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1.
J Psychiatr Pract ; 27(3): 172-183, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33939371

RESUMO

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.


Assuntos
Atitude do Pessoal de Saúde , Pacientes Internados , Transtornos Mentais/terapia , Recursos Humanos em Hospital , Unidade Hospitalar de Psiquiatria , Adulto , Humanos , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/normas , Unidade Hospitalar de Psiquiatria/organização & administração , Unidade Hospitalar de Psiquiatria/normas
2.
Lakartidningen ; 1182021 03 17.
Artigo em Sueco | MEDLINE | ID: mdl-33754329

RESUMO

Psychiatric care has changed dramatically from inpatient to outpatient care in the last decades. While a lot of resources have been spent on developing outpatient care, less interest has been invested in inpatient care, which has repeatedly been critisezed for being dominated by control, lack of collaboration between staff and patient and boredom. We suggest that there are three main functions of the psychiatric ward: the asylum function, the intensive care and the observational/diagnostic function. We also present some recent projects aimed at improving the quality of care and we argue for more involvment of the psychiatrists in the internal life and functioning of the psychiatric ward.


Assuntos
Pacientes Internados , Serviços de Saúde Mental , Hospitalização , Humanos , Unidade Hospitalar de Psiquiatria
3.
Harefuah ; 160(2): 87-93, 2021 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-33760409

RESUMO

BACKGROUND: One of the most serious problems in closed psychiatric wards is the issue of violence. Many studies have tried to characterize the violent patients hospitalized in a closed ward. Some research has shown that the strongest predictor of violence is past violence. The closed wards in the country consist of civil patients and patients hospitalized according to a court order following a history of violence, side by side. In this article, we characterized cases of violence that took place in closed wards in 2015, and in addition we examined the effect of hospitalization status on patient aggression and the level of violence in the wards. METHODS: The study was performed retrospectively using data from hospital medical and nursing records and reports of unusual events from a risk management database. The subjects included in the study are men and women between the ages of 18-65 years who were admitted to a closed ward in 2015 with a reported violent incident for which they were responsible. The data were examined for the specific event and the percentage of those admitted due to a court order out of all the participants in the violent events was noted. Furthermore, the authors examined the number of violent events with respect to the percentage of those hospitalized by court order in the department at that time. In addition, we examined each violent case and characterized it by pre-determined variables. RESULTS: As to the legal status, it was clearly found that those hospitalized with a court order were more involved in assault cases. However, it was not found that a higher percentage of those hospitalized by a court order raised the level of violence in the department. In terms of their characterization, the cases of assault were more frequently performed by men, by young people and by bachelors. The clinical diagnoses that characterized the attackers were prolonged disorders of the psychotic spectrum. Most of the events involved physical assault of other patients and staff. The event usually took place in the early days of the hospitalization, most often in the ward lobby and during morning hours. CONCLUSIONS: According to the research hypothesis, patients under a court order are found to be responsible for more cases of violence in active wards. At the same time, the high attendance of those hospitalized by a court order does not increase the amount of violence in the department. These results support the idea of separating outpatients in court orders from other patients, in order to reduce violence in active psychiatric wards, improve inpatient conditions, and adjust dedicated care for populations of different legal status.


Assuntos
Transtornos Mentais , Unidade Hospitalar de Psiquiatria , Adolescente , Adulto , Idoso , Agressão , Feminino , Humanos , Pacientes Internados , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Violência , Adulto Jovem
4.
BMC Psychiatry ; 21(1): 79, 2021 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-33549077

RESUMO

BACKGROUND: Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalisation of patients who attempted suicide and aimed to provide criteria for hospitalisation decisions by physicians. METHODS: This study included patients who had deliberately self-harmed (age ≥ 19 years) and presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those admitted to the psychiatric wards were excluded. RESULTS: This study included 414 patients in the hospitalisation group and 1346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalised and discharged groups (p < 0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalised and discharged groups, respectively. In the hospitalised group, the odds ratio and confidence interval for aged 35 ~ 64 (2.222, 1.343-3.678), aged over 65 (2.788, 1.416-5.492), sex -male (2.041, 1.302-3.119), and consciousness (1.840, 1.253-2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255-1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalise patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7, 85.5%, and 0.924, respectively. CONCLUSION: The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalisation and reduce ED LOS and crowding.


