasing incidence of mental health problems in children and adolescents and the impact of these problems on students’ school success and predisposition to self- and other-directed violence, the Multnomah Education Service District Department of School Health Services determined to become proactive by providing preventive interventions for students experiencing actual or potential mental health problems. An educational program was designed to assist school nurses in the identification of potential mental health problems. In addition, information about appropriate interventions for students at risk for aggression, violence, and other mental health pathology was presented. The program involved education on mental health assessment and intervention, as well as expert psychiatric clinical support for the development of student support groups. School nurses were then challenged to develop practice improvement projects incorporating this knowledge for a group of students in their work setting. This introductory article describes the project’s general rationale and implementation process. The four articles following in this issue of The Journal of School Nursing describe the goals, implementation, and outcomes of the practice improvement projects developed for early intervention with students exhibiting attention disorders, school absenteeism, social withdrawal, and depression.
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Rahman, Mehtab, and Vernanda Julien. "Improving cardiometabolic health assessments and interventions at St Charles Hospital, London." BJPsych Open 7, S1 (June 2021): S214. http://dx.doi.org/10.1192/bjo.2021.571.
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AimsSt Charles is one of the largest inpatient mental health units in London with 8 wards and covers the boroughs of Kensington & Chelsea and Westminster. This project aimed was set up so that 95% of patients in St Charles Mental Health Centre would have a complete cardiometabolic health assessment by December 2020. This would include Weight, Smoking, Alcohol, Substance Use, Hypertension, Cholesterol and Diabetes assessments with necessary interventions recorded. The outcome of the intervention would improve overall physical health and life expectancy.MethodPeople with serious mental illness experience significantly worse physical health and shorter life expectancy of up to 10 to 15 years than the general population. CNWL is making Physical Health of patients in Mental Health Services a priority. Performance in this area has been challenging across the Trust because of: –Buy in from clinicians.–Staff did not feel empowered to discuss interventions with patients.–High sickness and absence as a result of COVID was found to directly correlate with reduced physical health monitoring/recording.–Lack of training in completing the SystmOne physical health templateThe following cardiometabolic risk monitoring interventions were recorded on SystemOne (electronic documentation platform) and performance reviewed using Tableau : Weight, Smoking, Alcohol, Substance Use, Hypertension, Cholesterol and Diabetes assessments with necessary interventions recorded.ResultPrior to the commencement of this project, the wards in St Charles Mental Health Centre completed physical health assessments on roughly 8% of the patients in February 2020. The QI project was implemented in June 2020. By September 2020, physical health recording across 8 wards across St Charles had increased to 89% following successful implementation of the interventions.ConclusionThe following interventions resulted in a significant improvement in physical health cardiometabolic risk monitoring at a busy inpatient mental health setting: –Monthly physical heath meetings to enable shared learning with ward doctors, nurses and healthcare assistants.–Ongoing one-to-one and group support to train staff with completing and recording physical health assessments.–Tableau Physical Health Report regularly reviewed with MDT during ward round meetings.–Physical health leads given supernumerary days to run physical health clinics on the wards.–Fortnightly Physical health monitoring meetings with the Director of Nursing and Head of Governance.
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Azermai, Majda, Monique Elseviers, Mirko Petrovic, Luc van Bortel, and Robert Vander Stichele. "Assessment of antipsychotic prescribing in Belgian nursing homes." International Psychogeriatrics 23, no. 8 (March 22, 2011): 1240–48. http://dx.doi.org/10.1017/s104161021100024x.
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ABSTRACTBackground: Given the potential adverse effects of antipsychotics, high use in nursing homes creates concern. Our study goal was to explore the use of antipsychotics in relation to resident characteristics, and to assess the appropriateness of antipsychotic prescribing in Belgian nursing homes.Methods: Data were used from a cross-sectional study (Prescribing in Homes for the Elderly; PHEBE) conducted in 76 nursing homes in Belgium. Antipsychotics were classified into typical and atypical, using the anatomical therapeutic and chemical classification. Ten inappropriate antipsychotic prescribing indicators were selected from the updated Beers criteria (2003), Bergen District Nursing Home Study (BEDNURS) indicators, and Screening Tool of Older People's Prescriptions criteria (STOPP).Results: The residents' mean age was 84.8 years, 78.1% of whom were female. The prevalence of antipsychotic utilization was 32.9%. Antipsychotics were mainly indicated for dementia-related agitation, and psychosis with/without dementia. Higher use of antipsychotics was found for dementia (OR: 3.27; 95% CI: 2.61–4.09), insomnia (OR: 1.38; 95% CI: 1.10–1.73), depression (OR: 1.30; 95% CI: 1.03–1.65), and age <80 years (OR: 1.79; 95% CI: 1.38–2.33). Inappropriate antipsychotic prescribing indicators scoring the highest among users were: long-term use (92.6%), use despite risk of falling (45.6%), combined use with other psychotropics (31.8%), and duplicate use (15.1%). Inappropriate prescribing was associated with depression (OR: 3.41) and insomnia (OR: 2.17).Conclusion: The indicator-driven analysis of antipsychotic prescribing quality revealed a need for improvement, with the main prescribing problems relating to duration and combination of therapies. Risks/benefits of off-label use need to be evaluated more consciously at the start of therapy, and at periodic re-evaluations.
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Maguire, Tessa, Michael Daffern, Steven J. Bowe, and Brian McKenna. "Risk assessment and subsequent nursing interventions in a forensic mental health inpatient setting: Associations and impact on aggressive behaviour." Journal of Clinical Nursing 27, no. 5-6 (January 30, 2018): e971-e983. http://dx.doi.org/10.1111/jocn.14107.
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Patabendige, M., S. R. Athulathmudali, and S. K. Chandrasinghe. "Mental Health Problems during Pregnancy and the Postpartum Period: A Multicenter Knowledge Assessment Survey among Healthcare Providers." Journal of Pregnancy 2020 (June 29, 2020): 1–7. http://dx.doi.org/10.1155/2020/4926702.
