| Summary, etc. |
[Article Title: Prescribing With a Trauma-Informed Perspective / Barbara J. Limandri, p. 7-10] Abstract: As a survival strategy, trauma arouses intensive neurobiological mechanisms that, if unchecked, contribute to severe chronic stress responses and disability. Although posttraumatic stress disorder can be considered a distinctive psychiatric disorder, it likely underlies many psychiatric disorders, including depression and mood, anxiety, substance use, and personality disorders. Psychiatric-mental health nurses need to carefully assess for trauma symptomatology in all patients and diverse populations, such as children; adolescents; immigrants; active and inactive military personnel; women; and lesbian, gay, bisexual, transgender, queer individuals. Pharmacotherapy should focus on priority of target symptoms with first-line medications including serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and adrenergic blocking agents. Serotonin antagonists (i.e., second-generation antipsychotic agents) and benzodiazepine drugs are contraindicated and should be used sparingly and with caution. Psychotherapy is an effective adjunct to pharmacotherapy in treating trauma-related conditions.;[Article Title: It's Not a Nightmare: Understanding Sleep Terrors / Erin Ellington, p. 11-14] Abstract: Sleep terrors, one of the non-rapid eye movement parasomnias, are interesting nighttime phenomena that can be distressing for parents. For most children, this behavior is temporary and does not cause significant problems. However, some psychiatric conditions may have a higher prevalence of parasomnias, including sleep terrors. Although sleep terrors may be a benign and common event in children, a basic mental health examination should include a sleep-related screening to possibly identify underlying issues. Nurses must be knowledgeable about sleep terrors and able to provide education and support when parents share their concerns.;[Article Title: Implementation of Trauma-Informed Care and Brief Solution-Focused Therapy: A Quality Improvement Project Aimed at Increasing Engagement on an Inpatient Psychiatric Unit / Babatunde Aremu, Pamela D. Hill, Joanne M. McNeal, Mary A. Petersen, Debbie Swanberg and Kathleen R. Delaney, p. 16-22] Abstract: 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.;[Article Title: Service Models for Urgent and Emergency Psychiatric Care: An Overview / Dominiek Coates, p. 23-30] Abstract: There is variation in the way mental health services respond to urgent and emergency presentations, with few evidence-based models reported in the literature, and no agreed on best practice models. To inform the development of urgent and emergency psychiatric care models, a literature review was performed. The review sought to identify strengths and critiques of varying models, evidence gaps, and areas for future research. After review, significant variation was found in the design and scope of urgent and emergency care models. Most models are either community or hospital based, with few integrated models that span community and hospital care. The development of integrated models has the potential to reduce service duplication and support a shift toward provision of least restrictive care. The overall evidence base of urgent and emergency care models is limited, with few studies in the area, and there is a need for further research.;[Article Title: Psychiatric Nursing Care in a General Hospital: Perceptions and Expectations of the Family/Caregiver / Marciana Fernandes Moll, Fabiana Cristina Pires, Carla Aparecida Arena Ventura, Nathália Nunes Boff and Núbia Ferreira da Silva, p. 31-36] Abstract: The current study aimed to investigate the perceptions and expectations of family members/caregivers regarding nursing care provided to psychiatric inpatients in a general hospital. The study was a descriptive-exploratory study with a qualitative approach. Data were collected through open interviews with 10 relatives of patients hospitalized in the psychiatric unit and analyzed using content analysis. Participants reported that nursing care was good and emphasized a good relationship between the patient and nursing staff marked by professionalism, care, and dedication. Participants' expectations highlighted staff's need for relational skills, represented by patience, attention, and interaction, and for meeting the basic human needs of patients. Most participants did not have higher expectations regarding the care provided. Future studies should address the family/caregiver's point of view, as psychiatric hospitalizations in general hospitals are a recent practice that should be the subject of further reflection and discussion to improve the quality of care.;[Article Title: Resources for Psychiatric Clinicians Working With Breastfeeding Mothers / Nancy M. Terres, p. 37-46] Abstract: In today's health care-focused climate, in which encouraging breastfeeding is part of national and international health care initiatives, clinicians in any field should have resources available for breastfeeding mothers. The current article provides information for psychiatric clinicians on how breastfeeding may affect women with psychiatric conditions, the type of lactation counselor likely to be best prepared to collaborate with psychiatric clinicians, and resources available regarding maternal psychiatric medications safe for breastfeeding infants. These resources can assist informed choices that support the mother's breastfeeding goals while providing the psychological care the nursing mother requires. |
