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