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Background. Mental illness related to pregnancy can have long-lasting consequences. Healthcare providers are often the most frequent medical contact with the potential for early detection of these. Objectives were to study the awareness regarding mental health problems during pregnancy and the postpartum period among healthcare providers. Methods. A cross-sectional study was carried out with healthcare providers including the nursing staff, midwifery staff, and medical officers working at obstetric wards in three tertiary care hospitals in Sri Lanka. A self-administered questionnaire assessed staff experience with mothers having mental problems, knowledge on mental health problems related to pregnancy, and knowledge about risk factors, common symptoms, and possible consequences on a five-point Likert scale from “Strongly Agree” to “Strongly Disagree.” Results. A total of 300 staff were approached and invited to participate. Only 152 responded to the questionnaire (response rate of 50.1%). Mean (SD) age was 35.8 (9.7) years and mean (SD) years of experience was 10.1 (9.1) years. Age more than 35 years of healthcare providers is associated with statistically significant (p=0.02) average knowledge scores on the consequences of maternal mental health problems. The symptom of “excessively worrying about baby’s health” had the lowest score across all three categories with an average of 34.2%. Only 42.8% have ever heard of EPDS. Overall awareness and knowledge about risk factors, symptoms, and consequences regarding pregnancy-related maternal mental health problems are generally good among the healthcare providers studied. However, some of the few aspects are not satisfactory. Health education of pregnant women, promoting regular in-service training sessions, improvement of infrastructure, and involvement of family members from the antenatal period were discussed by the majority. Conclusion. Despite good overall awareness and knowledge, application into practice with the utilization of validated assessments is poor. This may probably explain why Sri Lanka has a high prevalence of postpartum depression suggesting urgent attention.
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Linville, Deanna, Heather McClure, Charles Martinez, and Celeste Mena Morales. "Latinx Immigrant Farmworker Community Health Promotion: A Needs Assessment." Health Promotion Practice 21, no. 3 (August 24, 2019): 372–82. http://dx.doi.org/10.1177/1524839919869923.
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The present study examined the health promotion intervention needs of Latinx immigrant farmworker families residing in Oregon. Grounded theory qualitative procedures were used to analyze the needs assessment data from 31 Latinx immigrant farmworker residents and key informant interviews as well as four focus groups with resident youth and parents. A theoretical model of how key family-based health behaviors can both confer risk for and protection against negative physical, mental, and social health outcomes among Latinx farmworking communities emerged. Six primary areas of concern emerged from these data, leading to the identification of primary health promotion intervention needs with three foci: (a) the provision of sustainable supports and resources, (b) skill development so that individuals could successfully negotiate identified challenges, and (c) greater community efficacy. Findings underscore the importance of social support and resource accessibility for Latinx immigrant populations.
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Clements, Paul Thomas, Karyn E. Holt, Catherine M. Hasson, and Theresa Fay-Hillier. "Enhancing assessment of interpersonal violence (IPV) pregnancy-related homicide risk within nursing curricula." Journal of Forensic Nursing 7, no. 4 (December 2011): 195–202. http://dx.doi.org/10.1111/j.1939-3938.2011.01119.x.
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Uchida, Tomohiro, Noriaki Satake, Toshimichi Nakaho, Akira Inoue, and Hidemitsu Saito. "Bereavement risk assessment of family caregivers of patients with cancer: Japanese version of the Bereavement Risk Assessment Tool." Palliative and Supportive Care 17, no. 04 (November 14, 2018): 448–52. http://dx.doi.org/10.1017/s1478951518000755.
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AbstractObjectivesThe Bereavement Risk Assessment Tool (BRAT) seems to be useful in identifying those who are likely to suffer from the more severe consequences of bereavement. To date, however, only a few studies have examined bereavement risk using the BRAT. This study investigated bereavement risk in family caregivers of patients with cancer using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). We also investigated the relationship of bereavement risk with psychological distress and resilience among caregivers to determine the validity of the BRAT-J.MethodsWe conducted family psychoeducation in the palliative care unit of Tohoku University Hospital with participants who were recruited in this study. Among the participants, 50 family caregivers provided their written informed consent and were included in this study. Participants were assessed using the BRAT-J and completed the Japanese version of the Kessler Psychological Distress Scale (K6) and the Tachikawa Resilience Scale (TRS).ResultsAccording to the BRAT-J, five individuals (10%) were in the high category of bereavement risk (level 4 or 5). We also found that family caregivers of patients experienced many different pressures, such as facing the unknown; their own work; and insufficient financial, practical, or physical resources. These issues are associated with various mental problems. Additionally, the level of bereavement risk was significantly correlated with K6 scores (ρ = 0.30, p = 0.032), and the TRS score (ρ = –0.44, p = 0.001). These correlations confirmed previous findings and that the BRAT-J can be an efficient screening tool for the bereavement risk of family caregivers of patients with cancer.Significance of resultsIt appears that the BRAT-J is useful in predicting the likelihood of difficulties or complications in bereavement for family caregivers and could help to provide support with these issues when needed.
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Oshima, Kensuke, Tsuyoshi Asai, Fumihiro Naruse, Junshiro Yamamoto, and Chie Minami. "92 Development and Validity of a Fall-Risk Score for Older People who Receive Nursing-Care-Service." Age and Ageing 48, Supplement_4 (December 2019): iv18—iv27. http://dx.doi.org/10.1093/ageing/afz164.92.
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Abstract Introduction Older people who receive nursing-care-service have multiple fall-risk than well-functioning older people. To our knowledge, there is no appropriate fall-risk assessment for them. Most of the fall-risk assessments in previous researches were subjective. Thus, we aimed to develop a new fall-risk score included major fall-related factors such as objective motor-functions for older who receive nursing-care-service, and to verify the validity of the score. Method We recruited 264 older people who receive nursing-care-service. They were randomly allocated to the fall-risk score development group (Development group) and the score validity group (Validity group). All assessment items were major fall-risk related factors. As motor-function tests, Short-Physical-Performance-Battery (SPPB) including single-task-walking (STW), and dual-task-walking (DTW) were performed. Dual-task-cost (DTC) was computed. The DTC score was made with 0 = lower than 20%, 1 = more than 20%, 2 = incomplete DTW. As a cognitive-function test, Mini-Mental-State-Examinations was examined. Basic-health-related-information and past one-year fall-history were obtained via patient care records. Information of fear of falling was obtained via interview. In the Development group, the association between fall-history and the major fall-related factors were analyzed using multiple-logistic-regression analysis. Based on these results, we developed the 4-point fall-risk score consisted of DTC score and SPPB score (0=more than 10-point, 1=7 to 9 point, 2=less than 6-point). Finally, in the Validity group, the association between fall-history and the fall-risk score was investigated using logistic-regression analysis, and we computed area-under-the-curve (AUC). Results In the Development group, the fall-history was associated with SPPB (Odds ratio[95%CI] = 0.73[0.61-0.87]), and DTC score (Odds ratio[95%CI] = 2.50[1.14-5.79]). In the Validity group, our fall-risk score was significantly associated with fall-history [ AUC=73%, sensitivity=67%, specificity=71% ]. Conclusion In the fall-risk assessment for older people who receive nursing-care-service, our fall-risk score included SPPB and DTC are useful. The validity of our fall-risk score was confirmed.