Assuntos
Serviço Hospitalar de Emergência , Tentativa de Suicídio , Adulto , Idoso , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Unidade Hospitalar de Psiquiatria , Adulto Jovem
5.
Psychiatry Res ; 298: 113779, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33561619

RESUMO

This current cross sectional survey was carried out amongst patients and staff in an acute psychiatric inpatient unit in the very first weeks of the ongoing pandemic outbreak of COVID-19 in Norway. Most patients found the visiting restrictions difficult, many reported that the pandemic made them feel unsafe, affected their sleep and that they feared transmission from other patients. Among staff, almost half were afraid that they would contract the virus, a majority feared they would bring the virus home and infect their family and one third were concerned that the pandemic compromised the treatment provided for the patients.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pacientes Internados/psicologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Recursos Humanos em Hospital/psicologia , Unidade Hospitalar de Psiquiatria , Doença Aguda , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega
6.
Psychiatry Res ; 298: 113776, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33571800

RESUMO

Inpatient psychiatric facilities can face significant challenges in containing infectious outbreaks during the COVID-19 pandemic. The main objective of this study was to characterize the epidemiology, testing data, and containment protocols of COVID-19 in a large academic medical center during the height of the COVID-19 outbreak. A retrospective cohort analysis was conducted on hospitalized individuals on five inpatient psychiatric units from March 1st to July 8th, 2020. Demographic data collected include age, race, gender, ethnicity, diagnosis, and admission status (one or multiple admissions). In addition, a Gantt chart was used to assess outbreak data and timelines for one unit. Testing data was collected for patients admitted to inpatient psychiatric units, emergency room visits, and employees. 964 individuals were hospitalized psychiatrically. The study population included ethnically diverse patients with various mental illnesses. We also describe infection prevention strategies, screening, and triage protocols utilized to safely continue patient flow during and beyond the study period with a low patient and employee infection rate. In summary, our study suggests that early implementation of triage, screening, extensive testing, and unit-specific interventions can help prevent and contain the spread of COVID-19 in inpatient psychiatric units and help facilitate safe delivery of care during a pandemic.


Assuntos
Centros Médicos Acadêmicos , Transtornos Mentais , Unidade Hospitalar de Psiquiatria , Triagem , Centros Médicos Acadêmicos/normas , Centros Médicos Acadêmicos/estatística & dados numéricos , Adulto , /epidemiologia , Feminino , Humanos , Pacientes Internados , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Unidade Hospitalar de Psiquiatria/normas , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Estudos Retrospectivos , Triagem/normas , Triagem/estatística & dados numéricos
7.
Front Public Health ; 9: 625691, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33604325

RESUMO

The exceptional circumstances of the Coronavirus disease (COVID-19) pandemic are making the grief processes challenging for families who are losing a relative for COVID-19. This community case study aimed to describe a phone-based primary preventive psychological intervention that has been delivered to these families by the Clinical Psychology unit of an Italian hospital. In particular, the article reports how the intervention has been organized within the overall hospital care pathway for families, the specific contents and components of the intervention, and the seven-phase structure of the intervention. The unique features and related challenges of the intervention, along with the implications for clinical practice, are discussed.


Assuntos
Luto , Família/psicologia , Telefone , Serviços Hospitalares de Assistência Domiciliar , Humanos , Itália , Unidade Hospitalar de Psiquiatria
8.
Artigo em Inglês | MEDLINE | ID: mdl-33525740

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a "pandemic-free" period in 2016 and a "during-pandemic" period in 2020. The study included 579 consultations at psychiatric ED in the "during-pandemic" period and 702 in the "pandemic-free" period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.


Assuntos
/psicologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Pandemias , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Humanos , Saúde Mental , Suíça/epidemiologia
9.
An. pediatr. (2003. Ed. impr.) ; 94(1): 11-18, ene. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200272

RESUMO

INTRODUCCIÓN: El ingreso de menores en unidades de hospitalización de psiquiatría de adultos constituye un problema debido a la ausencia de recursos adecuados y de datos epidemiológicos. OBJETIVO: Describir y analizar las características sociodemográficas y clínicas de los menores que ingresaron en la Unidad de Hospitalización Breve de Psiquiatría en Cáceres. Sujetos y métodos: Estudio observacional, descriptivo y retrospectivo. La muestra estuvo definida por pacientes de edades comprendidas entre los 12 y los 18 años, hospitalizados en la unidad de psiquiatría. El periodo de evaluación fue entre el 1 de enero del 2014 y el 31 de diciembre del 2018. RESULTADOS: Se incluyeron 79 pacientes. La edad media fue de 15,72 (± 1,65) años. El 93,6% presentaron antecedentes psiquiátricos personales. El diagnóstico al alta más frecuente en los varones fueron los trastornos destructivos del control de impulsos; en las mujeres los trastornos afectivos. El 40,6% presentaron antecedentes de consumo de sustancias, siendo más frecuente en varones, lo cual empeoraba el pronóstico. La estancia media fue de 5,4 (± 4,7) días. La prolongación de la estancia media se relacionó con los antecedentes de ingresos psiquiátricos previos, el número de diagnósticos al alta, un mayor número de fármacos al alta y aquellos que recibieron antipsicóticos inyectables de liberación prolongada (p < 0,005 en todos los casos). CONCLUSIONES: El estudio identifica el perfil sociodemográfico y clínico del menor ingresado en la unidad de psiquiatría y cómo la estancia hospitalaria se asoció con antecedentes psiquiátricos previos y una complejidad diagnóstica y clínica


