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Specialist ServicesSecure Adolescent Inpatient
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Adolescent Psychiatric Intensive Care Units (PICU) provide short-term management of behavioural disturbance which cannot be contained within a General Adolescent Unit, including a High Dependency Area. Specific risk behaviours requiring admission to an Adolescent PICU include a serious risk of either suicide, absconding with a significant threat to safety, aggression or vulnerability, for example, due to agitation or sexual disinhibition. Levels of physical, relational and procedural security in Adolescent PICUs should be similar to those in Adolescent Low Secure Units (see below).
Data and how data is collected
Published in Jeremy Jolley, Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals, 2020
Qualitative research comes into its own when, basically, we don’t know what questions to ask and where a shared and meaningful communication with the research participant is not at all straightforward. Healthcare practitioners are often interested in the things that make their patients and clients psychologically uncomfortable. These things often exist as experiences that trouble the patient or client in some way. Consider, for example, the experience of having a child in the paediatric intensive care unit (PICU), or the experience of someone who is in grief or distress.
Continuity Model of Care
Published in Meidan Turel, Michael Siglag, Alexander Grinshpoon, Clinical Psychology in the Mental Health Inpatient Setting, 2019
Kim Griffiths, Hannah Green, Suzie Lemmey
Amy was a 23-year-old art graduate. In the last 2 years, she was admitted to a private hospital and had a three-month stay in an eating disorder unit, both of which she had absconded. Prior to transfer to our unit she had a 61 day stay in a psychiatric intensive care unit because of her high suicide risk and self-harming behavior. She was admitted under the UK’s Mental Health Act.
What Do We Do When Things Fall Apart? Rapid Creation of a Pilot Psychiatric Intensive Care Unit in Response to Increased Acuity on a Psychiatric Inpatient Unit for Children and Adolescents
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2021
Alysha D. Thompson, Ravi Ramasamy, Shannon Simmons, Kyrill Gurtovenko, Sarah Caufield, Tyler Sasser, Brittany Beauchamp, Maureen O’Brien
In this article, we describe the creation of a psychiatric intensive care unit (ICU) within a large child and adolescent IPU for the subset of patients who were not being effectively treated in the general milieu. These patients were continuing to demonstrate unsafe behaviors, including self-injury, aggression toward staff and peers, and property destruction, and were disengaged in milieu programming. Our goal was twofold: to improve functioning of the entire IPU (improving safety metrics across the board) and to provide better care for this subset of patients, who largely presented with suicidal behavior, aggression, and a trauma history. They had many features identified above as being associated with higher S/R use. The ICU program’s foundation combined DBT, an incentive-based behavioral management program, and a focus on building community, to increase these youth’s distress tolerance, emotion regulation, and interpersonal communication skills, utilization of safe behaviors, and sense of belonging and pride. We examined the program’s impact on the use of restraints, adverse patient safety events (aggression, self-injury, property destruction), and staff injuries. We also examined impact on readmissions and emergency department (ED) visits post-discharge, as well as staffing costs and consumer satisfaction. We hypothesized that these metrics would decrease with use of the ICU, and that general milieu restraints would also decrease as ICU patients were physically segregated.
Rediscovery of penicillin of psychiatry: haloperidol decanoate
Published in Psychiatry and Clinical Psychopharmacology, 2019
Nazan Aydın, Hasan Mervan Aytaç, Esra Yazıcı, Doğan Yılmaz, Pınar Çetinay Aydın, Gökşen Yüksel Yalçın, Yücel Kadıoğlu, Cana Canbay, Merve Terzioğlu, Onur Şenol, Cavide Çakmak, Aysel Özer
The study population consisted of schizophrenic patients who were admitted to a major mental health care facility (the Prof. Dr. Mazhar Osman Mental Health and Neurological Disorders Hospital). Male and female patients undergoing inpatient treatment in segregated male and female (one male and one female) patient wards for acute psychiatric disorders were included. Patients with mental retardation, alcohol substance use for the last 3 months, relevant organic pathology were excluded. The departments in which the patients were hospitalized function as psychiatric intensive care units (PICU), which are specialized, high-security wards with high staffing levels. The patients in PICUs are acute and severely symptomatically challenging with low treatment adherence and poor responsiveness to therapy. Rapid tranquilization is required for most patients during the acute management phase.
Gross Motor Development of Children with Congenital Heart Disease Receiving Early Systematic Surveillance and Individualized Intervention: Brief Report
Published in Developmental Neurorehabilitation, 2021
Solène Fourdain, Marie-Noëlle Simard, Lynn Dagenais, Manuela Materassi, Amélie Doussau, Justine Goulet, Karine Gagnon, Joëlle Prud’Homme, Marie-Claude Vinay, Mathieu Dehaes, Ala Birca, Nancy C. Poirier, Lionel Carmant, Anne Gallagher
Fifteen children were excluded due to incomplete neurodevelopmental assessments at either 12 or 24 months of age. For six children, data regarding the use of physical therapy between 4 and 8 months were unavailable. Therefore, a total of twenty-nine (N = 29) infants were included in this retrospective study: six (n = 6) infants in the no-intervention group, thirteen (n = 13) in the occasional intervention group, and ten (n = 10) in the regular intervention group. Perinatal, surgical, critical, and demographic characteristics of the cohort are presented in Table 1. The most common heart defects were transposition of the great arteries, coarctation of the aorta, ventricular septal defect, and double outlet right ventricle. The most represented anatomic CHD categories were classes I and II, that is, two-ventricle hearts without arch obstruction (72.4%) and two-ventricle hearts with arch obstruction (20.7%). Surgical risk categories 2, 3, and 4 were represented in 10 (34.5%), 13 (44.8%), and 6 (20.7%) cases, respectively. The median age at cardiac repair was 9.5 days (IQR: 6–23). Twenty (68.9%) infants required both cardiopulmonary bypass (CPB) and cross-clamp (CC) during heart surgery, six (20.7%) only CC, two (6.9%) did not require any mechanical support, and one (3.5%) had missing data. Median pediatric intensive care unit (PICU) and hospital length stays were 5 and 19 days (IQR: 4–11.50 and IQR: 10–26). There were no differences in gestational age, birth weight, age at cardiac repair, duration of CPB or CC during cardiac surgery, anatomic CHD classification, surgical risk category, PICU, and hospital length stay between groups. Infants of the no-intervention group had a lower Apgar score at 5 min (P = .040 with the occasional intervention group and P = .010 with the regular intervention group).