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Worringer, Britta, Melanie Genrich, Andreas Müller, Harald Gündel, and Peter Angerer. "Hospital Medical and Nursing Managers’ Perspective on the Mental Stressors of Employees." International Journal of Environmental Research and Public Health 17, no. 14 (July 13, 2020): 5041. http://dx.doi.org/10.3390/ijerph17145041.
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Working conditions in hospitals are characterized by occupational stressors, which lead to potentially harmful psychosocial stress reactions for medical and nursing staff. Representative surveys showed that almost every second hospital physician or nurse is affected by burnout and that there is a strong association between leadership behavior and employee health. Workplace health promotion programs can only be successful and sustainable if managers support them. However, it is still unclear whether hospital managers are aware of the working conditions and perceive them as an influence on the health of their employees. Therefore, the aim of this qualitative study was to explore the hospital medical and nursing managers’ perspective on the mental stress of their employees. Semi-standardized interviews with 37 chief physicians (CP), senior physicians (SP) and senior nurses (SN) in total were carried out in one German hospital. The interviews were content-analyzed based on the guideline for the mental risk assessment of the ‘Gemeinsame Deutsche Arbeitsschutzstrategie’ (GDA). Most reported work characteristics related to work organization, work task, and social factors. Staff shortage could be identified as an underlying stressor for several other burdens. Social support by managers and among colleagues was mentioned as main resource. The findings indicate that managers strive to reduce the burden on their staff, especially through their personal support. Nevertheless, it seemed that managers need additional resources to counteract stressors.
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Swift, Pamela, Brian Gillatt, Emma Drysdale, Hollie Walker, Pamela Johnston, and Emma Jackson. "Staff survey on using the new clinical risk assessment framework for teams (CRAFT) tool." BJPsych Open 7, S1 (June 2021): S294—S295. http://dx.doi.org/10.1192/bjo.2021.781.
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AimsRisk assessment and management are crucial elements of clinical practice in mental health. Healthcare Improvement Scotland identified risk management as a key area for change, with risk tools identified as one necessary component. In NHS Greater Glasgow and Clyde (GG&C) the CRAFT tool replaced the Glasgow Risk Screen (GRS) in October 2019. The CRAFT tool is a 2 page document that comprises a broad risk screen, details of historical risk events and prompts for family and carer involvement. The aim of this study was to assess staff attitudes to the CRAFT, 12 months after it had been rolled out. Looking at whether the CRAFT tool is used to inform decision making about risk in clinical settings and if patients were involved in the risk management process.MethodAn electronic staff survey was distributed to all clinical staff within NHS GG&C Mental Health Services. Clinical staff includes the following professional groups: Medical, Nursing, Psychology, Occupational Therapists and Allied Health Professionals. Contact details were accessed via the relevant managers and surveys were sent via secure global address lists. Questions were focused around the following areas: time taken to complete/update/frequency of use/contact and ease of use, role in decision making, patient and carer involvement/knowledge, view on the impact of the CRAFT.ResultThere were 209 responses. This represents a response rate of approximately 10%. 89% of respondents had completed a CRAFT tool at some point but only 38% had received training. 15% reported that the CRAFT did not aid decision making about risk in clinical settings, whereas 37% said it did and 42% said it did sometimes. 46% report patients are consulted most of the time (34%) or always (12%). The qualitative impression was that the CRAFT was an improvement on its predecessor. However common themes from responders highlighted a lack of clinical relevance or impact decision making, lack of training in filling it out and cumbersome integration with the electronic case notes.ConclusionStaff perceptions of the CRAFT tool were generally negative with many feeling it was a box ticking exercise that had minimal real world impact on patient risk and its management. However many felt it was an improvement over the previous risk tool and the majority used it at some point to aid clinical decision making.
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Tiaprapong, Krueakaew, Achiraporn Sirikul, Chamawee Krajangmek, Namfon Duangthongkul, Nichaya Pandam, and Nitita Piya-amornphan. "Awareness of COVID-19 influences on the wellness of Thai health professional students: An ambulatory assessment during the early “new normal” informing policy." PLOS ONE 16, no. 6 (June 14, 2021): e0252681. http://dx.doi.org/10.1371/journal.pone.0252681.
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The COVID-19 global pandemic has had a socioeconomic effect, including many people suffering from stress and mental disorders. Health professional students are at risk of health issues as well when compared to their age-matched counterpart in the population. The present study aimed to find out the impact of COVID-19 awareness on the wellness of Thai health professional students. The awareness of COVID-19 and wellness among Thai health professional students, such as medical, physical therapy, nursing, pharmacy, and medical technology students were surveyed during the early “new normal” informing policy. The participants included 1,001 students, aged 17 to 25 years old, who responded to a Google form questionnaire set by request. The results showed that the prominent health risks among the Thai health professional students included sedentary behavior, obesity, and mental symptoms. A positive rating in attitude towards the COVID-19 epidemic was mostly observed. There was a negative influence on anxiety symptoms (standardized coefficient beta = -0.079, p-value = 0.012), but a positive impact on social well-being (standardized coefficient beta = 0.158, p-value < 0.001) and quality of life (standardized coefficient beta = 0.136, p-value < 0.001) among the students even when the situation was improving. To relieve the domino effect of the COVID-19 pandemic on students’ wellness, an updated policy for enhancing awareness and providing updated information is continuously required. Improvements on self and situational awareness may help prevent health risk behaviors and promote health among Thai health professional students.
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Simons, Kelsey, Katherine Luci, Lauren Hagemann, Lindsey Jacobs, Emily Bower, Morgan Eichorst, and Michelle Hilgeman. "SAVE-CLC: An Intervention to Reduce Suicide Risk in Veterans Who Discharge From VA Nursing Homes." Innovation in Aging 4, Supplement_1 (December 1, 2020): 91–92. http://dx.doi.org/10.1093/geroni/igaa057.302.
