RESUMO
Safewards reduces conflict and containment on adult inpatient wards but there is limited research exploring the model in Children and Young People (CYP) mental health services. We investigated whether Safewards can be successfully implemented on twenty CYP wards across England. A process and outcomes evaluation was employed, utilizing the Integrated Promoting Action on Research Implementation in Health Sciences (i-PARiHS) framework. Existing knowledge and use of Safewards was recorded via a self-report benchmarking exercise, verified during visits. Implementation of the 10 Safewards components on each ward was recorded using the Safewards Organizational Fidelity measure. Data from 11 surveys and 17 interviews with ward staff and four interviews with project workers were subject to thematic analysis and mapped against the four i-PARiHS constructs. Twelve of the 20 wards implemented at least half of the Safewards interventions in 12 months, with two wards delivering all 10 interventions. Facilitators and barriers are described. Results demonstrated Safewards is acceptable to a range of CYP services. Whilst implementation was hindered by difficulties outlined, wards with capacity were able and willing to implement the interventions. Results support the commissioning of a study to evaluate the implementation and outcomes of Safewards in CYP units.
Assuntos
Avaliação de Processos e Resultados em Cuidados de Saúde , Humanos , Criança , Adolescente , Inglaterra , Masculino , Feminino , Unidade Hospitalar de Psiquiatria/organização & administraçãoRESUMO
This manuscript presents the pioneering use of a post-event staff debriefing tool, TALK, in Acute Child and Adolescent Mental Health Units (CAMHU). While unsuccessful in reducing the rate and severity of patient behavioural events, our centre observed promising psychological benefits for CAMHU staff as a result of debriefing, with the tool promoting emotional resiliency and providing a platform for open conversations. Debriefing also served as a venue for patient concerns with care to be raised by staff, addressed and reflected in updated care plans. This initiative demonstrates the utility of debriefing to foster a culture of learning, improve staff wellness and enhance patient safety in CAMHU settings.
Assuntos
Pacientes Internados , Humanos , Adolescente , Criança , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Feminino , Unidade Hospitalar de Psiquiatria/organização & administração , Unidade Hospitalar de Psiquiatria/estatística & dados numéricosRESUMO
Background: Acute inpatient mental health services report high levels of safety incidents. The application of patient safety theory has been sparse, particularly concerning interventions that proactively seek patient perspectives. Objective(s): Develop and evaluate a theoretically based, digital monitoring tool to collect real-time information from patients on acute adult mental health wards about their perceptions of ward safety. Design: Theory-informed mixed-methods study. A prototype digital monitoring tool was developed from a co-design approach, implemented in hospital settings, and subjected to qualitative and quantitative evaluation. Setting and methods: Phase 1: scoping review of the literature on patient involvement in safety interventions in acute mental health care; evidence scan of digital technology in mental health contexts; qualitative interviews with mental health patients and staff about perspectives on ward safety. This, alongside stakeholder engagement with advisory groups, service users and health professionals, informed the development processes. Most data collection was virtual. Phase 1 resulted in the technical development of a theoretically based digital monitoring tool that collected patient feedback for proactive safety monitoring. Phase 2: implementation of the tool in six adult acute mental health wards across two UK NHS trusts; evaluation via focused ethnography and qualitative interviews. Statistical analysis of WardSonar data and routine ward data involving construction of an hour-by-hour data set per ward, permitting detailed analysis of the use of the WardSonar tool. Participants: A total of 8 patients and 13 mental health professionals participated in Phase 1 interviews; 33 staff and 34 patients participated in Phase 2 interviews. Interventions: Patients could use a web application (the WardSonar tool) to record real-time perceptions of ward safety. Staff could access aggregated, anonymous data to inform timely interventions. Results: Coronavirus disease 2019 restrictions greatly impacted the study. Stakeholder engagement permeated the project. Phase 1 delivered a theory-based, collaboratively designed digital tool for proactive patient safety monitoring. Phase 2 showed that the tool was user friendly and broadly acceptable to patients and staff. The aggregated safety data were infrequently used by staff. Feasibility depended on engaged staff and embedding use of the tool in ward routines. There is strong evidence that an incident leads to increased probability of further incidents within the next 4 hours. This puts a measure on the extent to which social/behavioural contagion persists. There is weak evidence to suggest that an incident leads to a greater use of the WardSonar tool in the following hour, but none to suggest that ward atmosphere predicts future incidents. Therefore, how often patients use the tool seems to send a stronger signal about potential incidents than patients' real-time reports about ward atmosphere. Limitations: Implementation was limited to two NHS trusts. Coronavirus disease 2019 impacted design processes including stakeholder engagement; implementation; and evaluation of the monitoring tool in routine clinical practice. Higher uptake could enhance validity of the results. Conclusions: WardSonar has the potential to provide a valuable route for patients to communicate safety concerns. The WardSonar monitoring tool has a strong patient perspective and uses proactive real-time safety monitoring rather than traditional retrospective data review. Future work: The WardSonar tool can be refined and tested further in a post Coronavirus disease 2019 context. Study registration: This study is registered as ISRCTN14470430. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128070) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 14. See the NIHR Funding and Awards website for further award information.
