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A Professional Containment Method in Acute Psychiatric Care: Nursing Observations

Year 2014, Volume: 6 Issue: 1, 79 - 91, 06.11.2014
https://doi.org/10.5455/cap.20130706041217

Abstract

Observation is a method that is used in place of other control methods such as chemical and physical detention, isolation. Observation is used especially as an interference method to ensure the safety of the patients with suicidal and aggressive behaviors in acute psychiatric care in many countries. Especially in acute psychiatric wards using observations of nursing as a professional control method is an important issue. This article aims to draw attention to the importance of the subject in our country about using nursing observations as a control method in acute psychiatric care from the view of the literature. In this article several studies related to risk assessment, decision making, the levels of observation, the application of observation and the ethical aspects of observation on acute psychiatric care have been discussed.

References

  • Langenbach M, Junaid O, Hodgson-Nwaefulu CM, Kennedy J, Moorhead SR, Ruiz P. Observation levels in acute psychiatric admissions. Eur Arch Psychiatry Clin Neurosci 1999; 249:28-33.
  • Phaneuf M. Psychiatric observation: a skill worth developing. http://www.infiressources.ca/fer/ Depotdocument_anglais/Psychiatric_observation_a_skill_worth_developing.pdf. (accessed at 19.05.2013)
  • Bowers L, Alexander J, Simsson A, Ryan C, Carl-Walker P. Cultures of psychiatric and the professional socialization process: the case of containment methods for disturbed patients. Nurse Educ Today 2004; 24: 435-42.
  • Bowers L, Simpson A. Observing and engaging. Mental Health Pract 2007; 10:12–14.
  • Reid W, Long A. The role of the nurse providing therapeutic care for the suicidal patient’s. J Adv Nurs 1993;18:1369-1376. Jones J, Jackson A. “Observation” Acute Mental Health Nursing. London, Sage Publications, 2004.
  • Tekkaş K, Bilgin H. Psikiyatri servislerinde kullanılan profesyonel kontrol yöntemleri: kullanım nedenleri, türleri, uluslararası uygulamalar ve algılamalar. Turk Psikiyatri Derg 2010; 21:235-242.
  • Sercan M, Bilici R. Türkiye’de bir ruh sağlığı bölge hastanesindeki hasta bağlama uygulamalarının değişkenleri. Turk Psikiyatri Derg 2009; 20:37-48.
  • Canadian Fedaration of Mental Health Nurses. Standart of Practice, Canadian Standards for Psychiatric- Mental Health Nursing, 3rd Edition 2006. http://cfmhn.ca/sites/cfmhn.ca/files/CFMHN%20standards%201.pdf. (accessed at 02.06.2013) American Nurses Association Psychiatric Mental Health Nursing Scope & Standards Draft Revision 2006. http://www.ispnpsych.org/docs/standards/scope-standards-draft.pdf (accessed at 02.06.2013)
  • Hewitt JL, Edwards SD. Moral perspectives on the prevention of suicide in mental health settings. J Psychiatr Ment Health Nurs 2006; 13:665-672.
  • Marangos-Frost S, Wells D. Psychiatric nurses’ thoughts and feelings about restraint use: a decision dilemma. J Adv Nurs 2000; 3:362-369.
  • Wallace B. Increased levels of observation in a mental health setting: challenge or chore? Advancing Practice in Bedfordshire 2012; 4:52-57.
  • Ray R, Perkins E, Meijer, B. The evolution of practice changes in the use of special observations. Arch Psychiat Nurs 2011; 25:90-100.
  • Bowers L, Park A. Special observation in the care of psychiatric inpatients: a literature review. Issues Ment Health Nurs 2001; 22:769-786.
  • Standing Nursing and Midwifery Advisory Committee (SNMAC). Department of Health Practice Guidance: Safe and Supportive Observation of Patients at Risk. Mental Health Nursing: Addressing Acute Concerns. London: The Stationery Office 1999. http://www.publications.doh.gov.uk/pub/docs/doh/snmacobs.pdf (accessed at 18.05.2013)
  • NHS Forth Valley .Mental health services psychiatric observations. http://www.nhsforthvalley.com /__documents/qi/CE_Guideline_MentalHealth/PsychiatricObservations.pdf (accessed at 18.05.2013).
  • CRAG/SCOTMEG (Working Group on Mental Illness). Nursing Observation of Acutely Ill Psychiatric Patients in Hospital: A Good Practice Statement. Edinburgh, The Scottish Office, 1995.