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Abstract Prior research has established transitions into and out of nursing homes as periods of suicide risk for older adults. Deaths by suicide were found to be 2.4 times as likely among Veterans within six months of discharge from US Veterans Health Administration (VA) nursing homes when compared with gender and age-matched Veterans from the general VA patient population (McCarthy, Szymanski, Karlin, & Katz, 2013). Despite these trends, suicide prevention interventions implemented during nursing home and post-acute care transitions, including those taking place from Centers for Medicare and Medicaid Services regulated nursing homes, are lacking. Suicide Awareness for Veterans Exiting the Community Living Center (SAVE-CLC) was piloted as a quality improvement intervention to reduce suicide risk for older Veterans discharging from VA nursing homes. VA clinicians from three sites provided a friendly contact by phone after discharge (n = 66) to screen for depression, facilitate a strengths-based discussion about service needs, and provide service referrals. Compared to a group of patients discharged prior to the start of the intervention (matched on location, age range, and Care Assessment Need scores), SAVE-CLC patients received more depression screening within 30 days after discharge (chi square = 38.7, p < .001) and were seen more quickly for mental health care (t = 3.1, p = .005) when indicated. Implications for suicide prevention with older Veterans and for the general population of older adults receiving short stay services in US nursing homes will be addressed.
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Toot, Sandeep, Tom Swinson, Mike Devine, David Challis, and Martin Orrell. "Causes of nursing home placement for older people with dementia: a systematic review and meta-analysis." International Psychogeriatrics 29, no. 2 (November 3, 2016): 195–208. http://dx.doi.org/10.1017/s1041610216001654.
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ABSTRACTBackground:Up to half of people with dementia in high income countries live in nursing homes and more than two-thirds of care home residents have dementia. Fewer than half of these residents report good quality of life and most older people are anxious about the prospect of moving into a nursing home. Robust evidence is needed as to the causes of admission to nursing homes, particularly where these risk factors are modifiable.Methods:We conducted a systematic literature search to identify controlled comparison studies in which the primary outcome was admission to nursing home of older adults with dementia. Identified studies were assessed for validity and 26 (17 cohort and 9 case-control) were included. Qualitative and quantitative analyses were conducted, including meta-analysis of 15 studies.Results:Poorer cognition and behavioral and psychological symptoms of dementia (BPSD) were consistently associated with an increased risk of nursing home admission and most of our meta-analyses demonstrated impairments in activities of daily living as a significant risk. The effects of community support services were unclear, with both high and low levels of service use leading to nursing home placement. There was an association between caregiver burden and risk of institutionalization, but findings with regard to caregiver depression varied, as did physical health associations, with some studies showing an increased risk of nursing home placement following hip fracture, reduced mobility, and multiple comorbidities.Conclusion:We recommend focusing on cognitive enhancement strategies, assessment and management of BPSD, and carer education and support to delay nursing home placement.
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Muir, A., and S. Paul. "An audit of medical and nursing records of 100 emergency short-term (< 7 dys) psychiatric admissions to acute adult wards in Dumfries." European Psychiatry 26, S2 (March 2011): 748. http://dx.doi.org/10.1016/s0924-9338(11)72453-1.
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IntroductionThe study population is served by CMHTs and in addition (in one sector) by a Crisis and Home Treatment Team.ObjectivesTo evaluate the recorded admission and discharge processes in the medical and nursing notes.To record relevant clinical characteristics of the admission and the patient.AimsTo assess recorded admission and discharge processes against standards defined in the protocol.MethodsA random sample of 100 records, which met inclusion criteria, was selected. A protocol evaluating the recorded processes, and relevant information re the admission was completed by psychiatric trainees and senior nurses.Results51% of admissions occurred on week-ends and 58% occurred “out of hours”. In 35% of admissions a further admission had occurred within 4 weeks. 34% of admissions derived from 2 areas, highly correlated with deprivation. Alcohol or drug misuse contributed to 69% of admissions. In 77% of admissions, the patient was known to the service. 10% of patients had a diagnosis of major mental illness.Recorded medical and nursing assessments of admission were incomplete i.e. 66% of medical records and 80% of nursing records. Assessment of discharge records indicated similar failings in record -keeping.ConclusionsThe recurrent pattern of admissions(33%), the association with deprivation(34%) and drug or alcohol misuse(69%), indicate the need for more effective management of these patients. The failings in recording admission and discharge information are significant. Improvements in these processes could identify those patients who require additional support and /or are at risk of futher admissions.
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Sagna, Atami O., and Lorraine O. Walker. "Analysis of the Tidal Model and Its Implications in Late-Life Suicidality." Nursing Science Quarterly 33, no. 4 (September 17, 2020): 315–21. http://dx.doi.org/10.1177/0894318420943139.
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Late-life suicide is a public health issue in the United States, and recent CDC data show that the number of deaths related to suicide in older adults continue to increase. Still, few researchers focus on a theoretical framework for the clinical assessment and care of older adults at risk for suicide. We performed a review and critical analysis of the Tidal Model, using Fawcett and DeSanto-Madeya’s framework, to increase our understanding of the clinical presentation of older adults with suicidal ideation and present strategies for caring for this population. The Tidal Model is a well-structured theory with relevant concepts and propositions founded on a highly patient-centered and pragmatic approach that facilitates its application in late-life suicidality. The model provides a framework for nursing and healthcare practice in psychiatry and mental health with goals and boundaries that help promote a better assessment of the clinical picture of older adults with suicidal ideation.
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Marcussen, Jette, Lise Hounsgaard, Poul Bruun, Merete Golles Laursen, Frode Thuen, and Rhonda Wilson. "The Divorced Family–Focused Care Model: A Nursing Model to Enhance Child and Family Mental Health and Well-Being of Doubly Bereaved Children Following Parental Divorce and Subsequent Parental Cancer and Death." Journal of Family Nursing 25, no. 3 (August 2019): 419–46. http://dx.doi.org/10.1177/1074840719863918.