Mental health wards can feel unsafe. We know that patients and staff have different ideas about what makes a hospital ward safe or unsafe. Patients are often the first to know when the atmosphere on a ward becomes tense but, often, no one asks them for input or feedback at the time. We worked with service users and staff to develop new technology to make it easy for patients to tell staff about changes in the ward atmosphere. We put everyone's ideas together and some technical developers then built a digital safety tool to use on a tablet computer. Patients put in anonymous information about the ward atmosphere and staff can read it straight away. We tested it on six adult acute mental health wards for 10 weeks. We asked patients and staff what they thought about the tool and we looked at how it was being used. Patients and staff liked the look of the tool on the tablet computer. Some staff said they did not need it because they could tell how patients were feeling, but patients told us that staff did not talk with them much and did not always know when patients were feeling tense. Coronavirus disease 2019 made life difficult on the wards. Most ward managers said the tool could be helpful, but they had not had time to get used to it on the wards. Occasionally, the tablet computers were out of action. Many staff tried hard to use the tool. Most patient information was gathered when it was calm, perhaps because staff were not too busy to help them. We found that this tool could help staff know about tensions on the ward, but they need to get used to it and bring it into ward routines.
Assuntos
COVID-19 , Segurança do Paciente , Humanos , Adulto , Masculino , Feminino , COVID-19/epidemiologia , Unidade Hospitalar de Psiquiatria/organização & administração , Reino Unido , Pesquisa Qualitativa , Pessoa de Meia-Idade , Tecnologia Digital , Serviços de Saúde Mental/organização & administração , Medicina Estatal/organização & administração , Participação do Paciente/métodosRESUMO
In Australia, acute inpatient units within public mental health services have become the last resort for mental health care. This research explored barriers and facilitators to safe, person-centred, recovery-oriented mental health care in these settings. It utilised participant observations conducted by mental health nurses in acute inpatient units. These units were located in three distinct facilities, each serving different areas: a large metropolitan suburban area in a State capital, a mid-sized regional city, and a small city with a large rural catchment area. Our findings highlighted that, in the three inpatient settings, nurses tended to avoid common areas they shared with consumers, except for brief, task-related visits. The prioritisation of administrative tasks seemed to arise in a situation where nurses lacked awareness of alternative practices and activities. Consumers spent prolonged periods of the day sitting in communal areas, where the main distraction was watching television. Boredom was a common issue across these environments. The nursing team structure in the inpatient units provided a mechanism for promoting a sense of psychological safety for staff and were a key element in how safety culture was sustained.