INTRODUCTION: The admission of minors into adult psychiatric units is a problem and is due to the lack of adequate resources and epidemiology data. OBJECTIVE: The aim of this study is to describe and analyse the sociodemographic and clinical characteristics of minors that were admitted into the Short-Stay Psychiatric Hospitalisation Unit of Caceres, Spain. MATERIALS AND METHODS: A retrospective, observational, and descriptive study was conducted on a sample of patients between 12 and 18 years-old admitted to the Psychiatric Unit. The study period was between January 1, 2014 and December 31, 2018. RESULTS: A total of 79 patients, with a mean age of 15.72 (± 1.65) years, were included. Almost all of them (93.6%) had a personal psychiatric history. The most common diagnoses at discharge in males were disruptive, impulse-control and conduct disorders, and mood disorders in females. A history of substance consumption was present in 40.6%, and was more common in males, which led to a worse prognosis. The mean stay was 5.4 (± 4.7) days. Prolongation of the mean stay was associated with a history of previous psychiatric admissions, the number of diagnoses at discharge, a greater number of drugs at discharge, and those that received long-acting injectable antipsychotic drugs (p < 0.005 in all cases). CONCLUSIONS: The study identified the sociodemographic and clinical profile of the minor admitted to the Psychiatric Unit, and how the hospital stay was associated with previous psychiatric history, as well as diagnostic and clinical complexity


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Hospitalização , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Psiquiatria do Adolescente/métodos , Psiquiatria Infantil/métodos , Epidemiologia Descritiva , Estudos Retrospectivos , Tempo de Internação
12.
Gen Hosp Psychiatry ; 69: 126-128, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33431231

RESUMO

OBJECTIVE: A Canada-wide survey was disseminated to collect information regarding changes in processes related to providing care to patients on inpatient psychiatry units in response to the COVID-19 pandemic. Our aim was to share this information with those who have an interest in problem-solving these significant and unique challenges. METHOD: The survey was distributed through the Association of Chairs of Psychiatry of Canada to Department Heads of Psychiatry at all sixteen medical schools. Information was collected via SurveyMonkey April 26-May 9, 2020. Eleven psychiatrists representing 11 different Canadian city/centre/zone(s) completed the survey. RESULTS: Information was collected about process changes: physical separation on the wards, symptom and vital signs screening, testing, isolation, rationales for number of beds allocated for COVID-positive, -suspect and -negative patients and for selecting a particular hospital to provide care to these different groupings of patients. One subsection of the information is presented in this letter. Further information is available upon request. CONCLUSION: Similarities and differences existed between city/centre/zone(s) regarding approaches to providing care to patients on inpatient psychiatry wards. Significant preparation and consideration was put into determining necessary changes in response to this pandemic, and this is reflected in the information provided from each city/centre/zone.


Assuntos
Alocação de Recursos para a Atenção à Saúde , Número de Leitos em Hospital , Unidades Hospitalares , Unidade Hospitalar de Psiquiatria , Canadá , Planejamento Hospitalar , Humanos , Isolamento de Pacientes , Inquéritos e Questionários
13.
Soins Psychiatr ; 41(330): 34-37, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33353606

RESUMO

The desire for emotional and/or sexual relations, although universally felt, is not freely expressed because it's usually shaped by modesty, taboos, the norms and values of the surroundings and of the cultural environment of the people who feel such a desire. It is even constrained, or repressed, by certain laws. This complexity can be significantly increased by the existence of mental health disorders requiring psychiatric care in secure units. Certain notions must be taken into account, such as the relative freedom of patients, compliance with rules, discernment, informed consent, the vulnerability of potential partners, the impact of treatments, etc.