  • Stewart D, Bowers, Warburton FM. Constant special observation and self-harm on acute psychiatric wards: a longitudinal analysis. Gen Hosp Psychiatry 2009; 31:523–530.
  • Winship G. Further thoughts on the process of restraint. J Psychiatr Ment Health Nurs 2006; 13:55-60.
  • O’Brien L, Cole R. Close-observation areas in acute psychiatric units: a literature review. Int J Ment Health Nurs 2003; 12:165-176.
  • Cleary M, Jordan R, Horsfall J, Mazoudier P, Delaney J. Suicidal patients and special observation. J Psychiatr Ment Health Nurs 1999; 6:461-467.
  • Moore P, Berman K, Knight M, Devine J. Constant observation: implications for nursing practice. J Psychosoc Nurs 1995; 33:46-50.
  • Mackay I, Paterson B, Cassells C. Constant or special observations of inpatients presenting a risk of aggression or violence: nurses’ perceptions of the rules of engagement. J Psychiatr Ment Health Nurs 2005; 12:464-471.
  • O’Brien L, Cole R. Mental health nursing practice in acute psychiatric close-observation areas. Int J Ment Health Nurs 2004; 13:89-99.
  • Neilson P, Brennan W. The use of special observations: an audit within a psychiatric unit. Int J Ment Health Nurs 2001; 8:147-155.
  • Jones J, Lowe T, Ward M. Inpatients’ experiences of nursing observation on an acute psychiatric unit: a pilot study. Ment Health Care 2000; 4:125-129.
  • Jones J, Lowe T, Ward M, Wellman N, Hall J, Lowe T. Psychiatric inpatients’ experiences of nursing observation – a UK perspective. J Psychosoc Nurs Ment Health Serv 2000; 38:10-20.
  • Ashaye O, Ikkos G, Rigby E. Study of effects of constant observation of psychiatric in-patients. Psychiatr Bull 1997; 21:1451
  • Dodds P, Bowles N. Dismantling formal observation and refocusing nursing activity in acute inpatient psychiatry: a case study. J Psychiatr Ment Health Nurs 2001; 8:183-188.
  • Velioğlu P. Hemşirelikte Kavram ve Kuramlar. İstanbul, Alaş Ofset Matbaası, 1999.
  • Pitula CR, Cardell R. Suicidal inpatients’ experience of constant observation. Psychiatr Serv 1996; 47:649-651.
  • Cardell R, Pitula CR. Suicidal inpatients’ perceptions of therapeutic and nontherapeutic aspects of constant observation. Psychiatr Serv 1999; 50:1066-1070.
  • Younge O, Stewin LL. What psychiatric nurses say about constant care. Clinical Nurs Res 1992; 1:80-90.
  • Duffy D. Out of the shadows: a study of the special observation of suicidal psychiatric in-patients. J Adv Nurs 1995; 21:9449
  • Fletcher RF. The process of constant observation: perspectives of staff and suicidal patients. J Psychiatr Ment Health Nurs 1999; 6:9-14.
  • Thomas B. Supervising suicidal patients within a hospital setting. Br J Nurs 1995; 4:212-215.
  • Wilson J. Suicide prevention. Health Care Risk Report. 1997; 9:18-21.
  • Manna M. Effectiveness of formal observation in inpatient psychiatry in preventing adverse outcomes: the state of the science. J Psychiatr Ment Health Nurs 2010; 17:268-273.
  • Lehane M, Rees C. Alternatives to seclusion in psychiatric care. Br J Nurs 1996 ; 5:974-979.
  • Doğan S. Bir psikiyatri kliniğinde hemşire gözlem kayıtları ve yeni bir gözlem kayıt form geliştirilmesi. Turk Hemsire Derg 1988; 38:29-30.
  • Tün H, Oflaz F. Psikiyatri kliniğinde riskli hastalar (3. derece) için düzenlenen hemşire gözlem formlarının kapsam ve nicelik olarak incelenmesi. IV. Ulusal Psikiyatri Hemşireliği Kongre Özet Kitabı, Samsun, 2010; 75-76.
  • Tün H, Oflaz F, Bozkurt A. The examination of the observation forms for the risky patients in the psychiatry clinics comprehensively and quantitatively in terms of nursing problem areas. Eur Psychiatry 2011; 26 (suppl 1):1761.
  • Doğan S. Psikiyatri kliniklerinde hemşirelik gözlemleri. Turk Hemsire Derg 1988; 38:33-36. Selma Sabancıoğulları, Yrd.Doç.Dr., Cumhuriyet Üniversitesi Suşehri Sağlık Yüksek Okulu, Sivas; Arzu Anıl Açıl, Cumhuriyet Üniversitesi, Sivas; Saliha Hallaç, Arş. Gör. Dr., Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya Yazışma Adresi/Correspondence: Saliha Hallaç, Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya, Turkey. E-mail: saliha.alkan@gmail.com Yazar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no1/ Çevrimiçi yayım / Published online 01 Ağustos/August 01, 2013; doi: 10.5455/cap.20130706041217