Assuntos
Enfermagem Psiquiátrica , Humanos , Transtornos Mentais/terapia , Unidade Hospitalar de Psiquiatria/organização & administração , Segurança do Paciente , Serviços de Saúde Mental/organização & administração , Cultura Organizacional , Pacientes Internados/psicologiaRESUMO
ABSTRACT: Suicide is an increasingly serious public health care concern worldwide. The impact of decreased in-house psychiatric resources on emergency care for suicidal patients has not been thoroughly examined. We evaluated the effects of closing an in-hospital psychiatric ward on the prehospital and emergency ward length of stay (LOS) and disposition location in patients who attempted suicide.This was a retrospective before-and-after study at a community emergency department (ED) in Japan. On March 31, 2014, the hospital closed its 50 psychiatric ward beds and outpatient consultation days were decreased from 5 to 2âdays per week. Electronic health record data of suicidal patients who were brought to the ED were collected for 5âyears before the decrease in in-hospital psychiatric services (April 1, 2009-March 31, 2014) and 5âyears after the decrease (April 1, 2014-March 31, 2019). One-to-one propensity score matching was performed to compare prehospital and emergency ward LOS, and discharge location between the 2 groups.Of the 1083 eligible patients, 449 (41.5%) were brought to the ED after the closure of the psychiatric ward. Patients with older age, burns, and higher comorbidity index values, and those requiring endotracheal intubation, surgery, and emergency ward admission, were more likely to receive ED care after the psychiatric ward closure. In the propensity matched analysis with 418 pairs, the after-closure group showed a significant increase in median prehospital LOS (44.0âminutes vs 51.0âminutes, Pâ<â.001) and emergency ward LOS (3.0âdays vs 4.0âdays, Pâ=â.014) compared with the before-closure group. The rate of direct home return was significantly lower in the after-closure group compared with the before-closure group (87.1% vs 81.6%, odds ratio: 0.66; 95% confidence interval: 0.45-0.96).The prehospital and emergency ward LOS for patients who attempted suicide in the study site increased significantly after a decrease in hospital-based mental health services. Conversely, there was significant reduction in direct home discharge after the decrease in in-house psychiatric care. These results have important implications for future policy to address the increasing care needs of patients who attempt suicide.
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Serviço Hospitalar de Emergência/estatística & dados numéricos , Fechamento de Instituições de Saúde/estatística & dados numéricos , Hospitais Comunitários/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Desinstitucionalização/estatística & dados numéricos , Serviços Médicos de Emergência/normas , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Fechamento de Instituições de Saúde/legislação & jurisprudência , Hospitalização/estatística & dados numéricos , Humanos , Japão/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/legislação & jurisprudência , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/economia , Unidade Hospitalar de Psiquiatria/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Tentativa de Suicídio/estatística & dados numéricosRESUMO
The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to the provision of inpatient psychiatric care. The nature of the physical plant, programmatic constraints, and the patient population required a rapid and agile approach to problem-solving under conditions of uncertainty and stress. Flexibility in decision-making, excellent communication, an effective working relationship with infection prevention and control experts, and attention to staff morale and support were important elements of successful provision of care to our inpatients. We present our experience, lessons learned, and recommendations should a resurgence of the pandemic or a similar crisis occur.
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Atitude do Pessoal de Saúde , COVID-19 , Pacientes Internados , Transtornos Mentais/terapia , Recursos Humanos em Hospital , Unidade Hospitalar de Psiquiatria , Adulto , COVID-19/prevenção & controle , Humanos , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/normas , Unidade Hospitalar de Psiquiatria/organização & administração , Unidade Hospitalar de Psiquiatria/normasRESUMO
AIM: To understand nurses' responses to COVID-19 and identify their uptake of changes in the procedure required for the management of COVID-19 in an inpatient psychiatric ward. BACKGROUND: The infection risk for COVID-19 in an enclosed inpatient psychiatric ward is high due to living arrangements in the ward and the nature of the infectious disease. INTRODUCTION: This paper describes inpatient nurses' experiences, challenges and strategies deployed at the institutional and national levels to contain the spread of infection. METHODS: Written feedback was collected to understand nurses' responses and identify their uptake of changes in procedure following the COVID-19 outbreak in the ward. FINDINGS: Nurses felt shocked, worried, isolated, expressed a lack of confidence, and experienced physical exhaustion. COVID-19 specific challenges were highlighted in the delivery of safe and quality nursing care. Nurses were satisfied with the hospital policy and strategies implemented during the outbreak, acknowledging the importance of support from nursing leaders. DISCUSSION: Practical support and strong nursing leadership have been imperative in the battle against the COVID-19 outbreak in the psychiatric hospital. Psychiatric nursing care was maintained with a modified management and treatment approach. IMPLICATIONS FOR NURSING PRACTICE: Nurses' willingness to adjust to the reconfiguration of operations to accommodate changes has been crucial for the healthcare system to run effectively. Good practices and policies established during this crisis should be developed and established permanently in nursing practice. IMPLICATIONS FOR HEALTH POLICY: Prompt and effective contingency planning and policymaking at the national and institutional level, targeting human resource management and infection control, can introduce changes and alternative options for nursing care in a pandemic. CONCLUSION: With support from influential nursing leaders, strategies and policies are imperative in ensuring the successful management of COVID situations in an inpatient psychiatric setting.
