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1.
J Am Assoc Nurse Pract ; 31(11): 657-662, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31584505

RESUMEN

As demand expands for nurse practitioner clinical practicum sites, the supply of preceptors is decreasing. The traditional model of in-kind clinical training is losing its foothold for a variety of reasons. A looming question is how quickly a "pay to precept" norm will grow and what will be the costs. The pay for precepting movement is discussed including current trends, costs, and emerging compensation models. To adapt to this trend, alternative ways of drawing the precepting value proposition are suggested, particularly decreasing preceptor and site demands while increasing students' readiness to enter clinical practicum and tapping into faculty expertise to add value to the partnership. The authors provide suggestions on building a strategy for rethinking the structure of student precepting arrangements and compensation models.

2.
J Child Adolesc Psychiatr Nurs ; 32(3): 110-111, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31389083
3.
J Psychosoc Nurs Ment Health Serv ; 57(11): 22-27, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31305951

RESUMEN

The current quality improvement project was conducted on an adult, short-term inpatient psychiatric unit to improve the consistency and structure of group sessions. The aim of the current project was the implementation of groups that were consistent with an acceptance and commitment therapy (ACT) framework. Following staff education and discussion, ACT focused groups were systematically introduced into patient schedules. Patient responses to groups were monitored by the Acceptance and Action Questionnaire II (AAQII) and patients' perception of the group experience. Data gathered indicated patients' positive perception of new group programming. Patients' AAQII scores showed a slight improvement, particularly psychological flexibility. Findings indicate ACT is an appropriate and useful framework for individuals hospitalized on inpatient psychiatric units. [Journal of Psychosocial Nursing and Mental Health Services, 57(11), 22-27.].

4.
Perspect Psychiatr Care ; 55(4): 576-583, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31104337

RESUMEN

PURPOSE: Conduct a systematic review of abuse of transgender and gender nonconforming (TGNC) people in childhood. DESIGN AND METHODS: Scopus, PubMed, PsychInfo databases were searched. Articles included in final analysis were those with respondents who reported childhood abuse and were either transgender adults or described gender nonconforming traits in childhood. Of 186 articles originally identified, 14 are included in the final review. FINDINGS: Research on TGNC individuals and child abuse varied in how populations were identified and methodology used. Those who are transgender and those who display gender nonconforming traits in childhood are at risk for child abuse and sequelae. CONCLUSION: Research should use the two-step methodology of identifying transgender people. Recalled Childhood Gender Identity Scale should be used. Providers should screen for child abuse.

5.
J Prof Nurs ; 35(2): 133-137, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30902405

RESUMEN

Of the children and adolescents with mental health concerns who receive treatment, most do so in outpatient community mental health service sites, systems of care which have largely failed to produce significant clinical outcomes. Suggested strategies to improve care in child mental health treatment include improving families' access to services, increasing use of evidence-based practices (EBPs), and holding service sites accountable for demonstrating outcomes. Producing a workforce to implement these strategies will require cultivating providers who have developed specific competencies within a range of agencies that naturally interface with the daily lives of families and their children. The authors report on a recently developed interprofessional child community fellowship for psychiatry residents and psychiatric mental health nurse practitioners aimed at training providers to deliver child mental health services in a variety of community settings. Activities that focus the fellowship are outlined along with the development of the related competencies: EBP translation, collaboration skills, and outcome measurement. Evaluation strategies for fellows' competency development are discussed.


Asunto(s)
Centros Comunitarios de Salud , Práctica Clínica Basada en la Evidencia , Relaciones Interprofesionales , Enfermeras Practicantes/educación , Psiquiatría/educación , Recursos Humanos , Adolescente , Niño , Educación de Postgrado en Medicina , Becas , Humanos , Internado y Residencia , Servicios de Salud Mental/provisión & distribución , Servicios de Salud Mental/tendencias , Enfermería Psiquiátrica
6.
J Am Psychiatr Nurses Assoc ; 25(1): 11-18, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30793650

