Mental health nursing practice in acute psychiatric close-observation areas

School of Nursing, Family and Community Health, University of Western Sydney, Parramatta Campus, Penrith DC, New South Wales 1797, Australia.
International journal of mental health nursing (Impact Factor: 1.95). 07/2004; 13(2):89-99. DOI: 10.1111/j.1440-0979.2004.00324.x
Source: PubMed


The provision of evidence-based therapeutic nursing care in close-observation units or psychiatric intensive care units, has been identified as a problem internationally. These areas of nursing practice have been the subject of considerable discussion particularly in relation to the management of aggression, violence, involuntary treatment, and seclusion. This study used a participatory action research framework to identify qualitative and quantitative measures of activity in the area. Quantitative data collected included rates of critical incidents, the use of prn medication, and the use of seclusion. These data were used as base-line data and were predicted as a measure of change. Qualitative data, collected by interview and focus groups, were used to reveal the experience of patients, relatives, and nurses in a close-observation area. Analysis of this data revealed three main themes: design and environment, lack of activity and structured time, and nursing care. The importance of this study is in demonstrating the multiple problems that exist in the provision of care in close-observation areas and the corresponding need for fundamental changes.

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    • "As with Martin and Street's (2003) work on qualified nurses and patients within secure mental health settings, ''joining in'' with patients in activities was reported to aid the formation of relationships. Similarly, participants reported that patients enjoyed spending time talking to, and engaging in activities with, staff (O'Brien and Cole, 2004). "
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    ABSTRACT: Purpose – Therapeutic relationships have been identified to be a key feature of staff working with patients within mental health settings and are widely referred to within research literature. The aim of this study is to explore the experiences of support staff within secure mental health services with regards to the formation and development of therapeutic relationships with patients. Design/methodology/approach – Ten participants were interviewed, all of whom were unqualified support staff based within secure establishments and working directly with patients. Findings – Interpretative phenomenological analysis of the data resulted in the identification of three themes: “Building bridges”: developing relationships with patients; “You do forget what they've done”: seeing the person and managing risk, and “Playing your cards close to our chest”: maintaining boundaries. Originality/value – The themes are discussed and evaluated in terms of relationship formation and development, barriers that may prevent such relationships from being built and the implications for clinical practice.
    Full-text · Article · May 2012 · British Journal of Forensic Practice
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    • "Skillnader inom de olika specialiteterna skildras dock bristfälligt med denna metod, men detta var inte heller syftet. Av artiklarna som framkom var sju från äldrevård, de flesta från olika särskilda boenden (Strand et al, 2004; Åström et al, 2002; Åström et al, 2004, Whittington, 2002; Badgar & Mullan,2003; Chambers, 1998; Fry et al, 2002) sju var från psykiatrisk vård(Flannery et al,2005; Mackay et al, 2005; Owen et al, 1998; O´Brien & Cole, 2004; Duxbury & Whittington, 2005; Duxbury, 2002; Bonner et al, 2002) och tre från somatisk vård(Uzun, 2003; Farell, 1997; o`Conell et al, 1998). I en artikel intervjuades sjuksköterskor från både psykiatrisk och somatisk vård(Duxbury1999). "

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