2.50
Hdl Handle:
http://hdl.handle.net/10755/166391
Category:
Abstract
Type:
Presentation
Title:
Evening Activities in the Inpatient Psychiatric Unit
Author(s):
Sterling, Elizabeth; Libby, Donna; Nadeau, Kathy
Author Details:
Elizabeth Sterling, RN, BSN at the Maine Medical Center, Portland, ME, email: sterle@mmc.org; Donna Libby, RN, MSN; Kathy Nadeau, RN, MSN, CNS
Abstract:
HEALTHCARE ORGANIZATION DESCRIPTION: Maine Medical Center (MMC) is a nonprofit, private corporation governed by volunteer trustees from the communities we serve. MMC serves as a community hospital for the people of greater Portland, Maine, and is the premier tertiary care center for northern New England. The hospital has 606 licensed beds and provides comprehensive inpatient services in all medical specialties. BACKGROUND OF PRACTICE INNOVATION: It was identified through survey and anecdotal evidence that the lack of evening recreational activities on P6 (inpatient psychiatric unit) was leading to staff and patient boredom, lack of stimulation, decreased social interaction, and (potentially) delayed rehabilitation of patients. Symptoms of dementia and problematic behaviors - confusion, disorientation, withdrawal, decreased physical conditioning, communication problems, agitation/wandering, sleep disruptions - were seen to be exacerbated by this lack of evening programming. Patients were often put to bed because of a lack of "something to do" and bedtime sleep medications were being administered earlier and earlier. Attendant reawakening in the night and re-medication with PRNs (anxiolytics, antipsychotics) for sleep or agitation were believed to be causing increased confusion, potential for falls, daytime sleepiness, and overuse of restraint for safety. In addition, bored inactive patients with nothing to do were thought to be more likely to become anxious or agitated, eliciting PRNs to calm them, and causing increased confusion, sedation, orthostatic hypotension, and increased risk of falls. Although daytime programming had been adjusted to address the increasing number of geriatric psychiatry clients, evening programming had not. A team of RNs, geriatric specialists, activities experts, OTs, CNAs, and social workers worked together to create a pilot evening recreational therapy program to address these clients' needs. PRACTICE INNOVATION PURPOSE: To determine if the development and implementation of an evening activities program on a Geriatric Psychiatry unit would decrease the use of sleep medication and antipsychotic medication use among patients and thereby prevent early bedtimes, falls, behavior issues, and patient, family, and staff satisfaction? PRACTICE INNOVATION OBJECTIVES: Through the establishment of a program of daily one-hour evening activities, we hoped to: (a) reduce the use of anxiolytics, antipsychotics, and hypnotics between the hours of 1800 and 0600; (b) reduce the number of falls noted between the hours of 1800 and 0600; (c) reduce the use of restraint between the hours of 1800 and 0600; and (d) increase staff, patient, and family satisfaction with care provided on P6. PRACTICE INNOVATION IMPLEMENTATION: (1) Literature review and consultation with experts at MMC and local agencies and institutions. (2) Proposal made to management on P6 for pilot program. (3) Support elicited from P6 staff for program execution on a daily and long-term basis. (4) Training sessions instituted (RNs, CNAs). (5) Pilot program instituted-- over 200 documented activities groups done. (6) Post-pilot survey conducted and evaluated. (7) Continuing support elicited from management to continue program. PRACTICE INNOVATION OUTCOMES: Outcomes of focus are (a) patient and staff satisfaction and (b) patient safety & family-centered care. A monthly calendar of recommended events has been compiled and the needed supplies for the activities are on hand on the unit. We welcome guests for musical activities and pet therapy. CONCLUSIONS: The benefits of active recreation are well-documented. Anecdotal evidence indicates that the pilot program has addressed many of these goals: (1) Increased patient, family, and staff satisfaction with care given on P6. (2) Increased communication, establishment of new relationships, and new learning. (3) Increased self-expression and reminiscence. (4) Increased exercise and fun. (5) More regular sleep patterns. (6) Engagement of patients to prevent boredom, agitation and wandering. (7) Improved mood and overall wellness. Continuation plans include: (1) Follow-up survey of staff after one year of pilot program. (2) Continuous monitoring of patient and family satisfaction with program through. (3) Rigorous evaluation of effectiveness of evening groups in decreasing use of PRNs, falls, and posey use (chart review process). (4) Training of staff in group process and details of program. (5) Continued involvement of social work, nursing, OTs and CNAs in program development. (6) Establishment of funding for program including materials and staff support.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
ANCC Magnet Practice Innovations
Conference Host:
American Nurses Credentialing Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEvening Activities in the Inpatient Psychiatric Uniten_GB