Akut Psikiyatrik Bakımda Bir Profesyonel Kontrol Yöntemi: Hemşirelik Gözlemleri

Year 2014, Volume: 6 Issue: 1, 79 - 91, 06.11.2014
https://doi.org/10.5455/cap.20130706041217

Abstract

Gözlem, kimyasal ve fiziksel tespit, izolasyon gibi kontrol yöntemlerinin yerine kullanılan bir kontrol yöntemidir. Gözlem özellikle birçok ülkede psikiyatri kliniklerinde akt dönemdeki bakımda intihar ve saldırgan davranışları olan hastaların güvenliğini sağlamak için bir müdahale yöntemi olarak kullanılmaktadır. Özellikle psikiyatri kliniklerinde profesyonel bir kontrol yöntemi sağlayan hemşirelik gözlemlerinin kullanılması önemli bir konudur. Bu makalenin amacı akut psikiyatrik bakımda bir kontrol yöntemi olarak kullanılan gözlem hakkında literatür bilgisini gözden geçirerek, konu ile ilgili çalışma sayısının kısıtlı olduğu ülkemizde konunun önemine dikkat çekmektedir. Makalede akut psikiyatrik bakımda risk değerlendirme, karar verme, gözlem düzeyleri, gözlem uygulaması, gözlemin etik yönü ve yapılan çalışmaların sonuçları ele alınmıştır.

