More and more children and adolescents are using self-harm as a coping mechanism to mange their mentally distressed state-of-mind. Children who are experiencing a mental crisis are commonly referred to an acute inpatient psychiatric setting where they are to regain safe and effective functioning so they can return to their homes and communities. Over the past decade, inpatient admissions for pediatric patients have significantly increased by 68% due to the exhibition of self-injurious behaviors and increased suicidal ideation (YoungMinds, 2015). The focus of this paper is to introduce the quality improvement proposal of implementing a safety plan for staff to adhere to in order to promote ultimate patient safety on an inpatient child and adolescent psychiatric unit. The following information will also reflect the practice and challenges of the psychiatric team at St. Elizabeth Hospital in order to achieve ultimate patient safety.
St. Elizabeth Hospital, owned by Ascension Health, is one of the few facilities in Wisconsin which provides psychiatric care to children and adolescents in an inpatient-based setting. The behavioral health program administers a thorough, multidisciplinary approach to the assessment, treatment and disposition process of pediatric patients undergoing mental, emotional, and/or substance abuse concerns. The multidisciplinary treatment team is led by a board-certified child and adolescent psychiatrist. The team further consists of
Mental health clinical this week was located at Avera Behavior Health in Sioux Falls. My patient interview took place in the adolescence mental health wing. The type of treatment provided was structured, inpatient treatment and the average length-of-stay in this unit was around 6 days.
A safety plan may be developed for individuals whose pose a risk to themselves or to others. The guiding purpose of a safety plan is to provide individuals resources to redirect their actions. Plans may list detailed sets of particular strategies to use in an effort to decrease the person’s risk of self harm. Safety plans generally include coping strategies to be used by individuals in an effort to immunize their risks. The plan is generally viewed as a collaborative effort between the treatment provider and the client. A safety plan consists of a course of action for individuals whose patterns may prove harmful to them.
This article addresses how modern constructed public buildings are often unsafe. This is because most of them include big windows and large open spaces designed to inspire patrons of the building. Instead of fortressing these structures, this piece suggests renovating the entrances. This agrees with the essay in the way both stress the importance of front-end security. It gives many helpful tips at further improving entrance security. Atlas does mention not wanting to make schools
This article attempts to establish that it is imperative for all school nurses to be properly trained in mental health issues. Ensuring they have the confidence needed to recognize the early signs of mental issues so they may support and intervene in a cohesive manner. The reason this article is important to mental health nursing is that it relates to many newly graduated registered nurses, who may feel inadequate in assessing mental health illnesses and how to handle each individual case. These issues must be addressed in order to eliminate unwanted self-harming individuals.
ensure her safety is to assess her suicidal ideations and safety environment, as well as her medication compliance. In addition, it would be appropriate to assess and address any cultural and spiritual needs the client has. The patient’s plan of care for risk for injury and self-harm violence include the following: • Assess for self-destructive ideas and behavior q shift. The trauma may result in feelings of hopelessness and worthlessness, leading to high risk for suicide.
Suicide is the second leading cause of death among people age 15 to 34 years of age (Center for Disease Control [CDC], 2015). More than 25% of all high school age adolescents in the United States who took part in a youth risk behavior survey felt symptoms of depression almost every day for two or more consecutive weeks (CDC, 2012). Adolescents who are depressed are at higher risk for suicide. Early recognition and treatment is crucial to preventing suicide attempts (King & Vidourek, 2012). Screening for adolescent depression is an important step in implementing the Institute of Medicine (2001) recommendation for improving safety in health care. In addition, the care provided must be patient centered and equitable. This quality improvement project aims to provide screening for adolescent depression for all patients age 12 years and older during routine well-child visits.
Quality improvement is defined by Kelly (2012) as “a systematic process of organization wide participation and partnership in planning and implementing continuous improvement methods to understand, meet, or exceed customer needs and expectations and improve patient outcomes” (p.477). The women’ unit can receive thirty patients from age eighteen to late adulthood. The unit is a receiving facility for everyone Baker acted in the state of Florida. Like any other organization, change is always happening in the women’s unit. One of the areas that need improvement on the unit is a reduction in the number of seclusion and restraint that we do every month. Patients that are violent and present a danger to either
In order to prevent future violent situations, people need to be educated about why youth self harm. When people self harm they may feel like they have lost touch with reality, “They say it eases their pain. That it clears their minds and makes them feel calm. But to those on the outside looking in, slicing your arm with a razor blade is the stuff of horror movies” (Galley). School violence is overtaking headlines, and teens are struggling with untreated mental illnesses, “Federal health officials recommended universal mental health screenings for students nearly a decade ago, they still aren’t required” (Kennedy). Schools would rather suspend or send mentally ill youth to an alternative program, then helping the student get the resources they
In the United States alone there are 98,000 deaths per year caused by low quality health care (Ignatavicius & Workman, 2013, pg. 2). This statistic is disturbing because the errors that resulted in death were errors that were preventable. The intent of this chapter is to bring awareness to health care providers that are able to make a change in the quality of health care. In current practice patients are subjected to medication errors, preventable hospitalizations, premature death, and poor care provided due to racial, ethical, or low-income factors.
