| Summary, etc. |
[Article Title: Benzodiazepine Use: The Underbelly of the Opioid Epidemic / Barbara J. Limandri, p. 11-15] Abstract: In the United States, benzodiazepine medication use is the secondary epidemic to opioid drug use and carries serious consequences as well, even though its use is enabled by well-intended clinicians. Benzodiazepine drugs are intended for short-term use, not to exceed 2 to 4 weeks; yet, it is common for clients to be taking benzodiazepine medications for up to 10 years. In addition to dependence or addiction, adverse effects include depression, emotional blunting, ataxia, aggression, irritability, nervousness, and cognitive impairment. These medications also contribute to increased risk for falls, suicide, overdose fatality, and vehicle crashes. The current article describes the epidemiology of benzodiazepine medication use, patient and prescriber factors that contribute to overuse and misuse, and recommendations for prescribing and deprescribing.;[Article Title: Complementary Alternative and Integrative Treatment for Substance Use Disorders / Gail Van Kanegan and Julie Worley, p. 16-21] Abstract: Complementary alternative and integrative medicine (CAIM) modalities are increasingly sought after by patients with chronic health conditions such as substance use disorders (SUDs). Evidence suggests that CAIM interventions can improve symptoms commonly seen in patients with SUDs, such as stress, anxiety, depression, and pain. Mindfulness-based intervention (MBI), such as meditation, has proven effective for a variety of conditions, including SUDs. Other CAIM strategies, such as manipulative body practices and healing energy medicine techniques, are also showing some evidence of effectiveness. These methods center on the concept of restoring balance to energy fields or acupoints on the body, including chakras and meridians. Nurses are in an ideal position to educate, administer, and teach patients these CAIM methods to integrate with traditional medical care. Resources to learn CAIM methods can be accessed online, and specialized certification in this field is also available.;[Article Title: Effects of a Staff Training Intervention on Seclusion Rates on an Adult Inpatient Psychiatric Unit / Julie Newman, Olimpia Paun and Louis Fogg, p. 23-30] Abstract: The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes. Seclusion rates were reduced from a 6-month pre-intervention average of 2.95 seclusion hours per 1,000 patient hours to a 6-month post-intervention average of 0.29 seclusion hours per 1,000 patient hours, a 90.2% reduction. Completed staff surveys showed significant staff knowledge gains, non-significant changes in staff attitudes about seclusion, non-significant changes in staff de-escalation skill confidence, and use of the new resource sheet by only 17% of staff. The key study implication is that time-limited, focused staff training interventions can have a measurable impact on reducing inpatient seclusion rates. ;[Article Title: Motivational Interviewing to Increase Outpatient Attendance for Adolescent Psychiatric Patients / Laurel Chiappetta, Stacy Stark, Khadejah F. Mahmoud, Kyle R. Bahnsen and Ann M. Mitchell, p. 31-35] Abstract: Motivational interviewing (MI) is a therapeutic technique that has been demonstrated to increase adherence to various treatment regimens. Nonattendance at outpatient appointments is associated with read-mission to psychiatric hospitals. The purpose of the current study was to examine the effectiveness of MI in promoting treatment adherence and increasing pediatric attendance rates at patients' first follow-up appointment after inpatient admission. A sample of 111 patients discharged from one of two child and adolescent units at an urban, inpatient psychiatric hospital in Southwestern Pennsylvania participated in the MI discharge process. Compared to hospital population data from 1 month prior to the current study, the MI discharge process demonstrated an increase of approximately 10% in attendance at the scheduled follow-up appointments and a decrease of approximately 4% in cancellations and no-show appointments. It was concluded that particularly for adolescents, MI may be a valuable treatment approach grounded in partnerships with health care providers, patients, and families to enhance outpatient appointment attendance. ;[Article Title: Managing Opioid Use Disorder and Co-Occurring Posttraumatic Stress Disorder Among Veterans / Rhonda Snow and Stephanie T. Wynn, p. 36-42] Abstract: Support and safety measures are essential for Veterans admitted to acute psychiatric units with co-occurring posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) to avoid unpleasant withdrawal symptoms. A human patient simulator was used to train clinicians to recognize opioid withdrawal symptoms. Clinicians were educated to assess for opioid withdrawal symptoms using the Clinical Opiate Withdrawal Scale. Knowledge was evaluated via pre/posttest. All participants' (N = 12) posttest scores improved. Participants self-rated their perception of clinical knowledge and practice skills as higher postintervention. Veterans indicated decreased concern about opioid withdrawal symptoms and increased perception that symptoms were adequately evaluated and treated by clinicians. Overall, the intervention appeared to enhance the provision of quality care in Veterans with OUD and co-occurring PTSD on an acute inpatient psychiatric unit. ;[Article Title: Non-Psychiatric Nurses' Perceived Self-Efficacy After an Educational Intervention on Suicide Prevention and Care / Ellen W. Blair, Jyoti Chhabra, Cynthia Belonick and Maria Tackett, p. 43-51] Abstract: Potential for suicide risk can be a safety concern for patients in all health care settings. Inadequate training of nurses in suicide assessment and prevention is a serious patient safety concern. A non-randomized pre-/postintervention research design was used to measure the effects of education on non-psychiatric nurses' perceived self-efficacy in assessment and inquiry about suicide risk and in implementing suicide prevention strategies. The intervention was an educational module about suicide prevention and care delivered to non-psychiatric nurses employed on a neuro-trauma unit in an acute care urban hospital setting. Statistically significant increases occurred in the non-psychiatric nurse's self-efficacy in caring for the patient at risk for suicide. The outcomes of this project offer an important contribution to future research in the area of education about suicide prevention and care for non-psychiatric nurses, promoting safer outcomes for patients. |
