Psychiatric Mental Health Nursing in Acute Care Settings: Inpatient Care

1. Chapter 4 Psychiatric Mental Health Nursing in Acute Care Settings

2. Inpatient Psychiatric Care • Admissions reserved for • Suicidal • Homicidal or • Extremely disabled in need of short-term acute care

3. Funding Psychiatric Mental Health Care • Private pay insurance • Managed care plans • Health maintenance organizations (HMOs) • Preferred provider organizations (PPOs) • Managed behavioral health care organizations (MBHOs) • Medicaid • Medicare

4. Mental Health Funding Legislation • Paul Wellstone and Peter Domenici Mental Health and Addiction Equity Act of 2008 • Restricts insurance companies from requiring higher co-payments or higher deductibles for mental health or substance abuse

5. Uninsured Patients • Medicare • Medicaid • Social Security • Social Security Disability Income (SSDI) • Supplemental Security Income (SSI) • Veterans Administration

6. Inpatient Psychiatric Care • Admission options • Direct admission • Hospital emergency department • Criteria to justify admissions • Danger to self or others or unable to care for basic needs • Voluntary or involuntary

7. Patient Rights • Hospitalized patients retain their rights as citizens • Obligation to balance patient's needs for safety with patient's rights as a citizen • Mental health facilities have written statements of patient's rights and applicable state laws

8. Multidisciplinary Treatment Team • Meet within 72 hours of patient's admission • Multidisciplinary treatment plan or clinical pathway is guideline for patient’s care during hospital stay

9. Nursing Care • Admission assessment • Ensuring safety • Physical health assessment • Milieu management

10. Nursing CareContinued • Structured group activities • Documentation • Medication administration • Medication adherence

11. Nursing CareContinued • Pain management • Crisis management • Medical crises • Behavioral crises • Preparation for discharge to community