Using the Nursing Interventions Classification to identify nursing interventions in free‐text nursing documentation in adult psychiatric outpatient care setting

Delirium superimposed on dementia in post-acute care: Nurse documentation of symptoms and interventions

Delirium superimposed on dementia (DSD) is common in older adults being discharged to post-acute care settings (PAC). Nurse documentation remains poorly understood. Aims were to describe nurse documentation and to determine associations in a secondary data analysis of a large, single-blinded randomized controlled trial (Recreational Stimulation For Elders As A Vehicle To Resolve DSD (Reserve For DSD). Just under 75% of the sample had at least one symptom of delirium documented by the nursing staff, while 25.9% had none despite being CAM positive by expert adjudication. Only 32% had an intervention documented. Number of documented interventions were significantly associated with number of documented symptoms. There is a need for research and innovation related to nurse documentation and communication of DSD symptoms and interventions in an efficient and accurate manner to impact care for vulnerable older adults in these settings.

What are dually diagnosed patients' problems represented to be in mental health? A WPR analysis of the multistability purpose of digital health records

No previous studies have investigated how political measures, opinions and views of people with dual diagnoses, organisational requirements and professional values are purposefully communicated, mediated and/or integrated in digital records in mental health care. It remains unclear how health records function as both clinical vehicles for documentation, audit and quality assurance in patient care as well as political vehicles of power to articulate and reproduce idealised relations among actors and their roles in mental health. Informed by Bacchi's 'What's the problem represented to be' (WPR) approach, we consider how problems of dually diagnosed persons with co-occurring mental health conditions and drug use (DDPs) are represented and how the tools required to fix the patients' problems are communicated and legitimised in 10 digital health records consisting of 3830 pages of data. In the discussion, we distinguish their multiple purposes by discussing how their structure is shaped by broader discourses in health care. Then, we consider how the structure of records delineates professionals' autonomy, discretionary action and service provision in ways that limit possibilities for including mental health patients' experiences and exclude service users' voices from care planning.

The Core Nursing Interventions in Adult Psychiatric Outpatient Care Identified by Nurses, a Delphi Study

PURPOSE

To define the core nursing interventions identified by nurses in the adult psychiatric outpatient care setting.

METHODS

A two-round Delphi study. The panel consisted of nurses and nurse managers.

FINDINGS

Nurses identified 53 core interventions, 50 of which are described in the Nursing Interventions Classification (NIC). Altogether, two thirds of these interventions were in the NIC domain 'Behavioral' and the emphasis was on NIC classes 'Coping Assistance' and 'Behavior Therapy,' suggesting that nurses define providing psychosocial support as the core in their work.

CONCLUSIONS

The findings indicate that the main role of nurses in the psychiatric outpatient care is to deliver psychosocial care for their patients. The lack of family interventions among the core interventions and the need to add the missing three interventions into the classification need more research in the future.

IMPLICATIONS FOR NURSING PRACTICE

This study helps to define nurses' role in the psychiatric outpatient care. The findings can be used in developing nursing education programs.