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Nurse Managed Center: Psychiatric-Mental Health Nursing Practica Nurs 147A

Nurse Managed Center: Psychiatric-Mental Health Nursing Practica Nurs 147A. Dr. Connolly Dr. Mao Mr. Crider Mrs. Judith Berkley. Student & Client Population. Population Served Widely diverse in cultural, and ethnic background

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Nurse Managed Center: Psychiatric-Mental Health Nursing Practica Nurs 147A

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  1. Nurse Managed Center:Psychiatric-Mental Health Nursing Practica Nurs 147A Dr. Connolly Dr. Mao Mr. Crider Mrs. Judith Berkley

  2. Student & Client Population Population Served • Widely diverse in cultural, and ethnic background • typically 60 (MH) 90 students in CH course in clinical groups of 10 students per section -

  3. Type of Clinical Rotation: Service Learning • Nursing 147B-Practicum • First Semester of Senior Year • Community Health Experience • Home Visits & Community Agencies • Most students have prior home care experience and had at least one lecture on the Omaha system • Nursing 147A-Practicum IV • Community Psych/Mental Health Experience • Nurse Managed Center, Community

  4. Structure • History – background and evolution • Settings • Zoe House, 1993 • Crossroads, 1994 San Jose, Morgan Hill, San Jose • Casa Feliz, 1995, closed f05 • Litteral House, 2003 • Donna’s Day Program, 2005 • John 23rd, 2005 • Staff – Faculty & Students

  5. Process • Course objectives • Service learning • Faculty as staff; role models for students • Documentation • Omaha System

  6. Outcome • Direct service to the clients • Identification of health problems – Validity issue • Implementation of interventions • Targets selection – inter-rater reliability • Evaluation of final outcomes – K, B, S. • Others • Collaboration – bake sale, health education, staff education, • Advocacy – improvement of physical care, identification of medical disorders, improved nutrition, exercise, and symptom management

  7. Outcome Student Evaluation Tool, NURS 147A Scope & Standards of Psychiatric-Mental Health Nursing Practice (APNA, ISPN, ANA, 2000) • Standard V. Interventions are documented in a format that is related to patient outcomes, accessible to the interdisciplinary team, and retrievable for future data analysis and research

  8. Omaha Rating Scale

  9. Knowledge 2 Behavior 2 Status 2 Knowledge 3 Behavior 3 Status 3 CCF # 9075, Problem 42,Medication Regimen, Fall 98 Initial Rating Final Rating

  10. Knowledge: 4 Behavior: 1 Status: 1 Knowledge: 4 Behavior: 2 Status: 2 CCF #9523, Problem 35, Nutrition, Fall 2000 Initial Rating Final Rating

  11. Rating Change of the Problem-Personal Hygiene S 2002 N = 20

  12. Rating Change of the Problem –Nutrition S 2002 N = 20

  13. Fall 2001 N = 47T-Test for Pre and Post Rating Intervention top 3 Omaha Problems

  14. Most Frequently Identified Omaha Problems, Interventions and Targets (Spring, 2005 N=85) HTGC = Health Teaching Guidance/Counseling SUR = Surveillance

  15. Results of Paired t-testOutcome Ratings, K, B, S Spring 2005 N= 85 * statistical significance p ≤ .05

  16. Student Outcomes • Experience with measuring client outcomes • Recognizing change in persons with chronic health problems • Experience applying Omaha System to diverse populations • Data available for graduate student projects • Barrera, C., Machanga, M., Connolly, P. M., & Yoder, M. (2003). Nursing care makes a difference: Application of the Omaha documentation system. Outcomes Management, 7 (4), 181 – 185. • Improved nursing care • Better prepared for job market

  17. Challenges & Opportunities • Training • Maintaining System in NMCs • Faculty changes • Resources for data collection, analysis & reporting • Involving more faculty • Sustaining high levels of resilience

  18. Challenges and Issues (Continued) • Lack of university support • Staff turnover • Client hospitalizations • Communications • Cutbacks in county funding • Obtaining permission to provide services from conservators and case managers • HIPPA regulations • Conflicts with OT clinic schedule

  19. Faculty Outcomes • Improved teaching effectiveness • Redesigning the learning paradigm • Publications & presentations • Case Study on-line • Improved student evaluations • Meeting retention, tenure and promotion expectations • Better supervision of students • Collaboration opportunities • Participation in research • Submission of grants

  20. Summary • Link the use of the Omaha System to program outcomes and accrediting bodies’ standards • Identify course (s) for teaching the System • Develop teaching strategies: Modules; Omaha System website: case studies; Videos; Webcasting • Involve faculty: Research; Presentations & Publications; Report data results back to faculty; Mentor new faculty • “It’s a good thing,” Martha Stewart

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