“The overall goal for the Quality and Safety Education for Nurses (QSEN) project is to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work”("Graduate KSAs," 2014 para.1) In looking through the competencies that this statement embodies, I have chosen the competency of safety. This competency is defined as minimizing the risk of harm to patients and providers through both system effectiveness and individual performance (2014). The topic I have chosen to discuss in regards to safety is the role that the Pediatric Nurse Practitioner (PNP) plays in the recognition and the treatment of teen suicide. According to the National Youth Risk Behavior Surveillance survey (2013) suicide among teens and adolescents is a major health problem. It is the 3rd leading cause of death in 10-24 year olds in the United States. In the survey, 17% of students reported seriously considering suicide in the 12 months prior to the survey (Center for Disease Control and Prevention (CDC), 2013). With these reported numbers in the pediatric population, it is of vital importance that the PNP as the primary care provider (PCP) knows how to appropriately screen for, refer and treat this patient. This paper discusses the suicidal teen and the role of the PNP to promote the
Intervention/goals Risk for self-injury related to depression/psychosis as evidenced by previous suicide attempt and suicidal behavior. Patient will verbalize feelings; express decreased anxiety and anger
This week clinical I felt better prepared than I did with my first week. I was able to focus a lot more on interpersonal skills and develop therapeutic relationship with my patients. In terms of Mental Status Examination (MSE), this assessment provided me with a helpful base of information from which to observe changes, progress, and monitor risks. Especially, suicide risk assessment is a gateway to patient treatment and management. The purpose of suicide risk assessment is to identify treatable and modifiable risks and protective factors that inform the patient’s treatment and safety management requirements. I got insight into how important it is to document suicide risk assessments with sufficient information. Documentation of suicide risk assessments facilitates continuity of care and promotes communication between staff members across changing shifts. It is easy for suicidal patients to “fall through the cracks” of a busy psychiatric unit that has rapid patient turnover of admissions and discharges, and mostly during shift change. Asking question such as “What is your view of the future?” or “Do you think things will get better or worse?” helped me to elicit important information regarding patients suicidal ideation. Additionally, how my patients expressed their hope about the future assisted me to identify, prioritize, and integrate risk and protective factors into an overall assessment of the patient’s suicide risk and include in MSE.
The WGU nursing program helped me in developing my professional definition of quality and safety by enlightening my understanding of root cause analysis, and system failures. The IHI course was an eye opener in my understanding of quality improvement, and the processes required to enhance safety and quality improvement. The courses that really assisted me in my definition include, the Organizational Systems and Quality Leadership, the Leadership and Professional Image, and Professional Roles and Values; and the Evidence-Based Practice and Applied Nursing Research.
Inpatient adolescents were recruited from a psychiatric hospital located in the suburban region of a large metropolitan area. Respondents ranged in age from 13 to 18 years (Danielson, 2003). Of the 98 adolescents, 53 were girls and 85 were white. Most patients were of middle class socioeconomic status and possessed insurance that covered inpatient psychiatric treatment. Sixty-seven of the youths were hospitalized for attempting suicide. The remaining 31
Self-injury is an major issue in our society and schools need to do more to help teens handle mental issue. Self-injury is a complicated and often misunderstood phenomenon that is a growing problem in teenagers and adolescents (plante 1). Self-injury is also an dangerous act that can lead to a worst situation. Self-harm is not necessarily a serious mental illness, but a behavior that indicates a lack of coping skills. There are several illnesses that are associated with it such as: borderline personality disorder, depression, eating disorders, anxiety or posttraumatic distress disorder. In recent years, Self-injury as become more common. Approximately two million cases are reported annually in the United States (Gluck 1). Hospitalizations among youngs for intentional self-harm