dc.contributor.authorSterling, Elizabethen_US
dc.contributor.authorLibby, Donnaen_US
dc.contributor.authorNadeau, Kathyen_US
dc.author.detailsElizabeth Sterling, RN, BSN at the Maine Medical Center, Portland, ME, email: sterle@mmc.org; Donna Libby, RN, MSN; Kathy Nadeau, RN, MSN, CNSen_US
dc.identifier.urihttp://hdl.handle.net/10755/166391-
dc.description.abstractHEALTHCARE ORGANIZATION DESCRIPTION: Maine Medical Center (MMC) is a nonprofit, private corporation governed by volunteer trustees from the communities we serve. MMC serves as a community hospital for the people of greater Portland, Maine, and is the premier tertiary care center for northern New England. The hospital has 606 licensed beds and provides comprehensive inpatient services in all medical specialties. BACKGROUND OF PRACTICE INNOVATION: It was identified through survey and anecdotal evidence that the lack of evening recreational activities on P6 (inpatient psychiatric unit) was leading to staff and patient boredom, lack of stimulation, decreased social interaction, and (potentially) delayed rehabilitation of patients. Symptoms of dementia and problematic behaviors - confusion, disorientation, withdrawal, decreased physical conditioning, communication problems, agitation/wandering, sleep disruptions - were seen to be exacerbated by this lack of evening programming. Patients were often put to bed because of a lack of "something to do" and bedtime sleep medications were being administered earlier and earlier. Attendant reawakening in the night and re-medication with PRNs (anxiolytics, antipsychotics) for sleep or agitation were believed to be causing increased confusion, potential for falls, daytime sleepiness, and overuse of restraint for safety. In addition, bored inactive patients with nothing to do were thought to be more likely to become anxious or agitated, eliciting PRNs to calm them, and causing increased confusion, sedation, orthostatic hypotension, and increased risk of falls. Although daytime programming had been adjusted to address the increasing number of geriatric psychiatry clients, evening programming had not. A team of RNs, geriatric specialists, activities experts, OTs, CNAs, and social workers worked together to create a pilot evening recreational therapy program to address these clients' needs. PRACTICE INNOVATION PURPOSE: To determine if the development and implementation of an evening activities program on a Geriatric Psychiatry unit would decrease the use of sleep medication and antipsychotic medication use among patients and thereby prevent early bedtimes, falls, behavior issues, and patient, family, and staff satisfaction? PRACTICE INNOVATION OBJECTIVES: Through the establishment of a program of daily one-hour evening activities, we hoped to: (a) reduce the use of anxiolytics, antipsychotics, and hypnotics between the hours of 1800 and 0600; (b) reduce the number of falls noted between the hours of 1800 and 0600; (c) reduce the use of restraint between the hours of 1800 and 0600; and (d) increase staff, patient, and family satisfaction with care provided on P6. PRACTICE INNOVATION IMPLEMENTATION: (1) Literature review and consultation with experts at MMC and local agencies and institutions. (2) Proposal made to management on P6 for pilot program. (3) Support elicited from P6 staff for program execution on a daily and long-term basis. (4) Training sessions instituted (RNs, CNAs). (5) Pilot program instituted-- over 200 documented activities groups done. (6) Post-pilot survey conducted and evaluated. (7) Continuing support elicited from management to continue program. PRACTICE INNOVATION OUTCOMES: Outcomes of focus are (a) patient and staff satisfaction and (b) patient safety & family-centered care. A monthly calendar of recommended events has been compiled and the needed supplies for the activities are on hand on the unit. We welcome guests for musical activities and pet therapy. CONCLUSIONS: The benefits of active recreation are well-documented. Anecdotal evidence indicates that the pilot program has addressed many of these goals: (1) Increased patient, family, and staff satisfaction with care given on P6. (2) Increased communication, establishment of new relationships, and new learning. (3) Increased self-expression and reminiscence. (4) Increased exercise and fun. (5) More regular sleep patterns. (6) Engagement of patients to prevent boredom, agitation and wandering. (7) Improved mood and overall wellness. Continuation plans include: (1) Follow-up survey of staff after one year of pilot program. (2) Continuous monitoring of patient and family satisfaction with program through. (3) Rigorous evaluation of effectiveness of evening groups in decreasing use of PRNs, falls, and posey use (chart review process). (4) Training of staff in group process and details of program. (5) Continued involvement of social work, nursing, OTs and CNAs in program development. (6) Establishment of funding for program including materials and staff support.en_GB
dc.date.available2011-10-27T15:32:40Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T15:32:40Z-
dc.conference.date2008en_US
dc.conference.nameANCC Magnet Practice Innovationsen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.-
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