The main aims of this action research study were to implement primary nursing in two long-term psychiatric rehabilitation/continuing-care wards and to investigate the effects of the intervention of the quality of nursing care provision. This evaluation took the form of a quasi-experimental time series analysis. A package of measures together with a number of peripheral indicators was used before primary nursing was introduced on each ward and again after primary nursing had become established. The results showed that the implementation of primary nursing led to nurses being more accountable for care, resident who were seen to be more self-sufficient and independent and wards which had an improved environment for care and rehabilitation.
Long-stay psychiatric in-patients in South Glamorgan were reviewed using the MRC Needs for Care assessment. The majority were middle aged or elderly and were severely disabled, with problems encompassing symptoms/behavioural difficulties, social skills, and physical health. In most, long-standing psychiatric illness was compounded by physical illness and cognitive deficits as age advanced, producing care needs that were greater than existing community services could meet.
Service response to problems in 20 clinical and social competence areas was assessed in 156 long-stay in-patients, using the Needs for Care Assessment (NFC). Although there were few unmet needs for treatment, over 200 instances of unmet needs for the assessment of social skills were found, and reasons for this are discussed, as is the importance of social-skills assessment in this group. In around a third of the sample most of the social-skill areas in the NFC were not applicable.
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