RESUMEN

AIMS: To characterize the future Psychiatric Mental Health (PMH) Advanced Practice Registered Nurse (APRN) workforce in light of the high demand for psychiatric providers in all aspects of mental health service delivery. Over the past 20 years, there has been significant growth of the PMH APRN workforce, a provider group capable of addressing mental health provider shortages. However, continued growth may be limited by anticipated retirements and traditional volume of graduations from PMH nurse practitioner (NP) programs. Optimum utilization of PMH APRNs in service delivery systems and State workforce planning may also be impeded by their frequent mischaracterized in federal reports and mental health workforce studies. METHODS: Based on a review of the literature, this discussion paper evaluates trends related to PMH NP programs and graduates, anticipated retirements of current PMH ARPNs, facilitators and barriers to increasing the PMH APRN workforce, and opportunities and threats to workforce development. RESULTS: The PMH APRN workforce faces significant challenges owing to barriers and facilitators to growth of the specialty. These factors conspire to limit the supply of PMH APRNs at a time when they are needed to compensate for declining numbers of providers in the United States, particularly practicing psychiatrists. CONCLUSION: Recommendations are forwarded as to how best shape the educational pipeline to meet the current and emerging needs of American citizens for quality mental health care.

11.
Health Aff (Millwood) ; 37(11): 1853-1861, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30395512

RESUMEN

Behavioral health care has been slow to take up robust efforts to improve patient safety. This lag is especially apparent in inpatient psychiatry, where there is risk for physical and psychological harm. Recent investigative journalism has provoked public concern about instances of alleged abuse, negligence, understaffing, sexual assault, inappropriate medication use, patient self-harm, poor sanitation, and inappropriate restraint and seclusion. However, empirical evidence describing the scope of unsafe experiences is limited. While evidence-based inpatient psychiatry requires care to be trauma-informed, market failures and a lack of payment alignment with patient-centered care leave patients vulnerable to harm. Existing regulatory mechanisms attempt to provide accountability; however, these mechanisms are imperfect. Furthermore, research is sparse. Few health services researchers study inpatient psychiatry, the issue has not been a priority among research funders, and data on inpatient psychiatry is excluded from national surveys of quality. Several policy levers could begin to address these deficiencies. These include aligning incentives with patient-centered care, building trauma-informed care into accreditation and monitoring, conducting trend analyses of critical incidents, and improving research capacity.

13.
J Child Adolesc Psychiatr Nurs ; 31(1): 4-5, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30230141
14.
J Am Psychiatr Nurses Assoc ; : 1078390318777873, 2018 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-29862869

RESUMEN

BACKGROUND: Further exploration of the practice roles of psychiatric mental health (PMH) advanced practice registered nurses (APRNs) is warranted. OBJECTIVE: In March of 2016, the American Psychiatric Nurses Association (APNA) conducted a national survey to gather data on the demographics, practice roles, and activities of certified PMH APRNs. DESIGN: The e-mail survey contained 46 questions consistent with minimum data set requirements of the Forum of State Nursing Workforce Centers. RESULTS: The data indicate that PMH APRNs are a clinically active workforce; the majority deliver a wide variety of mental health services including diagnosis and management of both acute and chronic mental illness, prescribing, and providing psychotherapy. CONCLUSION: PMH APRNs are delivering care to clients dealing with a range of serious mental illnesses across the life span in a variety of roles. It will be critical to monitor the activities and outcomes of this expanding behavioral health care workforce.

15.
J Psychosoc Nurs Ment Health Serv ; 56(10): 21-26, 2018 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-29741746

RESUMEN

American individuals attempt suicide at alarmingly high rates of approximately 1.1 million times per year. Yet the United States has failed to adopt a systematic approach to suicide prevention, particularly via universal screening. Given the increasing number of individuals with suicidal ideation presenting to emergency departments (EDs), all patients who present to the ED for treatment should be screened, as opposed to only individuals with mental health complaints. In the current article, barriers to suicide screening in the ED are discussed, as well as strategies to move ED providers toward the goal of universal screening. The current article entreats nurses to be leaders in achieving universal screening and provides practical actions to begin the process. Specific recommendations for action include improving training, increasing lethal means assessment, and achieving compliance with The Joint Commission suicide screening guidelines. [Journal of Psychosocial Nursing and Mental Health Services, 56(10), 21-26.].