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The experience of parental death concomitant with parental divorce occurs for 46% of Danish children and 50% of American children who lose a parent to death. This experience of loss and double bereavement compounds increased risk of mental health problems. The aim of this study was to explore nursing interventions for double bereaved children that promoted their well-being. A phenomenological–hermeneutic approach was used to conduct 20 interviews with nurses in family cancer care. Ricoeur’s theoretical framework was followed with naïve reading, structural analysis, and critical interpretation, resulting in the formulation of a new model of nursing care for these children: the Divorced Family–Focused Care Model. Four themes were apparent: (a) collection of information about family structure, (b) assessment of support needs, (c) initiation of well-being support, and (d) coordination and follow-up focused on the child’s well-being. The new intervention model has implications for health care education and implementation of health care policies.
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Allgaier, A. K., I. Liwowsky, D. Kramer, R. Mergl, S. Fejtkova, and U. Hegerl. "Screening for depression in nursing homes: Validity of the WHO (Five) Well-Being Index." European Psychiatry 26, S2 (March 2011): 825. http://dx.doi.org/10.1016/s0924-9338(11)72530-5.
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IntroductionDepression is common in nursing home residents, but is still underrecognized. Screening for depression could be a first step to increase recognition rates within this high-risk group.ObjectivesTherefore, we investigated the validity of the WHO (Five) Well-Being Index (WHO-5) for early detection of depression in nursing home residents.MethodsThe Structural Clinical Interview for DSM-IV (SCID) was used as the gold standard for the validation of the WHO-5. The diagnoses covered in this assessment were both current major depression (MD) as well as minor depression (MinD) according to DSM-IV research criteria.ResultsIn our sample of 92 nursing home residents in Munich aged 65–97 years, (73.9% female, 26.1% male) 14.1% fulfilled the criteria of MinD, and again 14.1% fulfilled the criteria of MD in the SCID. Overall diagnostic validity (area under the ROC curve) of the WHO-5 was 90.1% (95% confidence interval: 83.5%–96.7%). The World Health Organization's recommended cut-off-point of 13 yielded a sensitivity of 92.3% for the category of ‘MinD or MD’, and a specificity of 74.2%. Corresponding values for an adapted cut-off point of 12 are 92.3% and 78.7%, respectively.ConclusionsThe diagnostic accuracy of the WHO-5 in our study is promising. The WHO-5 might be an efficient screening tool for nursing home residents, especially with the adapted cut-off point, but results have to be replicated in a larger sample.
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Rose, Caelin, Wendy Wainwright, Michael Downing, and Mary Lesperance. "Inter-rater reliability of the Bereavement Risk Assessment Tool." Palliative and Supportive Care 9, no. 2 (May 4, 2011): 153–64. http://dx.doi.org/10.1017/s1478951511000022.
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AbstractObjective:The Bereavement Risk Assessment Tool (BRAT) was designed to consistently communicate information affecting bereavement outcomes; to predict the risk for difficult or complicated bereavement based on information obtained before the death; to consider resiliency as well as risk; and to assist in the efficacy and consistency of bereavement service allocation. Following initial development of the BRAT's 40 items and its clinical use, this study set out to test the BRAT for inter-rater reliability along with some basic validity measures.Method:Case studies were designed based on actual patients and families from a hospice palliative care program. Bereavement professionals were recruited via the internet. Thirty-six participants assessed BRAT items in 10 cases and then estimated one of 5 levels of risk for each case. These were compared with an expert group's assignment of risk.Results:Inter-rater reliability for the 5-level risk scores yielded a Fleiss’ kappa of 0.37 and an intra-class correlation (ICC) of 0.68 (95% CI 0.5-0.9). By collapsing scores into low and high risk groups, a kappa of 0.63 and an ICC of 0.66 (95% CI 0.5-0.9) was obtained. Participant-estimated risk scores yielded a kappa of 0.24. Although opinion varied on the tool's length, participants indicated it was well organized and easy to use with potential in assessment and allocation of bereavement services. Limitations of the study include a small sample size and the use of case studies. Limitations of the tool include the subjectivity of some items and ambiguousness of unchecked items.Significance of results:The collapsed BRAT risk levels show moderately good inter-rater reliability over clinical judgement alone. This study provides introductory evidence of a tool that can be used both prior to and following a death and, in conjunction with professional judgment, can assess the likelihood of bereavement complications.
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Lemmer, B. "A review of violence and personal injury legal cases in psychiatric and mental health nursing to identify a practical framework for risk assessment." Journal of Psychiatric and Mental Health Nursing 7, no. 1 (February 2000): 43–49. http://dx.doi.org/10.1046/j.1365-2850.2000.00265.x.
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Camargo, Ana Luiza Lourenço Simões, Alfredo Maluf Neto, Fátima Tahira Colman, and Vanessa de Albuquerque Citero. "Development of psychiatric risk evaluation checklist and routine for nurses in a general hospital: ethnographic qualitative study." Sao Paulo Medical Journal 133, no. 4 (November 28, 2014): 350–57. http://dx.doi.org/10.1590/1516-3180.2013.8100711.
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CONTEXT AND OBJECTIVE:There is high prevalence of mental and behavioral disorders in general hospitals, thus triggering psychiatric risk situations. This study aimed to develop a psychiatric risk assessment checklist and routine for nurses, the Psychiatric Risk Evaluation Check-List (PRE-CL), as an alternative model for early identification and management of these situations in general hospitals.DESIGN AND SETTING:Ethnographic qualitative study in a tertiary-level private hospital.METHOD:Three hundred general-unit nurses participated in the study. Reports were gathered through open groups conducted by a trained nurse, at shift changes for two months. The questions used were: "Would you consider it helpful to discuss daily practice situations with a psychiatrist? Which situations?" The data were qualitatively analyzed through an ethnographic approach.RESULTS:The nurses considered it useful to discuss daily practice situations relating to mental and behavioral disorders with a psychiatrist. Their reports were used to develop PRE-CL, within the patient overall risk assessment routine for all inpatients within 24 hours after admission and every 48 hours thereafter. Whenever one item was present, the psychosomatic medicine team was notified. They went to the unit, gathered data from the nurses, patient files and, if necessary, attending doctors, and decided on the risk management: guidance, safety measures or mental health consultation.CONCLUSION:It is possible to develop a model for detecting and intervening in psychiatric and behavioral disorders at general hospitals based on nursing team observations, through a checklist that takes these observations into account and a routine inserted into daily practice.
