精神科重症监护病房感官室的实施:一项混合方法研究

IF 3.3 2区 医学 Q1 NURSING
Suzanne Dawson, Amy Hawke, Lemma Bulto, Patricia Whitelaw, Ngoni Jeranyama, Justin Newton Scanlan
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引用次数: 0

摘要

感官室为住院精神病患者提供了一个安全的空间,以自我管理痛苦和躁动,并可能减少限制性做法的使用。然而,感官室通常是不可用的,而且关于支持实施的策略的知识有限。本研究探讨了急性精神病重症监护病房(PICU)感官室的消费者和临床医生的体验,并检查了其对限制性实践使用(隔离和PRN药物)的影响。采用混合方法对消费者和临床医生的访谈进行分析,并定期收集有关限制性实践使用的数据。通过对理论领域框架(TDF)和COM-B的演绎分析,从定性数据中生成主题,以了解使用的障碍和促进因素。计算三个2个月期间PRN使用率和隔离率:在实施房间之前和实施后的两个时间点。突出的障碍是由于环境背景(房间位置)和资源(人员配备)导致使用房间的机会有限。引导者聚集在消费者和员工使用房间的动机周围。随着时间的推移,PRN的使用没有显著变化,虽然隔离使用的数量有所减少,但这没有达到统计学意义。总之,感官室受到消费者和大多数工作人员的重视,并被认为在PICU通常混乱和复杂的治疗环境中提供了一个安全的治疗空间。讨论了成功实施的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Implementation of a Sensory Room in a Psychiatric Intensive Care Unit: A Mixed-Methods Study

Implementation of a Sensory Room in a Psychiatric Intensive Care Unit: A Mixed-Methods Study

Sensory rooms provide a safe space for consumers in inpatient psychiatric settings to self-manage distress and agitation and potentially reduce the use of restrictive practices. However, sensory rooms are often not available, and there is limited knowledge about strategies that support the implementation. This study explored consumer and clinician experiences of a sensory room in an acute psychiatric intensive care unit (PICU) and examined its impacts on restrictive practice use (seclusion and Pro re nata [PRN] medication). A mixed-methods approach was employed in the analysis of interviews with consumers and clinicians and routinely collected data pertaining to restrictive practice use. Themes were generated from the qualitative data through deductive analysis against the Theoretical Domain Framework (TDF) and COM-B to understand the barriers and facilitators to use. Rates of PRN use and seclusion were calculated for three 2-month periods: prior to the implementation of the room and two time points following implementation. Prominent barriers related to limited opportunity to use the room due to the environmental context (room location) and resources (staffing). Facilitators were clustered around consumer and staff motivation to use the room. There were no significant changes in PRN use over time, and while there was a numeric decrease in the use of seclusion, this did not reach statistical significance. In summary, sensory rooms were valued by consumers and most staff and were considered to provide a safe therapeutic space within the often chaotic and complex treatment environment of a PICU. Strategies for successful implementation are discussed.

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来源期刊
CiteScore
7.60
自引率
8.90%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The International Journal of Mental Health Nursing is the official journal of the Australian College of Mental Health Nurses Inc. It is a fully refereed journal that examines current trends and developments in mental health practice and research. The International Journal of Mental Health Nursing provides a forum for the exchange of ideas on all issues of relevance to mental health nursing. The Journal informs you of developments in mental health nursing practice and research, directions in education and training, professional issues, management approaches, policy development, ethical questions, theoretical inquiry, and clinical issues. The Journal publishes feature articles, review articles, clinical notes, research notes and book reviews. Contributions on any aspect of mental health nursing are welcomed. Statements and opinions expressed in the journal reflect the views of the authors and are not necessarily endorsed by the Australian College of Mental Health Nurses Inc.
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