References

  • Langenbach M, Junaid O, Hodgson-Nwaefulu CM, Kennedy J, Moorhead SR, Ruiz P. Observation levels in acute psychiatric admissions. Eur Arch Psychiatry Clin Neurosci 1999; 249:28-33.
  • Phaneuf M. Psychiatric observation: a skill worth developing. http://www.infiressources.ca/fer/ Depotdocument_anglais/Psychiatric_observation_a_skill_worth_developing.pdf. (accessed at 19.05.2013)
  • Bowers L, Alexander J, Simsson A, Ryan C, Carl-Walker P. Cultures of psychiatric and the professional socialization process: the case of containment methods for disturbed patients. Nurse Educ Today 2004; 24: 435-42.
  • Bowers L, Simpson A. Observing and engaging. Mental Health Pract 2007; 10:12–14.
  • Reid W, Long A. The role of the nurse providing therapeutic care for the suicidal patient’s. J Adv Nurs 1993;18:1369-1376. Jones J, Jackson A. “Observation” Acute Mental Health Nursing. London, Sage Publications, 2004.
  • Tekkaş K, Bilgin H. Psikiyatri servislerinde kullanılan profesyonel kontrol yöntemleri: kullanım nedenleri, türleri, uluslararası uygulamalar ve algılamalar. Turk Psikiyatri Derg 2010; 21:235-242.
  • Sercan M, Bilici R. Türkiye’de bir ruh sağlığı bölge hastanesindeki hasta bağlama uygulamalarının değişkenleri. Turk Psikiyatri Derg 2009; 20:37-48.
  • Canadian Fedaration of Mental Health Nurses. Standart of Practice, Canadian Standards for Psychiatric- Mental Health Nursing, 3rd Edition 2006. http://cfmhn.ca/sites/cfmhn.ca/files/CFMHN%20standards%201.pdf. (accessed at 02.06.2013) American Nurses Association Psychiatric Mental Health Nursing Scope & Standards Draft Revision 2006. http://www.ispnpsych.org/docs/standards/scope-standards-draft.pdf (accessed at 02.06.2013)
  • Hewitt JL, Edwards SD. Moral perspectives on the prevention of suicide in mental health settings. J Psychiatr Ment Health Nurs 2006; 13:665-672.
  • Marangos-Frost S, Wells D. Psychiatric nurses’ thoughts and feelings about restraint use: a decision dilemma. J Adv Nurs 2000; 3:362-369.
  • Wallace B. Increased levels of observation in a mental health setting: challenge or chore? Advancing Practice in Bedfordshire 2012; 4:52-57.
  • Ray R, Perkins E, Meijer, B. The evolution of practice changes in the use of special observations. Arch Psychiat Nurs 2011; 25:90-100.
  • Bowers L, Park A. Special observation in the care of psychiatric inpatients: a literature review. Issues Ment Health Nurs 2001; 22:769-786.
  • Standing Nursing and Midwifery Advisory Committee (SNMAC). Department of Health Practice Guidance: Safe and Supportive Observation of Patients at Risk. Mental Health Nursing: Addressing Acute Concerns. London: The Stationery Office 1999. http://www.publications.doh.gov.uk/pub/docs/doh/snmacobs.pdf (accessed at 18.05.2013)
  • NHS Forth Valley .Mental health services psychiatric observations. http://www.nhsforthvalley.com /__documents/qi/CE_Guideline_MentalHealth/PsychiatricObservations.pdf (accessed at 18.05.2013).
  • CRAG/SCOTMEG (Working Group on Mental Illness). Nursing Observation of Acutely Ill Psychiatric Patients in Hospital: A Good Practice Statement. Edinburgh, The Scottish Office, 1995.
  • Stewart D, Bowers, Warburton FM. Constant special observation and self-harm on acute psychiatric wards: a longitudinal analysis. Gen Hosp Psychiatry 2009; 31:523–530.
  • Winship G. Further thoughts on the process of restraint. J Psychiatr Ment Health Nurs 2006; 13:55-60.
  • O’Brien L, Cole R. Close-observation areas in acute psychiatric units: a literature review. Int J Ment Health Nurs 2003; 12:165-176.
  • Cleary M, Jordan R, Horsfall J, Mazoudier P, Delaney J. Suicidal patients and special observation. J Psychiatr Ment Health Nurs 1999; 6:461-467.
  • Moore P, Berman K, Knight M, Devine J. Constant observation: implications for nursing practice. J Psychosoc Nurs 1995; 33:46-50.
  • Mackay I, Paterson B, Cassells C. Constant or special observations of inpatients presenting a risk of aggression or violence: nurses’ perceptions of the rules of engagement. J Psychiatr Ment Health Nurs 2005; 12:464-471.