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Haigis, Daniel, Rebekka Pomiersky, Dorothée Altmeier, Annika Frahsa, Gorden Sudeck, Ansgar Thiel, Gerhard Eschweiler, and Andreas Michael Nieß. "Feasibility of a Geriatric Assessment to Detect and Quantify Sarcopenia and Physical Functioning in German Nursing Home Residents—A Pilot Study." Geriatrics 6, no. 3 (July 2, 2021): 69. http://dx.doi.org/10.3390/geriatrics6030069.
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Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, the feasibility of sarcopenia screening has not yet been performed in the German nursing home setting. Methods: For sarcopenia screening, the specifications of EWGSOP2 were applied. The quantification of sarcopenia was performed according to the corresponding cut-off values. The collection of anthropometric data and the morbidity status were recorded. SARC-F, mini-mental state examination, Barthel Index, Short Physical Performance Battery and Timed Up and Go tests were implemented. Results: In one participant, severe sarcopenia could be identified. The quantification was not possible for four participants. A suspicion of sarcopenia was not confirmed in five participants. Only one person was able to perform all assessments. Conclusions: Sarcopenia screening according to EWGSOP2 presented satisfactory feasibility by nursing home residents. However, further tests to assess the physical functioning of the participants often could not be performed. Moreover, inconsistencies in individual assessments became apparent, leading to inconclusive analyses. The recording of sarcopenia prevalence in German nursing homes should be the goal of further research.
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Caçador, Catarina, Edite Teixeira-Lemos, Jorge Oliveira, João Pinheiro, Filipa Mascarenhas-Melo, and Fernando Ramos. "The Relationship between Nutritional Status and Functional Capacity: A Contribution Study in Institutionalised Portuguese Older Adults." International Journal of Environmental Research and Public Health 18, no. 7 (April 5, 2021): 3789. http://dx.doi.org/10.3390/ijerph18073789.
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Demographic aging of the population allied with the new family structures and societal dynamics is generating an increasing demand for institutions for older adults. Nutritional status is a key health determinant that impacts the quality of life among older adults. Hence, the aim of the present study was to evaluate the relationship between nutritional status and nutritional risk, functional capacity, and cognition in institutionalised Portuguese older adults by a cross-sectional study in 15 institutions. Nutritional status (body mass index (BMI), waist circumference (WC), nutritional risk (mini nutritional assessment (MNA)), degree of functional independence (Barthel index (BI)), and cognitive ability (mini mental state examination (MMSE)) were assessed. Of the 214 older adults evaluated, 28.0% were at risk of malnutrition, 69.6% were mildly functional dependent, and 39.3% presented minor cognitive impairment. The risk of malnutrition increased functional dependence and cognitive impairment. The MNA score, but not the BMI or WC, was related to disability and deficits in cognition. A differential interdependence was found between nutritional, cognitive, and functional status. Strategies to improve self-care and well-being in nursing homes should consider a correct diet and a closer evaluation of nutritional risk to preserve cognition, independence, and autonomy.
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Gunathillaka, Kavinda, Mariam Timbo, and Stephen Ginn. "Audit on nursing notes in a psychiatry in-patient setting." BJPsych Open 7, S1 (June 2021): S189. http://dx.doi.org/10.1192/bjo.2021.511.
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AimsWe aimed to assess the accessibility and informativeness of the content of daily nursing notes through an audit, and improve deficiencies identified.BackgroundNursing notes are an important source of observation findings, of in-ward psychiatry patients.There can be variations in the quality of the notes as well as information contained within.A basic level of clarity and information within all notes will be helpful in using these to inform the management of patients.MethodAn audit was carried-out in a ward treating working-age patients for psychiatric illnesses.Setting standards - standard required of a daily progress note was decided after discussion in multi-disciplinary team meeting (MDT). Clear language and information on; mental-state, medication, meals, physical health, personal care, activities, risks and use of leave, were identified as requirements.Retrospective audit - First audit cycle was carried-out by assessing the notes two weeks retrospectively. The assessment instrument used a qualitative measurement of the readability of the notes as well as quantitative assessment of the contents.Intervention - The standards set during the MDT, as well as a suggested format for recording notes, were communicated to the staff through email. Follow-up meetings with individual staff members and MDT, to evaluate staff satisfaction and new suggestions to improve the format were held. Difficulties staff encountered when implementing the format were discussed and resolved.Second audit cycle - Following implementation of the intervention, the notes were again assessed using the same instrument.ConclusionDifficulty in accessing information from the notes was noted in the first audit cycle. The average score for accessibility of information when scored on Likert scale + 3 to -3, was 1. Use of language scored 2 on average. On the second audit cycle, accessibility had increased to 3 on average while language score remained 2.Quantitative measurement was done for presence of information on; mental state, medication, meals, physical health, personal care, activities, risks and use of time away from ward. All of these parameters showed an increase in the post-intervention second audit cycle. Information on taking meals, medication, and physical health was present 100% of the time in the second cycle. Most improvement was in information on personal care which showed a five-fold increase, from 17% to 89%In conclusion, standard for nursing notes arrived via discussion and consensus in MDT, has been successful in improving the accessibility and information within nursing notes.
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Suksawatchon, Ureerat, Jakkarin Suksawatchon, and Wannarat Lawang. "Health Risk Analysis Expert System for Family Caregiver of Person with Disabilities using Data Mining Techniques." ECTI Transactions on Computer and Information Technology (ECTI-CIT) 12, no. 1 (June 28, 2018): 62–72. http://dx.doi.org/10.37936/ecti-cit.2018121.108619.
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The nursing care for the family caregiver of the disabled person is an important task for long-term care, since the caring people with disabilities is the difficult and hard task. In this paper, the Health Risk Analysis System or HRAS is introduced which is the new expert system for identifying the health risk level in three aspects including mental, physical, and social health aspects, and provides the intervention according to the health risk level of each aspect as well. The HRAS is the client-server system. The HRAS client proceeds on web-based application to collect health data via online questionnaire and shows the analysis results. The collected health data are transmitted to the server to analysis and to assess the health risk level by using the proposed classifier model named Risk Analysis Classifier or RAC. The classification algorithm and rule-based classifier are used to build the RAC. The RAC is evaluated using k-fold cross validation and the experts with annotated health data and unseen data. The evaluation results showed that Neural Network performs the best performance overall which it achieves the accuracy above 90% in all health data sets. Thus, the Neural Network is the most suitable classifier for this work. In addition, the HRAS has been deployed and collected the user experience via the formal survey. These survey results demonstrated that the system provides high accuracy assessment and very utilization in several aspects.