Assuntos
Transtornos Mentais , Unidade Hospitalar de Psiquiatria , Sexualidade , Humanos , Transtornos Mentais/terapia
14.
PLoS One ; 15(10): e0240163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33007027

RESUMO

Evidence of risk assessment procedures is scarce and inconclusive. The aim of this study is to evaluate the effects of risk assessment on aggression and the use of coercive interventions in an acute psychiatric admission setting. In addition, we evaluated nurse behaviour before and after the use of risk assessment. To take the fluctuations with regard to aggression and coercive interventions into account, we allowed 26 weeks for baseline measurements, followed by a 26 weeks steady-state period after the implementation of the risk assessment instrument. Contrary to expectations, no positive effects of risk assessment were found on aggression or on coercive interventions. Time spent in seclusion increased significantly with more than 10 hours on average after implementation. Furthermore, there were only negative effects on nurse behaviour and experiences. Among other things, they felt more stressed, spent more time on administration tasks and spent less time with patients after the implementation. In conclusion, there is insufficient evidence to use structured short-term risk assessment to reduce aggression or coercive interventions.


Assuntos
Agressão , Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros , Unidade Hospitalar de Psiquiatria , Medição de Risco , Adulto , Feminino , Humanos , Masculino , Análise Multinível , Avaliação de Resultados em Cuidados de Saúde , Análise de Regressão
15.
Rev. enferm. Cent.-Oeste Min ; 10(1): 3470, out. 2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1147108

RESUMO

Objetivo: caracterizar a unidade de psiquiatria do Hospital Geral, no tocante à estrutura, organização do trabalho, perfil profissional da enfermagem e tipo de paciente que recebe. Método: Trata-se de um estudo de caso de observação direta, abordagem qualitativa e quantitativa, com participação de dez profissionais de enfermagem. Resultados: Observou-se uma unidade com estrutura física moderna, pautada na intervenção multiprofissional. Profissionais de enfermagem jovens, do sexo feminino, com tempo de formação maior que 10 anos e mais de 3 anos de atuação na unidade psiquiátrica, mas cuja formação e experiência pouco se refere à saúde mental. Pacientes do sexo masculino, jovens, solteiros, em primeira internação, com longa taxa de permanência, sendo internados por situação de risco elevado de suicídio, seguidos de manifestações dos transtornos mentais relacionados ao uso de álcool e outras drogas. Conclusão: A unidade psiquiátrica, no hospital geral, possibilita o acesso ao cuidado de enfermagem e dos demais profissionais para uma atenção integral às necessidades das pessoas com transtorno mental. Contudo, há necessidade de maior formação da equipe de enfermagem para lidar, em saúde mental, nessas unidades, que se esbarram na reduzida oferta de cursos de especialização em algumas regiões do Brasil. (AU)


Objective: to characterize the General Hospital's psychiatric unit according to its structure, work organization, nursing professional profile and the type of patient it receives. Method: This is a direct observation case study of qualitative and quantitative nature, with the participation of ten nursing professionals. Results: A unit with a modern physical structure based on multiprofessional intervention was identified. Young female nursing professionals with a training time of more than 10 years and with more than 3 years of experience in the psychiatric unit were identified. However, their education and experience have little to do with mental health. Young, single, first-time, long-term male patients being hospitalized for high-risk of suicide, followed by manifestations of mental disorders related to alcohol and other drug use. Conclusion: The General Hospital's psychiatric unit provides access to nursing care and other health professionals for comprehensive attention to the needs of people with mental disorders. However, the nursing staff needs more training to deal with mental health in such units. The health professionals face a small number of specialization courses in some regions of Brazil.(AU)


Objetivo: caracterizar la unidad psiquiátrica del Hospital General en términos de estructura, organización del trabajo, perfil profesional de la enfermería y tipo de paciente recibido. Método: Se trata de un estudio de caso de observación directa, enfoque cualitativo y cuantitativo, con la participación de diez profesionales de enfermería. Resultados: Se observó una unidad con una estructura física moderna basada en la intervención multidisciplinar. Jóvenes profesionales de enfermería, mujeres, con más de 10 años de formación y más de 3 años de experiencia en la unidad psiquiátrica, pero cuya formación y experiencia no se refieren a la salud mental. Pacientes varones, jóvenes, solteros, en su primera hospitalización, con una larga estancia, siendo hospitalizados por alto riesgo de suicidio, seguidos de manifestaciones de trastornos mentales relacionados con el consumo de alcohol y otras drogas. Conclusión: La unidad psiquiátrica del hospital general proporciona acceso a la atención de enfermería y a otros profesionales para la atención integral de las necesidades de las personas con trastornos mentales. Sin embargo, es necesario seguir capacitando al personal de enfermería para que se ocupe de la salud mental en estas unidades, que se enfrentan a una oferta reducida de cursos de especialización en algunas regiones de Brasil.(AU)


Assuntos
Unidade Hospitalar de Psiquiatria , Saúde Mental , Enfermagem , Unidades de Internação , Hospitais Gerais
16.
Issues Ment Health Nurs ; 41(11): 969-975, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32940542

RESUMO

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.


