The administration of PRN medication by mental health nurses is an important, yet poorly explored aspect of psychiatric inpatient care. An examination of nurses' reasons for administering PRN medication is essential in ensuring its appropriate and effective use. Data were gathered from the drug charts of 44 inpatients on two acute psychiatric wards. Most PRN medication was given orally and the most frequently administered drugs were procyclidine, lorazepam, ibuprofen, diazepam and droperidol. The main reason for administering PRN medication was because patients had 'requested' it. Results were broadly consistent with previous research. It is recommended that nurses should give clear and specific reasons for administering PRN medication based on a valid assessment. Implications for clinical practice and further research are also discussed.
Every year thousands of returning military, state, and local police officers and civilians of every description suffer from the intrusive symptoms of posttraumatic stress disorder (PTSD). Current treatments rooted largely in extinction protocols require extensive commitments of time and money and are often ineffective. This study reviews several theories of PTSD and two important mechanisms that explain when treatment does and doesn't work: extinction and reconsolidation. It then reviews the research about and suggests an explanatory mechanism for the visual-kinesthetic dissociation protocol (V/ KD), also known as the rewind technique. The technique is notable for its lack of discomfort to the client, the possibility of being executed as a content-free intervention, its speed of operation, and its long-term, if largely anecdotal, efficacy. A case study, specific diagnostics for extinction, and reconsolidative mechanisms and suggestions for future research are provided.
RTM shows promise as a brief, cost-effective intervention for PTSD characterized primarily by intrusive symptoms. Clinical or methodological significance of this article: The article provides evidence to support a fast (5 hours or fewer) robust intervention for PTSD characterized by intrusive symptoms including current-month flashbacks, nightmares, and accompanied by sympathetic arousal in response to trauma narratives. The intervention is well tolerated and has demonstrated efficacy up to one year.
The use of nurses' holding power is a poorly explored aspect of psychiatric inpatient care. This study examined the use of Section 5(4) at the Maudsley Hospital, London, since the introduction of the 1983 Mental Health Act. Between 1983 and 1996 nurses' holding powers were used on 25 occasions. Seventy two per cent of patients detained under Section 5(4) of the Mental Health Act 1983 were subsequently detained under Section 5(2). Results were broadly consistent with previous studies, although some significant inconsistencies were observed which can probably be attributed to small sample sizes. Further, multicentre research is needed in order that substantive conclusions can be drawn.
Background Current guidance suggests that we should monitor the physical health of people with serious mental illness and there has been a significant financial investment over recent years to provide this. Objectives To assess the effectiveness of physical health monitoring as a means of reducing morbidity, mortality and reduction in quality of life in people with serious mental illness. Search methods We searched the Cochrane Schizophrenia Group Trials Register (October 2009) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. We updated this search October 2012 and added 61 new trials to the awaiting assessment section. Selection criteria All randomised or quasi-randomised clinical trials focusing on physical health monitoring versus standard care or comparing i) self monitoring vs monitoring by health care professional; ii) simple vs complex monitoring; iii) specific vs non-specific checks iv) once only vs regular checks or v) comparison of different guidance. Data collection and analysis The authors (GT, AC, SM) independently screened search results and identified three studies as possibly fulfilling the review's criteria. On examination, however, all three were subsequently excluded. Main results We did not identify any randomised trials which assessed the effectiveness of physical health monitoring in people with serious mental illness.
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