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Huang, Huaping, Wen-Jun Zhao, and Gui-Rong Li. "Knowledge and Psychological Stress Related to COVID-19 Among Nursing Staff in a Hospital in China: Cross-Sectional Survey Study." JMIR Formative Research 4, no. 9 (September 18, 2020): e20606. http://dx.doi.org/10.2196/20606.
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Background Since December 2019, coronavirus disease (COVID-19) has been rapidly spreading worldwide. Nurses play a key role in fighting this disease and are at risk of COVID-19 infection. Therefore, there is an urgent need to assess the mental health condition of nurses and establish appropriate interventions to reduce the negative psychiatric outcomes of the pandemic. Objective The objectives of this study were to evaluate the knowledge and psychological stress related to COVID-19 among nursing staff and to provide evidence of the need for targeted training and psychological intervention. Methods This cross-sectional web-based survey study was performed in a class 3 grade A general hospital in a southwest province of China from March 1 to March 15, 2020. A self-designed questionnaire with questions about COVID-19–related prevention and control knowledge and the Triage Assessment Form (TAF) were used to assess nursing staff’s knowledge of COVID-19 and their degree of psychological stress, respectively. SPSS 23.0 was applied for statistical analysis of the collected data. Results A total of 979 nurses completed the questionnaire. The results showed that the nursing staff provided the fewest correct answers to questions about continuous viral nucleic acid testing specifications (379/979 correct answers, 38.7%), isolation/discharge criteria (539/979 correct answers, 55.1%), and management measures for patients with suspected symptoms (713/979 correct answers, 72.8%). The median total score of the TAF was 7.0 (IQR 5.0-12.0), and there were statistically significant differences in scores between different nursing roles, years of work experience, and hospital departments (P<.05). Conclusions This study indicated that nursing staff have insufficient knowledge about COVID-19. Meanwhile, although the psychological damage to nurses during the pandemic was found to be low, nurse managers must continue to monitor the mental health of nursing staff and perform timely interventions.
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Simpson, Struan, and Jude Eze. "Police involvement, characteristics and outcomes of place of safety referrals in the Scottish Highlands." BJPsych Bulletin 44, no. 6 (February 24, 2020): 244–50. http://dx.doi.org/10.1192/bjb.2020.13.
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Aims and methodTo characterise police involvement with those detained under place of safety legislation and determine factors associated with admission to hospital. Place of safety referrals over a 1-year period were identified retrospectively and evaluated.ResultsPlace of safety legislation is generally used with regard to concerns about suicide. Individuals are often removed from high-risk areas and referrals to police are frequently initiated by individuals themselves. A diagnosis of mental illness or personality disorder predicted hospital admission. Presence of senior nursing staff at assessment, but not the seniority of the doctor, was associated with discharge.Clinical implicationsCloser multiagency working is required as police are currently being recruited to fill a void between mental health services and the population they serve. Junior doctors require more senior support in making complex, and often risky, emergency management decisions with this population.
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Smith, Eric E., and Zahinoor Ismail. "Mortality Risk Models for Persons with Dementia: A Systematic Review." Journal of Alzheimer's Disease 80, no. 1 (March 9, 2021): 103–11. http://dx.doi.org/10.3233/jad-201364.
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Background: Persons with dementia have higher mortality than the general population. Objective, standardized predictions of mortality risk in persons with dementia could help with planning resources for care close to the end of life. Objective: To systematically review prediction models for risk of death in persons with dementia. Methods: The Medline and PsycInfo databases were searched on November 29, 2020, for prediction models estimating the risk of death in persons with dementia. Study quality was assessed using the Prediction model Risk Of Bias ASsessment Tool. Results: The literature search identified 2,828 studies, of which 18 were included. These studies described 16 different prediction models with c statistics mostly ranging from 0.67 to 0.79. Five models were externally validated, of which four were applicable. There were two models that were both applicable and had reasonably low risk of bias. One model predicted risk of death at six months in persons with advanced dementia residing in a nursing home. The other predicted risk of death at three years in persons seen in primary care practice or a dementia specialty clinic, derived from a nationwide registry in Sweden but not externally validated. Conclusion: Valid, applicable models with low risk of bias were found in two settings: advanced dementia in a nursing home and outpatient practices. The outpatient model requires external validation. Better models are needed for persons with mild to moderate dementia in nursing homes, a common demographic. These models may be useful for educating persons living with dementia and care partners and directing resources for end of life care. Registration: The study protocol is registered on PROSPERO as RD4202018076.
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Martin-Key, Nayra A., Thea S. Schei, Eleanor J. Barker, Benedetta Spadaro, Erin Funnell, Jiri Benacek, Jakub Tomasik, and Sabine Bahn. "The Current State and Diagnostic Accuracy of Digital Mental Health Assessment Tools for Psychiatric Disorders: Protocol for a Systematic Review and Meta-analysis." JMIR Research Protocols 10, no. 1 (January 8, 2021): e25382. http://dx.doi.org/10.2196/25382.
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Background Despite the rapidly growing number of digital assessment tools for screening and diagnosing mental health disorders, little is known about their diagnostic accuracy. Objective The purpose of this systematic review and meta-analysis is to establish the diagnostic accuracy of question- and answer-based digital assessment tools for diagnosing a range of highly prevalent psychiatric conditions in the adult population. Methods The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) will be used. The focus of the systematic review is guided by the population, intervention, comparator, and outcome framework (PICO). We will conduct a comprehensive systematic literature search of MEDLINE, PsychINFO, Embase, Web of Science Core Collection, Cochrane Library, Applied Social Sciences Index and Abstracts (ASSIA), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for appropriate articles published from January 1, 2005. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any inconsistencies will be discussed and resolved. The two authors will then extract data into a standardized form. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool, and a descriptive analysis and meta-analysis will summarize the diagnostic accuracy of the identified digital assessment tools. Results The systematic review and meta-analysis commenced in November 2020, with findings expected by May 2021. Conclusions This systematic review and meta-analysis will summarize the diagnostic accuracy of question- and answer-based digital assessment tools. It will identify implications for clinical practice, areas for improvement, and directions for future research. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020214724; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020214724. International Registered Report Identifier (IRRID) DERR1-10.2196/25382
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Sadraei, Rosa, Puru Pathy, and Michael Collins. "Survey to evaluate care of complex clients in residential setting." BJPsych Open 7, S1 (June 2021): S216. http://dx.doi.org/10.1192/bjo.2021.577.
