Standards of Psychaitric Nursing

8/2/2019 Standards of Psychaitric Nursing

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STANDARDS OF

PSYCHAITRICNURSING


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The practice of psychiatricnursing is regulated by law butguided by standards of care.

STANDARDS OF CARE

Standards of care pertain toprofessional nursing activitiesthat are demonstrated by the

nurse through the nursingprocess.

ANA (2000)


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TheANA

TheAPNA

TheISPN


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The ANA, in collaboration with

the American PsychiatricNurses Association and the

International Society ofPsychiatric Mental Health

Nurses, has developed a set ofstandards that psychiatric nurses

are expected to follow as they


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STANDARD I: ASSESSMENT

The psychiatric mental health

nurse collects patient health

data:


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Assessment in mental health nursing is

based on the collection of data from

multiple sources, such as the

Client,

Family and friends,

Other health care providers,

Past and current medical records

and


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Importance ofAssessment

The assessment data provides

the data base for clinical decision

making: diagnosis, outcomes,

interventions and evaluation.


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NURSING CONDITIONSAND BEHAVIOURS

Self awareness

Accurate observations

Therapeutic communication Responsive dimensions of care

Establish nursing contracts

Obtain information from patient andfamily

Validate data with the patient


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STANDARD II: DIAGNOSIS:

Psychiatric or mental health nurse

analyses the assessment data in

determining diagnoses:


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A nursing diagnosis is a clinical

judgement about individual, family or

community responses to actual or

potential health problems/life

processes.

(NANDA, 2003)


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According to NANDA, the

components of nursing diagnosis

are

The label or name of diagnosis

Its definition; the defining

characteristics of the

diagnosis


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Examples

Imbalanced Nutrition: lessthan body requirements

related to use of substance in

place of nutritional food

evidenced by loss of weight,

pale conjunctiva and mucous

membranes, electrolyte


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Risk for self-directed

Violence: risk factors may

include depressed mood and

feeling of worthlessness and

hopelessness


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The defining characteristics are

particularly helpful because they

reflect the behaviours that are

the target of nursing

interventions.

They also provide specific

indicators for evaluating the


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AND BEHAVIOURS

Logical decision making Knowledge of normal parameters

Inductive and deductive reasoning

Identify patterns in data

Compare data with norms

Analyse and synthesize data Identify problems and strengths

Validate problems with patient


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STANDARD III: OUTCOMEIDENTIFICATION

The psychiatric mental healthnurse identifies expectedoutcomes individualized to

patients


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An outcome is a statement of a

desired, achievable behaviour or

expression of feelings, to be

attained within a predicted period

of time , that is based on the

clients current status and

available resources.


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Outcomes should be: Specific rather than general

Measurable rather than subjective

Attainable rather than unrealistic.

Current rather than outdated.

Adequate in number rather than too

few or too many.

Mutual rather than one sided


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Types of outcomes:

Outcome statements are

generally divided into two

categories

short term

long term.


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Example Nursing diagnosis: Alteration

in thought process related todepressive ideations.

Short term outcome: Unrealistic: client will verbalize

enjoyment in completing a project

within three days. Realistic: client will work on a

project for at least 10 minutes in a


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STANDARD IV: PLANNING:


nurse develops a plan of care

that prescribes interventions

to attain expected outcomes.

NURSING CONDITIONS


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NURSING CONDITIONSAND BEHAVIOURS

Application of theory

Respect for patient and family

Prioritize goals

Identify nursing activities

Validate plan with patient


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The plan of nursing care must always

be individualized for the patient. Planned interventions should be based

on current knowledge in the field and

contemporary clinical psychiatricmental health nursing practice.

Planning is done in collaboration with

the patient, family, and the health careteam.

Documentation of the plan of care is

an essential nursing activity


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STANDARD V:IMPLEMENTATION


nurse implements the

interventions identified in the

plan of care


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Nursing interventions should be

implemented in a manner that

recognizes the worth and dignity

of people and considers the

physical, emotional, social,

cultural and spiritual needs of

your client and their families.


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Nursing conditions andbehaviours

Past clinical experiences

Knowledge of research

Responsive and action dimensions of

care

Consider available resources

Implement nursing activities


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Standard Va: Counselling

standard Vb: Milieu therapy

Standard Vc: Promotion of self

care activities

Standard Vd: Psychobiological interventions

Standard Ve: Health teaching


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Advanced nursing practice

Standard Vh: Psychotherapy

Standard Vi: Prescriptive

Authority And Treatment

Standard Vj: Consultation

:


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:EVALUATION:

The psychiatric mental healthnurse evaluates the clients

progress in attaining expected

outcomes.


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The final step in the nursing

process is evaluation. In this step,nurse evaluate and document

client progress towards theoutcome criteria, as well as

evaluate their own clinicalpractice.


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Types of evaluation: There are two types of

evaluation:

Formative evaluation

Summative evaluation.


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Documentation:

Documentation is a critical

component of nursing practice.

The general rule is: if it is not

documented, it has not

occurred. All the steps of nursing

process pertinent to the client

m t m nt in th


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AND BEHAVIOURS:

Self analysis Peer review

Patient and family participation

Compare the patient responses andthe expected outcome.

Review nursing process. Modify the nursing process as

needed.

Participate in quality improvement


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PERFORMANCE

STANDARDSSTANDARD I: QUALITY OF CARE:


nurse systematically evaluates

the quality of care and

effectiveness of psychiatric

mental health nursing practice.

urs ng con ons an


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urs ng con ons anbehaviours

Personal and professionalintegrity,

Openness to inquiry

Critical thinking skills Identify improvement

opportunities

Collect and identify improvementdata

Formulate planned approaches


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STANDARD II :PERFORMANCEAPPRAISAL:

Psychiatric mental health

nurse evaluates ones own

psychiatric mental health

nursing practice in relation to

professional practice


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Performance appraisal forpsychiatric nursing is generally

provided in two ways: administrative

clinical


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Nursing conditions and

behaviours

Self awareness

Acceptance of feedback from

others

:


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:EDUCATION:


nurse acquires and maintains

current knowledge in nursing

practice.

N i diti d


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Nursing conditions andbehavior

Intellectual curiosity

Desire for professional growth

Access to new information.

Seek out new knowledge and learning

experience.

A l new information in clinical

:


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:COLLEGIALITY:


nurse interacts with and

contributes to the professional

development of peers, health

care clinicians and others ascolleagues.

STANDARD V ETHICS


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STANDARD V: ETHICS:

The psychiatric mental healthnurses assessments, actions,

and recommendations on behalf

of patients are determined and

implemented in an ethical

manner.

:


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:COLLABORATION:


nurse collaborates with the

patient, significant others and

health care clinicians in

providing care.

:


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:RESEARCH:


nurse contribute to nursing and

mental health through the use of

research methods and findings.


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Standards of Psychaitric Nursing

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