Assuntos
COVID-19/enfermagem , Controle de Infecções/organização & administração , Papel do Profissional de Enfermagem , Pneumonia Viral/enfermagem , Unidade Hospitalar de Psiquiatria/organização & administração , Enfermagem Psiquiátrica , COVID-19/epidemiologia , Humanos , Liderança , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , SARS-CoV-2 , Singapura/epidemiologiaRESUMO
OBJECTIVE: Aggressive behaviour is highly prevalent in long-term psychiatric inpatient care. We aimed to estimate the overall incidence of aggression, the time staff took to handle aggression incidents, and the weighted average financial costs thereof. METHODS: A random sampling procedure was conducted at long-term psychiatric inpatient care facilities. Nurses were asked to recall all incidents (i.e., verbal, physical towards objects, self, or others) of their shift. For the time spent on each type of incident, staff were monitored in real-time. Estimated costs were calculated by the time spent multiplied by hourly wages in addition to material-related costs. RESULTS: Incidence rates were 90 incidents per patient year. The average time spent per incident was 125 min but differed for each type of incident. Almost 80% of this time was consumed by nursing staff. The average cost per aggression incident was 78; extrapolated per patient year, the total costs were approximately 7000. CONCLUSIONS: The current study found a high rate of aggression incidents in closed long-stay psychiatric wards. Reports of aggression on these types of wards are scarce. Nevertheless, aggression seems to have a severe impact on invested time and related costs, which suggests a need for aggression-prevention and de-escalating programs.Key pointsAggression incidents are highly prevalent and are accompanied by high costs.The effect of aggression incidents on the workload for staff members is high, especially for nursing staff.Studies across countries on the incidence and the costs of aggression among psychiatric inpatients are needed to help model the effects of (new) strategies for aggression reduction.
Assuntos
Agressão , Pacientes Internados , Tempo de Internação , Unidade Hospitalar de Psiquiatria , Humanos , Incidência , Pacientes Internados/psicologia , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Transtornos Mentais/terapia , Unidade Hospitalar de Psiquiatria/economia , Unidade Hospitalar de Psiquiatria/organização & administraçãoAssuntos
Centros Médicos Acadêmicos/organização & administração , COVID-19/terapia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Unidade Hospitalar de Psiquiatria/organização & administração , Telemedicina/organização & administração , Adulto , COVID-19/epidemiologia , Comorbidade , Computadores de Mão , Humanos , Pacientes Internados , Transtornos Mentais/epidemiologiaRESUMO
Mental health facilities should be equipped to care for patients while preventing spread of COVID-19. Peer-reviewed literature and guidelines for government and health organizations were reviewed to guide best practices. Gunderson's five therapeutic functions of a milieu are used as a conceptual framework. Patients should be screened for infection according to local or national policy prior to admission to an inpatient mental health unit. While interacting with one another in a therapeutic milieu, patients should be encouraged to practice physical distancing and hand hygiene. Clinicians may need to alter therapeutic groups to prevent COVID-19 infection. Additionally, clinicians should monitor patients for emerging symptoms and conduct rapid testing and isolation of patients suspected of COVID-19. Recommendations are made for patients unable to adhere to physical distancing or hand hygiene policies.