Assuntos
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 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão
17.
Med Care ; 58(10): 889-894, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925415

RESUMO

BACKGROUND: Patients in inpatient psychiatry settings are uniquely vulnerable to harm. As sources of harm, research and policy efforts have specifically focused on minimizing and eliminating restraint and seclusion. The Centers for Medicare and Medicaid's Inpatient Psychiatric Facility Quality Reporting (IPFQR) program attempts to systematically measure and reduce restraint and seclusion. We evaluated facilities' response to the IPFQR program and differences by ownership, hypothesizing that facilities reporting these measures for the first time will show a greater reduction and that ownership will moderate this effect. METHODS: Using a difference-in-differences design and exploiting variation among facilities that previously reported on these measures to The Joint Commission, we examined the effect of the IPFQR public reporting program on the use and duration of restraint and seclusion from the end of 2012 through 2017. RESULTS: There were a total of 9705 observations of facilities among 1841 unique facilities. Results suggest the IPFQR program reduced duration of restraint by 48.96% [95% confidence interval (95% CI), 16.69%-68.73%] and seclusion by 53.54% (95% CI, 19.71%-73.12%). There was no change in odds of zero restraint and, among for-profits only, a decrease of 36.89% (95% CI, 9.32%-56.07%) in the odds of zero seclusion. CONCLUSIONS: This is the first examination of the effect of the IPFQR program on restraint and seclusion, suggesting the program was successful in reducing their use. We did not find support for ownership moderating this effect. Additional research is needed to understand mechanisms of response and the impact of the program on nontargeted aspects of quality.


Assuntos
Centers for Medicare and Medicaid Services, U.S./normas , Transtornos Mentais , Isolamento de Pacientes/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Restrição Física/estatística & dados numéricos , Humanos , Pacientes Internados , Propriedade , Registros Públicos de Dados de Cuidados de Saúde , Fatores de Tempo , Estados Unidos
19.
Psychosomatics ; 61(6): 662-671, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32800571

RESUMO

BACKGROUND: Patients with psychiatric illnesses are particularly vulnerable to highly contagious, droplet-spread organisms such as SARS-CoV-2. Patients with mental illnesses may not be able to consistently follow up behavioral prescriptions to avoid contagion, and they are frequently found in settings with close contact and inadequate infection control, such as group homes, homeless shelters, residential rehabilitation centers, and correctional facilities. Furthermore, inpatient psychiatry settings are generally designed as communal spaces, with heavy emphasis on group and milieu therapies. As such, inpatient psychiatry services are vulnerable to rampant spread of contagion. OBJECTIVE: With this in mind, the authors outline the decision process and ultimate design and implementation of a regional inpatient psychiatry unit for patients infected with asymptomatic SARS-CoV-2 and share key points for consideration in implementing future units elsewhere. CONCLUSION: A major takeaway point of the analysis is the particular expertise of trained experts in psychosomatic medicine for treating patients infected with SARS-CoV-2.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/complicações , Arquitetura Hospitalar/métodos , Unidades Hospitalares , Hospitalização , Controle de Infecções/métodos , Transtornos Mentais/terapia , Admissão e Escalonamento de Pessoal/organização & administração , Pneumonia Viral/complicações , Betacoronavirus , Humanos , Internação Involuntária , Transtornos Mentais/complicações , Pandemias , Equipamento de Proteção Individual , Unidade Hospitalar de Psiquiatria , Psicoterapia de Grupo/métodos , Recreação , Ventilação/métodos , Visitas a Pacientes
20.
Rev Infirm ; 69(262): 45-47, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32838868

RESUMO

Units for difficult patients are secure psychiatric wards for people with mental health disorders who could have or who have displayed dangerous behaviour. In this article, four students in their 3rd year of nursing studies share their experience on such a ward during their practice placement at Cadillac general hospital. Their learning and discovery of nursing care alongside experienced professionals enabled them to develop their competencies and change their perception of psychiatry.


Assuntos
Educação em Enfermagem/organização & administração , Transtornos Mentais/enfermagem , Unidade Hospitalar de Psiquiatria , Estudantes de Enfermagem/psicologia , Comportamento Perigoso , Humanos , Transtornos Mentais/psicologia , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem
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