standards of psychaitric nursing
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STANDARDS OF
PSYCHAITRICNURSING
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The practice of psychiatricnursing is regulated by law butguided by standards of care.
STANDARDS OF CARE
Standards of care pertain toprofessional nursing activitiesthat are demonstrated by the
nurse through the nursingprocess.
ANA (2000)
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TheANA
TheAPNA
TheISPN
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The ANA, in collaboration with
the American PsychiatricNurses Association and the
International Society ofPsychiatric Mental Health
Nurses, has developed a set ofstandards that psychiatric nurses
are expected to follow as they
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STANDARD I: ASSESSMENT
The psychiatric mental health
nurse collects patient health
data:
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Assessment in mental health nursing is
based on the collection of data from
multiple sources, such as the
Client,
Family and friends,
Other health care providers,
Past and current medical records
and
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Importance ofAssessment
The assessment data provides
the data base for clinical decision
making: diagnosis, outcomes,
interventions and evaluation.
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NURSING CONDITIONSAND BEHAVIOURS
Self awareness
Accurate observations
Therapeutic communication Responsive dimensions of care
Establish nursing contracts
Obtain information from patient andfamily
Validate data with the patient
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STANDARD II: DIAGNOSIS:
Psychiatric or mental health nurse
analyses the assessment data in
determining diagnoses:
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A nursing diagnosis is a clinical
judgement about individual, family or
community responses to actual or
potential health problems/life
processes.
(NANDA, 2003)
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According to NANDA, the
components of nursing diagnosis
are
The label or name of diagnosis
Its definition; the defining
characteristics of the
diagnosis
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Examples
Imbalanced Nutrition: lessthan body requirements
related to use of substance in
place of nutritional food
evidenced by loss of weight,
pale conjunctiva and mucous
membranes, electrolyte
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Risk for self-directed
Violence: risk factors may
include depressed mood and
feeling of worthlessness and
hopelessness
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The defining characteristics are
particularly helpful because they
reflect the behaviours that are
the target of nursing
interventions.
They also provide specific
indicators for evaluating the
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AND BEHAVIOURS
Logical decision making Knowledge of normal parameters
Inductive and deductive reasoning
Identify patterns in data
Compare data with norms
Analyse and synthesize data Identify problems and strengths
Validate problems with patient
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STANDARD III: OUTCOMEIDENTIFICATION
The psychiatric mental healthnurse identifies expectedoutcomes individualized to
patients
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An outcome is a statement of a
desired, achievable behaviour or
expression of feelings, to be
attained within a predicted period
of time , that is based on the
clients current status and
available resources.
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Outcomes should be: Specific rather than general
Measurable rather than subjective
Attainable rather than unrealistic.
Current rather than outdated.
Adequate in number rather than too
few or too many.
Mutual rather than one sided
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Types of outcomes:
Outcome statements are
generally divided into two
categories
short term
long term.
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Example Nursing diagnosis: Alteration
in thought process related todepressive ideations.
Short term outcome: Unrealistic: client will verbalize
enjoyment in completing a project
within three days. Realistic: client will work on a
project for at least 10 minutes in a
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STANDARD IV: PLANNING:
The psychiatric mental health
nurse develops a plan of care
that prescribes interventions
to attain expected outcomes.
NURSING CONDITIONS
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NURSING CONDITIONSAND BEHAVIOURS
Application of theory
Respect for patient and family
Prioritize goals
Identify nursing activities
Validate plan with patient
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The plan of nursing care must always
be individualized for the patient. Planned interventions should be based
on current knowledge in the field and
contemporary clinical psychiatricmental health nursing practice.
Planning is done in collaboration with
the patient, family, and the health careteam.
Documentation of the plan of care is
an essential nursing activity
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STANDARD V:IMPLEMENTATION
The psychiatric mental health
nurse implements the
interventions identified in the
plan of care
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Nursing interventions should be
implemented in a manner that
recognizes the worth and dignity
of people and considers the
physical, emotional, social,
cultural and spiritual needs of
your client and their families.
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Nursing conditions andbehaviours
Past clinical experiences
Knowledge of research
Responsive and action dimensions of
care
Consider available resources
Implement nursing activities
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Standard Va: Counselling
standard Vb: Milieu therapy
Standard Vc: Promotion of self
care activities
Standard Vd: Psychobiological interventions
Standard Ve: Health teaching
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Advanced nursing practice
Standard Vh: Psychotherapy
Standard Vi: Prescriptive
Authority And Treatment
Standard Vj: Consultation
:
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:EVALUATION:
The psychiatric mental healthnurse evaluates the clients
progress in attaining expected
outcomes.
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The final step in the nursing
process is evaluation. In this step,nurse evaluate and document
client progress towards theoutcome criteria, as well as
evaluate their own clinicalpractice.
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Types of evaluation: There are two types of
evaluation:
Formative evaluation
Summative evaluation.
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Documentation:
Documentation is a critical
component of nursing practice.
The general rule is: if it is not
documented, it has not
occurred. All the steps of nursing
process pertinent to the client
m t m nt in th
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AND BEHAVIOURS:
Self analysis Peer review
Patient and family participation
Compare the patient responses andthe expected outcome.
Review nursing process. Modify the nursing process as
needed.
Participate in quality improvement
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PERFORMANCE
STANDARDSSTANDARD I: QUALITY OF CARE:
The psychiatric mental health
nurse systematically evaluates
the quality of care and
effectiveness of psychiatric
mental health nursing practice.
urs ng con ons an
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urs ng con ons anbehaviours
Personal and professionalintegrity,
Openness to inquiry
Critical thinking skills Identify improvement
opportunities
Collect and identify improvementdata
Formulate planned approaches
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STANDARD II :PERFORMANCEAPPRAISAL:
Psychiatric mental health
nurse evaluates ones own
psychiatric mental health
nursing practice in relation to
professional practice
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Performance appraisal forpsychiatric nursing is generally
provided in two ways: administrative
clinical
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Nursing conditions and
behaviours
Self awareness
Acceptance of feedback from
others
:
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:EDUCATION:
The psychiatric mental health
nurse acquires and maintains
current knowledge in nursing
practice.
N i diti d
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Nursing conditions andbehavior
Intellectual curiosity
Desire for professional growth
Access to new information.
Seek out new knowledge and learning
experience.
A l new information in clinical
:
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:COLLEGIALITY:
The psychiatric mental health
nurse interacts with and
contributes to the professional
development of peers, health
care clinicians and others ascolleagues.
STANDARD V ETHICS
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STANDARD V: ETHICS:
The psychiatric mental healthnurses assessments, actions,
and recommendations on behalf
of patients are determined and
implemented in an ethical
manner.
:
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:COLLABORATION:
The psychiatric mental health
nurse collaborates with the
patient, significant others and
health care clinicians in
providing care.
:
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:RESEARCH:
The psychiatric mental health
nurse contribute to nursing and
mental health through the use of
research methods and findings.
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