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Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Serviços de Saúde Mental/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Unidade Hospitalar de Psiquiatria/organização & administração , Enfermagem Psiquiátrica/organização & administração , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , SARS-CoV-2Assuntos
Doenças Cardiovasculares , Infecções por Coronavirus , Demência , Pandemias , Pneumonia Viral , Unidade Hospitalar de Psiquiatria , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Demência/epidemiologia , Demência/terapia , Feminino , Humanos , Masculino , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Unidade Hospitalar de Psiquiatria/organização & administração , Reino UnidoRESUMO
OBJECTIVES: The current project aimed to implement evidence-based recommendations for the management of inpatient aggressive and violent behaviors in four behavioral health units (BHUs) in a mental healthcare area within an academic medical center. INTRODUCTION: Patient violence against healthcare workers is a global concern, particularly in mental health care. All employees who work in inpatient psychiatric environments are at higher risk for targeted violence than are other healthcare workers. For healthcare organizations and staff, violent episodes involving patients can bring about medical expenses, potential legal expenditure, sick leave and a high turnover rate. The hospital at which this project was implemented had been experiencing a steady increase in violence and aggressive behavior. METHODS: The project used the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting practice change in four BHUs. A baseline retrospective audit of 10 electronic health records from four BHUs assessed compliance with best practice regarding violent episodes. The Getting Research into Practice tool was used to identify barriers and develop an evidence-based educational strategy for 70 BHU staff aimed to improve compliance with best practice for managing aggression and violence. Staff education compliance was assessed via hospital education department records. A pre and postimplementation staff satisfaction survey assessed perceptions about education, confidence and unit safety. RESULTS: The baseline audit indicated that one of the three criteria had 0% compliance. Following implementation of an educational strategy using mock codes for BHU staff, there was 96% improvement in compliance for the BHU staff education audit criterion. Staff de-escalated patients in 83% of the episodes postimplementation. There was a slight decrease (9.1%) in the rate of violence across all four inpatient BHUs. Staff satisfaction survey findings did not show a statistically significant difference. CONCLUSION: Enhanced evidence-based education and mock codes resulted in BHU staff competence and confidence in managing aggressive and/or violent patients. Early signs of a decrease in the violence rate and improvement in the efficient use of de-escalation will be sustained with on-going yearly education, quarterly mock codes and future audits. This project was limited by its small size and short timeframe (21 weeks), making results not generalizable.
Assuntos
Agressão , Capacitação em Serviço , Unidade Hospitalar de Psiquiatria/organização & administração , Violência no Trabalho/prevenção & controle , Centros Médicos Acadêmicos , Prática Clínica Baseada em Evidências , Humanos , Ciência da Implementação , Segurança do PacienteRESUMO
BACKGROUND: In French prisons, psychiatric care for inmates is organized into three levels: ambulatory care within each jail in "unités sanitaires en milieu pénitentiaire" (USMP: sanitary units in correctional settings), day hospitalizations in the 28 services médico-psychologiques régionaux (SMPR, "regional medical-psychological services") and full-time hospitalizations in one of the nine "unités d'hospitalisation spécialement aménagées" (UHSA: specially equipped hospital units). Despite high prevalence of mental disorders among French prisoners, the efficiency of these specialized psychiatric care units has been insufficiently studied. The main goal of this study is to describe full-time psychiatric hospitalizations for inmates in the twenty prisons located in the North of France. METHODS: We conducted a descriptive study based on medical and administrative data and survey results. The following data were collected for each prison regarding 2016: 1) number and occupancy rates for mental health professionals and 2) psychiatric hospitalization rates (in the UHSA of Lille-Seclin and the general psychiatric hospitals). RESULTS: Provision of care is incomplete: the vacancy rate in the health units studied reaches 40 %. Moreover, access to UHSA is unequal: it varies pronouncedly according to the location of the prison; only inmates in prisons close to the UHSA benefit from satisfactory access. CONCLUSION: Access to psychiatric care for inmates remains problematic in France, particularly due to a lack of mental health professionals in USMPs, the overload of patients in UHSAs and the distance of theses facilities from certain prisons and jails.
