For all your custom writing, custom writing service, essay service, essay writing service, essay writing company, term paper service and research paper service, visit our essay writing company
A. 1. Nursing assessment
procedure for patients with psychiatric emergency
Research has shown that certain
psychiatric conditions cause severe or life-threatening harm to the patient and
the family (Srebnik et al.,
2014).
Sudden disturbance in the patient’s mood or behavior may result to homicide or
suicidal intent. Research has also shown that there are no premonitory symptoms
that can be used to assess the intensity of patients’ condition (Wolf, Miller & Devine, 2003). In
as much as initial assessment of the patient’s condition is deemed essential,
psychiatric patients require prompt evaluation (Gordon, 2012). This is because a patient
may present broad manifestations of the mental condition such as delusional
communication, profound sadness, apathy, self injury, intense agitation and
violence (Mundinger, Kane,Lenz & Totten,
2000).
Most patients may depict low risk intentions. As a result, psychiatrists
recommend intake of some medicine only for the patient to act lethal afterwards
by poisoning, shooting or hanging.
Therefore, for psychiatrists to
handle such patients effectively and particularly in the assessment stage, high
level skills and competencies must be applied (Srebnik et al., 2014). Statistics has revealed
that there are very few qualified adult and children psychiatrists who are able
to evaluate the patient’s condition before treatment procedures commence (Fontaine, Hudak & Gallo, 2005). In
other words, evidence has shown that the assessment procedures for psychiatric
patients have not been done well in the past.
Why the present process or
procedure needs to be changed
Wolf
et al (2003) highlight that psychologists and other emergency
physicians have been involved in the assessment process yet they are not
qualified to assess and diagnose mental illness. Fontaine, Hudak and Gallo (2005)
reiterate that poor assessment and diagnoses of psychiatric conditions adds
pressure to the nerve-cracking situation. Upon a careful review of literature, Mundinger et al (2000)
point out that distressed families and patients have fallen in the hands of
several self-proclaimed psychiatrists. Moreover, these are merely unscrupulous
personnel who propose to offer psychiatric services without proper
qualifications (Srebnik
et al., 2014). As a matter of fact, there is no particular test done
to diagnose a psychiatric disorder. Therefore, there are recurrent underlying
challenges while determining the measures to be applied for different patients.
This might therefore compel the nursing assessment to be done continuously for
weeks or months (Hopko,
Lachar, Bailley & Varner, 2014). Evidences have shown that
some patients decline accepting their predicament. As a result, they pose
serious difficulties to the medical staff who are not able to restrain them forcefully.
Hence, it is indisputable that assessment for psychiatric patients faces
numerous challenges and flaws on a daily basis. This implies that changes need
to be done in order to achieve successful outcomes such as increased patient
satisfaction (Gordon, 2012).
2. a. Explain who determined the basis for the
current process or procedure in your practice setting.
It is worth to note that there are medical
experts who play an essential role in determining the basis to be used during
the assessment procedure. Moreover, there is a medical team that offer support
and attend to emerging psychiatric cases. The team has well spelt out
procedures to be followed when assessing and treating psychiatric patients.
Nevertheless, Gordon (2012)
attests that the outcome of the treatment solely depends of the physician’s
personality and competence. As a matter of fact, successful outcomes in the
procedure entirely rely on the physician’s ability to reassure and calm
agitated patients. At this point, there is a need to develop a trustful
relationship between patients and therapists because it helps in improving
acute symptoms. Srebnik
et al (2014) highlight that there are basis of assessment that are
not included in the current outline procedures. For instance, in order for a
physician to administer appropriate psychotropic medication or recommend a
final diagnosis, there is a need to study the patient’s emotional and social
behavior. Patients also require supportive behavior and integrative therapies
b. Explain the decision
makers’ rationale for instituting or supporting the current process or
procedure.
Though the current assessment
procedure is not up-to-the-mark, decision makers have supported it for reasons
that are very obvious. As mentioned earlier, assessing psychiatric conditions
at times become tricky for physicians due to the numerous and varying
manifestations of the symptoms (Hopko
et al., 2014). The physicians may under-estimate the severity of the
patient’s condition when administering medication and this may result to
unsuccessful outcomes such as homicide, suicide and violence (Gordon, 2012).
c. Explain why the decision
makers decided to implement the current process or procedure.
Although
new strategies have been set to assess psychiatric cases, research studies indicate
that decision makers have entirely decided to implement the current assessment
procedure. This is because the current process is still effective and the
outcomes of the process depend on the physician’s personality and ability to
relate with the patient through integrative and supportive behavior therapy (Gordon, 2012).
3. Recommend a practice change for the process
or procedure you selected.
