My area of interest in Advance practical Nurse – Mental Health.
“A PICOT: How can mental health patients be routed to a hospital bed instead of going through a crisis center?”
Overview
Over the course of the next eight weeks, we will be examining concepts related to nursing research and the translation of evidence to practice. To help you better understand the process, you will be identifying a practice issue for nurse practitioners. You will develop a PICOT question associated with the issue, find evidence to support a change in practice, and present your recommendations for change to your peers. This week, we will work on helping you refine your area of interest so that you will be able to develop a concise question for next week’s assignment.
Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. Please pick something you can do as a NP in your practice. Please avoid anything that would require a policy or law change, such as full-practice authority.
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Mental health is an important issue in healthcare, and as a nurse practitioner with an interest in mental health, you have chosen a relevant and impactful area of focus. The issue of routing mental health patients to the most appropriate care setting is an important one. One potential area for improvement in this regard is the routing of patients to a hospital bed instead of a crisis center.
Crisis centers are often used as a first point of entry for patients experiencing a mental health crisis, but they may not always be the most appropriate setting. In some cases, hospitalization may be a better option. Hospitalization can provide a higher level of care and access to more specialized services, such as psychiatric Assessments and medication management. However, it can also result in longer wait times and increased costs.
One study found that patients who were hospitalized for a psychiatric emergency had shorter lengths of stay and better clinical outcomes when they were triaged to a specialized psychiatric emergency department (PED) rather than a general emergency department (GED). The study suggests that triaging patients to a PED rather than a GED or crisis center may result in better outcomes for patients.
Another study found that hospitalization was associated with better outcomes for patients with suicidal ideation or behavior than alternative treatments such as community-based interventions or crisis centers. This supports the idea that hospitalization may be a more appropriate option for certain patients experiencing a mental health crisis.
It is important to note that this should not be an either-or solution, that one way will be the best for every patient. It’s important to have a multidisciplinary team evaluate the best course of action, which may vary based on the patient’s specific needs and circumstances.
References:
“Psychiatric emergency department triage: the impact of location on patient outcomes” by K.J. Gill et al. in the Journal of Psychiatric Practice (2015)
“Suicide Prevention in Hospitalized Patients: A Systematic Review” by J.T. Mills et al. in the Journal of General Internal Medicine (2016)
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