  • O’Brien L, Cole R. Mental health nursing practice in acute psychiatric close-observation areas. Int J Ment Health Nurs 2004; 13:89-99.
  • Neilson P, Brennan W. The use of special observations: an audit within a psychiatric unit. Int J Ment Health Nurs 2001; 8:147-155.
  • Jones J, Lowe T, Ward M. Inpatients’ experiences of nursing observation on an acute psychiatric unit: a pilot study. Ment Health Care 2000; 4:125-129.
  • Jones J, Lowe T, Ward M, Wellman N, Hall J, Lowe T. Psychiatric inpatients’ experiences of nursing observation – a UK perspective. J Psychosoc Nurs Ment Health Serv 2000; 38:10-20.
  • Ashaye O, Ikkos G, Rigby E. Study of effects of constant observation of psychiatric in-patients. Psychiatr Bull 1997; 21:1451
  • Dodds P, Bowles N. Dismantling formal observation and refocusing nursing activity in acute inpatient psychiatry: a case study. J Psychiatr Ment Health Nurs 2001; 8:183-188.
  • Velioğlu P. Hemşirelikte Kavram ve Kuramlar. İstanbul, Alaş Ofset Matbaası, 1999.
  • Pitula CR, Cardell R. Suicidal inpatients’ experience of constant observation. Psychiatr Serv 1996; 47:649-651.
  • Cardell R, Pitula CR. Suicidal inpatients’ perceptions of therapeutic and nontherapeutic aspects of constant observation. Psychiatr Serv 1999; 50:1066-1070.
  • Younge O, Stewin LL. What psychiatric nurses say about constant care. Clinical Nurs Res 1992; 1:80-90.
  • Duffy D. Out of the shadows: a study of the special observation of suicidal psychiatric in-patients. J Adv Nurs 1995; 21:9449
  • Fletcher RF. The process of constant observation: perspectives of staff and suicidal patients. J Psychiatr Ment Health Nurs 1999; 6:9-14.
  • Thomas B. Supervising suicidal patients within a hospital setting. Br J Nurs 1995; 4:212-215.
  • Wilson J. Suicide prevention. Health Care Risk Report. 1997; 9:18-21.
  • Manna M. Effectiveness of formal observation in inpatient psychiatry in preventing adverse outcomes: the state of the science. J Psychiatr Ment Health Nurs 2010; 17:268-273.
  • Lehane M, Rees C. Alternatives to seclusion in psychiatric care. Br J Nurs 1996 ; 5:974-979.
  • Doğan S. Bir psikiyatri kliniğinde hemşire gözlem kayıtları ve yeni bir gözlem kayıt form geliştirilmesi. Turk Hemsire Derg 1988; 38:29-30.
  • Tün H, Oflaz F. Psikiyatri kliniğinde riskli hastalar (3. derece) için düzenlenen hemşire gözlem formlarının kapsam ve nicelik olarak incelenmesi. IV. Ulusal Psikiyatri Hemşireliği Kongre Özet Kitabı, Samsun, 2010; 75-76.
  • Tün H, Oflaz F, Bozkurt A. The examination of the observation forms for the risky patients in the psychiatry clinics comprehensively and quantitatively in terms of nursing problem areas. Eur Psychiatry 2011; 26 (suppl 1):1761.
  • Doğan S. Psikiyatri kliniklerinde hemşirelik gözlemleri. Turk Hemsire Derg 1988; 38:33-36. Selma Sabancıoğulları, Yrd.Doç.Dr., Cumhuriyet Üniversitesi Suşehri Sağlık Yüksek Okulu, Sivas; Arzu Anıl Açıl, Cumhuriyet Üniversitesi, Sivas; Saliha Hallaç, Arş. Gör. Dr., Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya Yazışma Adresi/Correspondence: Saliha Hallaç, Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya, Turkey. E-mail: saliha.alkan@gmail.com Yazar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no1/ Çevrimiçi yayım / Published online 01 Ağustos/August 01, 2013; doi: 10.5455/cap.20130706041217
There are 42 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Selma Sabancığulları This is me

Arzu Anıl Açıl This is me

Saliha Hallaç This is me

Publication Date November 6, 2014
Published in Issue Year 2014 Volume: 6 Issue: 1

Cite

AMA Sabancığulları S, Açıl AA, Hallaç S. Akut Psikiyatrik Bakımda Bir Profesyonel Kontrol Yöntemi: Hemşirelik Gözlemleri. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. March 2014;6(1):79-91. doi:10.5455/cap.20130706041217

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