Past research studies expound that
assessment procedure for psychiatric patient is unique for every patient and
requires high-level expertise. I therefore recommend that not any physician
should be allowed to handle psychiatric patients. Instead, only those that are
highly competent and are specialized in handling psychiatric cases should be
involved. As a matter of fact, quality delivery of care should be a priority
area for the medical staff.
4. Explain the clinical implications your
recommended change might have on patients, based on the relevant and credible
sources you listed in part A3a.
Increased specialization and
involvement of qualified physicians in emergency psychiatric cases lead to
successful outcome of the diagnoses and treatment. Besides, uncompromised
assessment helps in the process of administering appropriate psychotropic
medication and eliminate diagnosis crisis (Gordon,
2012).
Patients who are not diagnosed appropriately may not receive the much-needed
treatment regime that is in tandem with their conditions.
5. Explain
the implications your recommended change might have on the practice setting,
based on the relevant and credible sources you listed in part A3a.
Successful outcomes will foster
trustful relationship between patients and therapists (Gordon, 2012). If
the latter is done in the most professional manner, it can cultivate personal
satisfaction whereby physicians feel that they have delivered their best to
save patients from psychiatric disorders. Outbreaks of mental disease may be
handled even though relapses are to be expected. The outbreak can last a
few days or up to several years. Little is known about the factors that
bring recovery, but the convulsive therapy and psychotropic drugs have been
used very successfully in the treatment of these patients. ECT has been
the treatment of choice in cases of mental depression and also has good results
in cases of agitation. This can be treated preferably by psychotropic drugs. Worsening
of new outbreaks can be avoided by making up the patient understands his or her
case, know to recognize the signs of relapse and be able to seek medical advice
as soon as possible. This disease does not cause permanent damage to the
mind or the personality of the patient.
Involving key stakeholders
in the decision to change the process or procedure or to comply with the
recommended change
In
order to actively draw attention to all the stake holders, I would write a
formal report that is well researched and contain tangible evidences addressing
it to them in order to influence their decision to change or comply with the
new recommended changes.
B. 1.
Discuss the specific barriers you may encounter in applying research to
processes and procedures in your practice setting.
One of the potential challenges
includes insincerity especially when responses have to be obtained from
psychiatrists through interviews. Moreover, the other challenge is biasness
since the target respondents might tend to be subjective in their responses.
2. Identify at least two strategies that you and
your team could use to overcome the barriers you discussed in part B1.
To overcome the aforementioned
barriers, wide range of sources will be used to collect data. For instance,
both primary and second hand information will be equally considered during the
analysis. To overcome biased responses, the researcher may use closed-ended
questionnaires to get direct-to-the point answers unlike the case with
face-to-face interviews.
3. Explain how you would implement your
recommended process or procedure based on research findings.
Being a psychiatrist, I would
advocate for specialization within the medical team in order to ensure that
physicians are assigned tasks related to their expertise. Moreover, I would
influence the stakeholders to formulate new policies that are geared towards
improving the current procedures. Some of the new policies may include
motivating or appreciating physicians who record high rates of successful
outcomes while handling psychiatric cases and accelerating capacity building
and training among the medical staff handling psychiatric patients. In
addition, implementing the recommended processes also demand the establishment
of surplus centers and facilities where psychiatric patients can be restrained
and probably attended to without a lot of interruption. When it comes to motivating
physicians, availing adequate and functional facilities for use at workplace
may play the much-needed role.
References
Fontaine,
D. K., Hudak, C. M., & Gallo, B. M. (2005). Critical care nursing: a
holistic approach. Philadelphia: Lippincott Williams & Wilkins, Inc.
Gordon,
J. T. (2012). Emergency department junior medical staff’s knowledge, skills and
confidence with psychiatric patients: a survey. The Psychiatrist, 36(5),
186-188.
Hopko,
D. R., Lachar, D., Bailley, S. E., & Varner, R. V. (2014). Assessing
predictive factors for extended hospitalization at acute psychiatric admission.
Psychiatric Services. 1(2),
12-14.
Mundinger,
M. O., Kane, R. L., Lenz, E. R., & Totten, A. (2000). Primary care outcomes
in patients treated by nurse practitioners or physicians: a randomized trial. Jama,
283(1), 59-68.
Srebnik,
D. S., Rutherford, L. T., Peto, T., Russo, J., Zick, E., Jaffe, C., &
Holtzheimer, P. (2014). The content and clinical utility of psychiatric advance
directives. Psychiatric Services. 1(1),
8-12.
Wolf,
Z. R., Miller, P. A., & Devine, M. (2003). Relationship between nurse
caring and patient satisfaction in patients undergoing invasive cardiac
procedures. MedSurg Nursing, 12(6), 391-396.
