Biomedical subjects

H Visalli

Publications and source records attributed to H Visalli.

4 recordsLinked to original sources

PubMed1997

Medication self-administration: an outcome-oriented, consumer-driven program.

The ability to understand medication and consistently follow a prescribed medical regimen varies among the general population. The Department of Nursing at Mohawk Valley Psychiatric Center developed a medication self-administration program to help consumers gain knowledge and/or improve their ability to participate in medication and symptoms management. Results have demonstrated that consumers can learn at least one more piece of information about their illness and/or medication despite their level of cognitive functioning, can learn to self-administer medications with minimal supervision before leaving the hospital, and can make an easier transition into the community setting.

Humans↗

PubMed1997

Reducing high-risk interventions for managing aggression in psychiatric settings.

Seclusion and restraints have traditionally been major interventions for controlling patient aggression. The implementation of less restrictive measures may or may not be an option in managing individual cases of psychiatric emergencies. Improvement in patients, knowledge of alternatives and the need to reduce the use of restraints have led to the development of new tools to enhance prevention of high-risk interventions. At one institution, an anger management assessment tool and "Triangle of Choices" have assisted patients in identifying and managing feelings of frustration and anger. Since their inception 1 year ago, the implementation of documented alternatives to restraints has increased, and use of most restrictive measures has decreased.

Aggression↗

PubMed1997

Striving toward a best practice model for a restraint-free environment.

Our aim at reducing seclusion and restraint started as a Department of Nursing quality indicator. The administration then made this program a hospital goal. Administrators and managers monitor this information daily and share it with various hospital quality improvement committees for review and subsequent practice changes. Although clinical settings may have slightly different definitions or approaches when addressing prevention, crisis intervention, and treatment, it is important to assess, reassess, and evaluate these patients at every step throughout the treatment process. We have found that the above interventions were successful in producing a major reduction in the use of restrictive interventions. The use of restraints does not help patients learn to manage their anger but only serves to control people and cause an immediate division between those seeking help and those who offer it. When patients are treated as people, with dignity and respect, they are less likely to become aggressive. As clinical settings strive to meet this challenge and eliminate the option of using these highly restrictive and sometimes punitive measures, ongoing administrative and clinical support in collaboration with patients, advocates, and others is essential. It is only through this means that traditional high-risk hands-on techniques will be replaced with new and innovative methods making the transition from ineffective outdated interventions to an effective best practice model.

Aggression↗

PubMed1997

Developing a best practice model for care of patients with polydipsia.

Some psychiatric patients diagnosed with schizophrenia have a secondary diagnosis of polydipsia which is manifested by consuming excessive quantities of fluids, marked confusion, and disorientation. In most instances, these persons are less amenable to treatment and rehabilitative interventions due to the changes in cognitive and physical processes. A review of our own current practice found that we had a small group of polydipsia patients requiring a large amount of one-to-one staff time for little or no long-term benefit. Further, there was no uniform approach to identify, treat, and monitor outcomes for patients with polydipsia. A TQM team was assembled with the goal of identifying a protocol for assessing the presence of polydipsia and a care map for the treatment of confirmed cases. The outcome was the development of a care map using diagnostic procedures and interventions found in the professional literature and empirical data collected on site. A short pilot study revealed that a number of polydipsia patients on Clozaril along with other interventions were successfully discharged from the hospital.

Antipsychotic Agents↗