Assuntos
Atenção à Saúde , Hospitalização/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Prisioneiros/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria , Atenção à Saúde/organização & administração , Atenção à Saúde/normas , Atenção à Saúde/estatística & dados numéricos , França/epidemiologia , Geografia , Humanos , Corpo Clínico Hospitalar/estatística & dados numéricos , Corpo Clínico Hospitalar/provisão & distribuição , Admissão e Escalonamento de Pessoal/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Prevalência , Prisões/organização & administração , Prisões/normas , Prisões/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/organização & administração , Unidade Hospitalar de Psiquiatria/normas , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Qualidade da Assistência à SaúdeAssuntos
COVID-19/complicações , Transtornos Mentais/complicações , Unidade Hospitalar de Psiquiatria/organização & administração , Adulto , COVID-19/prevenção & controle , COVID-19/psicologia , COVID-19/transmissão , Comorbidade , Feminino , Unidades Hospitalares/organização & administração , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Quartos de Pacientes/organização & administração , Equipamento de Proteção Individual , Recursos Humanos em Hospital , Fatores de Risco , Gestão da Segurança/organização & administração , TurquiaRESUMO
OBJECTIVES: Cardiovascular disease is the leading cause of premature death in patients with mental illness. Metabolic syndrome is a cluster of co-occurring cardiovascular risk factors, seen in high frequency in severe mental illness. Despite ease of diagnosis, monitoring is often poor across psychiatric populations. This report details a quality improvement initiative undertaken on an inpatient psychiatric ward to improve rates of metabolic monitoring. METHODS: Four key interventions were developed: (1) A nurse-led intervention, where nurses were upskilled in performing metabolic monitoring, (2) Education was provided to all staff, (3) Introduction of a suite of interventions to improve metabolic risk and (4) Ongoing consumer involvement. A pre-post intervention study design was used to measure effectiveness, with an audit of metabolic monitoring rates performed 12 months after the intervention began. RESULTS: Rates of weight and height monitoring both increased from 46.0% to 69.5% (p=0.0185) and body mass index (BMI) recordings increased from 33% to 63% (p=0.0031). Rates of waist circumference monitoring increased from 44.2% to 65.2% (p=0.0498). Blood pressure (BP) measurements increased from 88.5% to 100% (p=0.0188). Lipid monitoring rates improved from 23% to 69.5% (p=0.001). Rates of glucose monitoring increased from 74% to 82.5% (p=0.8256), although this was not statistically significant. CONCLUSIONS: We found that metabolic monitoring improved following these simple interventions, with a statistically significant increase in measurement rates of weight, BP, height, lipids, BMI and waist circumference (p<0.05). Overall monitoring of glucose also improved, although not to significant levels. The intervention was acceptable to both patients and staff.
Assuntos
Hospitalização/estatística & dados numéricos , Síndrome Metabólica/enfermagem , Monitorização Fisiológica/normas , Adulto , Automonitorização da Glicemia/métodos , Índice de Massa Corporal , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/fisiopatologia , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Monitorização Fisiológica/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/organização & administração , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Fatores de RiscoAssuntos
Psiquiatria do Adolescente/organização & administração , Assistência ao Convalescente/organização & administração , COVID-19/prevenção & controle , Hospitais Universitários/organização & administração , Transtornos Mentais/terapia , Unidade Hospitalar de Psiquiatria/organização & administração , Telemedicina/organização & administração , Adolescente , Criança , Psiquiatria Infantil/organização & administração , Feminino , Humanos , Tempo de Internação , Masculino , Alta do Paciente , Medição de Risco , TurquiaAssuntos
Sintomas Comportamentais/terapia , COVID-19 , Doenças Profissionais/terapia , Ambulatório Hospitalar/organização & administração , Recursos Humanos em Hospital/psicologia , Unidade Hospitalar de Psiquiatria/organização & administração , Encaminhamento e Consulta/organização & administração , Consulta Remota/organização & administração , Triagem/organização & administração , Adulto , Sintomas Comportamentais/diagnóstico , Humanos , Doenças Profissionais/diagnóstico , SingapuraRESUMO
Life inside a secure psychiatric facility has seen its share of changes throughout the COVID-19 pandemic, including but not limited to increased agitation in patients and an increase in admissions.