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AimsDelivering a new efficient assessment and shorter term secondary mental Health intervention service for individual sectorsBackgroundIn November 2015, there was a transition to services with the focus on delivering more efficient service to clientsPreviously we had been a combined sector Service. This transition, a reduction in resources and a move away from delivering care Through specialist mental health teams created from the national service framework - such as Assertive outreach, early intervention in psychosis and community rehabilitation - to a more Streamlined generic service, catering for these differing groups of people using a “Pathways Model” approachResultAcross the two sectors we had 47 clients on CPA Pathway living in 24 hour residential Settings who all had a current care coordinator.These 47 clients represented the workload currently of 2.8 FTE Band 6 care coordinators.There were at Origin, 13 Residential/Nursing/Secure 24 Hour care providers, where clients were residing.However of these 90% of residents lived in one of 5 settings, 3 settings in Ashfield and 2 in Mansfield.Over 50% of individuals residing did not have existing connections with Mansfield or Ashfield before being placed into the area.18 Clients (%38) were under section of the mental health act and 1client (%2) was on a life-Licence from criminal justice.ConclusionTransfer of CPA Care Coordination ProtocolTo send paper referral to our Single Point of Access Meeting at the listed address at the earliest point relocation/placement is confirmed.Formal handover meeting for care will be coordinated, not sooner than 3 months after the placement commences. It will be expected that services currently involved in provision of service continue to hold care responsibility in the interim period.As we move to a paperless environment, provision of electronic documentation such has previous CPA documents, Risk assessments, social circumstance reports & Discharge summaries, would be greatly appreciated
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Weyerer, Siegfried, Martina Schäufele, and Andreas Zimber. "Alcohol Problems Among Residents in Old Age Homes in the City of Mannheim, Germany." Australian & New Zealand Journal of Psychiatry 33, no. 6 (December 1999): 825–30. http://dx.doi.org/10.1046/j.1440-1614.1999.00653.x.
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Objective: This study aims to determine the prevalence of alcohol problems among residents in old age homes, its demographic and clinical features, and its association with the risk of falling. Method: All residents (n = 1922) living in 20 randomly selected residential and nursing homes in the city of Mannheim, Germany, were included. Based on routine documentation, details of their sociodemographic features, medical diagnoses made upon admission, and current medication were compiled. The home staff filled out for each resident a standardised assessment sheet on activities of daily living-impairment (Barthel Index), behaviour problems, alcohol consumption, and frequency of falls. Results: According to the diagnoses of the primary care physicians, 7.4% of the residents had mental and behavioural disorders due to alcohol (ICD-10: F10). Rates were particularly high among men, and younger and single or divorced residents. A high percentage of those with a diagnosis of alcohol abuse/dependence (41.1%) were transferred from mental hospitals. Home staff reported current alcohol abuse/dependence among 3.4% of all residents. The risk of falling was significantly elevated (Odds ratio: 2.65; p < 0.01) among those with current alcohol problems. Conclusion: The results corroborate the findings from other studies wherein residents of old age homes constitute a group at risk of alcohol abuse and dependence. Alcohol problems were more the cause for, rather than the consequence of, home admission.
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Liu, Yi-Hsuan, Xiang Gao, Muzi Na, Penny M. Kris-Etherton, Diane C. Mitchell, and Gordon L. Jensen. "Dietary Pattern, Diet Quality, and Dementia: A Systematic Review and Meta-Analysis of Prospective Cohort Studies." Journal of Alzheimer's Disease 78, no. 1 (October 27, 2020): 151–68. http://dx.doi.org/10.3233/jad-200499.
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Background: Diet is an important lifestyle factor that may prevent or slow the onset and progression of neurodegeneration. Some, but not all, recent studies have suggested that adherence to a healthy dietary pattern may be associated with reduced risk of dementia. Objective: In this meta-analysis, we systematically examined the associations between overall dietary patterns, assessed a priori and a posteriori, and risk of dementia. Methods: We systematically searched PubMed, Web of Science, and the Cumulative Index for Nursing and Allied Health databases from January 1, 1981 to September 11, 2019. Prospective studies published in English were included. Random-effects model was used to calculate the pooled risk ratios and 95% confidence intervals (CIs). Results: Sixteen research articles were identified in the systematic review and 12 research articles including 66,930 participants were further included for the meta-analysis. Adherence to high diet quality or a healthy dietary pattern was significantly associated with lower risk of overall dementia (pooled risk ratio = 0.82; 95% CI: 0.70, 0.95; n = 12) and Alzheimer’s disease (pooled risk ratio = 0.61; 95% CI: 0.47, 0.79; n = 6) relative to those with low diet quality or an unhealthy dietary pattern. Subgroup analyses stratified by age, sex, follow-up duration, diet quality assessment approach, study location, and study quality generated similar results. Conclusion: Adherence to a healthy dietary pattern was associated with lower risk of overall dementia. Further randomized controlled trials are needed to provide additional evidence about the role of a healthy diet on the development and progression of dementia.
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Stanley, Mary Jo, Daryl L. Canham, and Virginia Young Cureton. "Assessing Prevalence of Emotional and Behavioral Problems in Suspended Middle School Students." Journal of School Nursing 22, no. 1 (February 2006): 40–47. http://dx.doi.org/10.1177/10598405060220010701.
Full textAbstract:
Schools are seeing an influx of disruptive behaviors related to an increase in emotional and behavioral issues. In the adolescent population, emotional and behavioral problems are manifested in a variety of forms and often result in some form of discipline within the school setting. Although discipline punishes the unwanted behavior, it does nothing to address the reason for the behavior. This study examined the prevalence of emotional and behavioral problems among middle school students who have been suspended. Students who are suspended are the very children at risk for social, emotional, and mental health problems. Results from the study indicate significance in some of the 14 subcategories of the Student Behavior Survey tool, lending support toward the conclusion that emotional and behavioral problems may be associated with suspensions. Advocating for assessment of emotional and behavioral needs should be considered for students with discipline problems that lead to suspension.