Contemporary Psychiatric Nursing Practice Chapter 6

Biopsychosocial Model Definition: Three separate, but interdependent, domains—biologic, psychological and social (Figure 6.1) Biologic: Theories that explain neurobiologic changes related to mental disorders Psychological: Theories related to psychological processess of thoughts, feelings and behavior Social: Theories that account for the influence of social forces encompassing the patient, family and community within cultural settings

Professional Practice Legal authority to practice (license), granted by states and provinces Professional standards set by professional nursing organizations ANA APNA ISPN

Scope of Psychiatric Mental Health Nursing in the United States Areas of Concern (Text Box 6.1) Standards of Care (Text Box 6.2) Standards of Professional Performance (Table 6.1) Basic level (Text Box 6.4, Table 6.2) Advanced level

Canadian Standards of Psychiatric and Mental Health Nursing Practice Provides competent professional care through the helping role Performs/refines client assessments through the diagnostic and monitoring function Administers and monitors therapeutic interventions Effectively manages rapidly changing situations Intervenes through the teaching-coaching function Monitors and ensures the quality of health care practices Practices within organizational and work-role structures

Tools of Psychiatric Nursing Practice Clinical Decision Making Nursing Care Plans Critical Pathways

Interdisciplinary Approaches Multidisciplinary Several disciplines providing different services to patient Not ideal Interdisciplinary Services are not provided independently of each other. Providers communicate in delivery of patient-oriented care. Supported by the IOM reports

Challenges of Psychiatric Nursing Knowledge development, dissemination and application Overcoming stigma Health care delivery system issues Impact of technology

Ethical Frameworks Canadian Code of Ethics (Text Box 6.6) ANA Code for Nurses (Text Box 6.5) Canadian Code of Ethics (Text Box 6.6) Principle of Autonomy: Each individual has the fundamental right of self-determination. Beneficence: Health provider uses knowledge and skills to develop an environment in which individuals achieve their maximum health care potential.

Psychiatric Nursing Organizations American Psychiatric Nurses Association (APNA) International Society of Psychiatric Mental Health Nurses (ISPN)