16.
West J Nurs Res ; : 193945918776617, 2018 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-29781393

RESUMEN

This study used a cross-sectional design to conduct a subgroup psychometric analysis of the Emotional Availability Scale among matched Hispanic ( n = 20), African American ( n = 20), and European American ( n = 10) English-speaking mother-child dyads in the United States. Differences by race/ethnicity were tested ( p < .05) among (a) Emotional Availability Scale dimensions with ANOVA, and (b) relationships of Emotional Availability Scale dimensions with select Dyadic Parent-Child Interaction Coding System variables with Pearson correlation and matched moderated regression. Internal consistency was .950 (Cronbach's α; N = 50). No significant differences in the six Emotional Availability Scale dimension scores by race/ethnicity emerged. Two Dyadic Parent-Child Interaction Coding System behaviors predicted two Emotional Availability Scale dimensions each for Hispanic and African American mother-child dyads. Results suggest emotional availability similarity among race/ethnic subgroups with few predictive differences of emotional availability dimensions by specific behaviors for Hispanic and African American subgroups.

17.
J Psychosoc Nurs Ment Health Serv ; 56(8): 16-22, 2018 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-29538793

RESUMEN

Addressing tense and escalating situations with noncoercive measures is an important element of inpatient psychiatric treatment. Although restraint rates are frequently monitored, the use of pro re nata (PRN) intramuscular (IM) injections to address agitation is also an important indicator. In 2015, at the current study site, a significant increase was noted in PRN IM medication use despite unit leadership's efforts to build a culture of trauma-informed care (TIC). The purpose of the current quality improvement project was to educate staff on methods to incorporate TIC into daily practice and the use of brief solution-focused therapy techniques in escalating situations. Measurement of attitudes toward patient aggression and engagement with patients followed two waves of staff education. Upon completion of the project, a decrease in PRN IM medications, improvement in staff attitudes toward patient aggression, and improved sense of staff competency in handling tense situations were noted. [Journal of Psychosocial Nursing and Mental Health Services, 56(8), 16-22.].


Asunto(s)
Agresión , Personal de Salud/educación , Trastornos Mentales/enfermería , Servicio de Psiquiatría en Hospital , Psicoterapia Breve/métodos , Mejoramiento de la Calidad , Antipsicóticos/uso terapéutico , Competencia Clínica , Esquema de Medicación , Humanos , Trastornos Mentales/tratamiento farmacológico , Enfermería Psiquiátrica/métodos
18.
J Behav Health Serv Res ; 45(2): 300-309, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28484943

RESUMEN

In the last ten years primary care providers have been encouraged to implement integrated models of care where individuals' medical and mental health needs are addressed holistically. Many integrated models use Psychiatric Mental Health (PMH) nurses as case managers and select exemplars use PMH Advanced Practice Nurses (APNs) as providers. However, the potential value of PMH nurses in integrated health care remains unrealized by health care planners and payers, limiting access to services for the populations most in need of comprehensive care approaches. This current situation is partially fueled by insufficient knowledge of the roles and skill sets of PMH nurses. In this paper, the PMH RN and APN skill sets are detailed, demonstrating how effective use of these nurses can further the aims of integrated care models. Finally, outlined are barriers and enabling factors to effective use of PMH RNs and APNs and attendant policy implications.

19.
Arch Psychiatr Nurs ; 31(6): 634-640, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-29179832

RESUMEN

Staff members' engagement with patients is a critical element of inpatient psychiatric care, essential to safety, the hospitalization experience and the development of a culture of care. Currently broad concerns exist around the amount of time inpatient psychiatric nurses expend in patient engagement and the quality of these interactions. In this paper we present a model of engagement that clarifies necessary skills to support the engagement process. The model is based on Peplau's theory of interpersonal relations, patients' ideas on healing elements of psychiatric hospitalization and research on inpatient therapeutic relationships. We are currently using this model for a web-based teaching/learning course to cultivate interpersonal engagement, and to explicate how through operationalizing their inpatient role, nurses support patients in the development of their mental health and well-being.


Asunto(s)
Modelos de Enfermería , Relaciones Enfermero-Paciente , Enfermería Psiquiátrica/educación , Humanos , Pacientes Internos/psicología , Teoría de Enfermería
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