Psychiatric-Mental Health Nursing Interventions Chapter 13

Nursing Interventions Nursing activities that promote and foster health, assess dysfunction, assist patients to regain or improve their coping abilities, or prevent further disabilities (ANA, 2000) Based on clinical judgment and knowledge Direct or indirect Scope & Standards guides the selection of interventions.

Interventions Scope & Standards of Psychiatric-Mental Health Nursing Practice Nursing Intervention Classification System (Text Box 14-1) Biopsychosocial Framework

Nursing Interventions: Biologic Dimensions Promotion of self-care activities Activity and exercise Sleep interventions Nutritional interventions Relaxation interventions Hydration interventions Thermoregulation Pain management Medication management

Nursing Interventions: Psychological Dimensions Counseling Conflict Resolution Bibliotherapy Reminiscence Behavior Therapy Cognitive Therapy Psychoeducation Health Teaching Spiritual Interventions

Conflict Resolution Conflict resolution process Cultural brokering in patient-system conflicts –Bridging, linking or mediating messages, instructions and belief systems between groups or people of differing cultural systems to reduce conflict –Must maintain a sense of connectedness or relationship with the patient

Behavior Therapy Interventions focusing on reinforcing or promoting desirable behaviors or altering undesirable ones Types of behavior therapy –Behavior modification –Token economy –Cognitive interventions

Interventions: Social Dimensions Group interventions Family interventions Privilege systems on inpatient units Milieu therapy (therapeutic environment) –Containment - safety –Validation - affirmations –Structured interaction - specific attitudes, approaches directed towards patients –Open communication - sharing information

Promotion of Patient Safety Observation De-escalation Seclusion Restraints

Interventions in the Community Home Visit Pre-visit phase Set goals. Agree on time. Assess neighborhood. Home visit (30-90 minutes) Greeting - Establish communication and atmosphere. Establish focus. Implementation of purpose of visit Closure - Summarize and clarify important points, closure. Post-visit phase Documentation and reporting Follow-up plans

Community Action Promotion of mental health awareness Support for humane treatment for people with mental disorders Advisor to support groups Participation in the political process Serving on community mental health boards