A study to assess the knowledge regarding nursing management of psychiatric emergencies among staff nurses of selected hospitals at Kolhapur.

INTRODUCTION

Emergency psychiatry is the clinical application of psychiatry in emergency settings. Conditions requiring psychiatric interventions may include suicide, substance abuse, depression, psychosis, violence or other rapid changes in behavior. Psychiatric emergency services are rendered by professionals in the fields of medicine, nursing, psychology and social work. The demand for emergency psychiatric services has rapidly increased throughout the world since the 1960s, especially in urban areas. Care for patients in situations involving emergency psychiatry is complex.

The place where emergency psychiatric services are delivered are most commonly referred to as Psychiatric Emergency Services, Psychiatric Emergency Care Centers, or comprehensive Psychiatric Emergency Programs. Mental health professionals from wide area of disciplines, including medicine, nursing, psychology, and social work work in these settings alongside psychiatrists and emergency physicians. The facilities, sometimes housed in a psychiatric hospital, psychiatric ward, or emergency room, provide immediate treatment to both voluntary and involuntary patients 24 hours a day, 7 days a week. Within a protected environment, psychiatric emergency services exist to provide brief stay of two or three days to gain a diagnostic clarity, find appropriate alternatives to psychiatric hospitalization for the patient, and to treat those patients whose symptoms can be improved within that brief period of time.¹

In India it has been estimated that, approximately one third of the person are suffering not from physical but primarily from psychological illness. Identification and handling of the emotional, behavioral and developmental disorders problems of the adolescents is very essential for any health care workers including nurses.²

The incidence rate of psychiatry emergencies such as suicide in India was 11.2 per 100,000 in 2002. Suicide rates in Army, Air Force and Naval personnel were 0.04, 0.011 and 0.12 per thousand respectively. Rates are higher in urban than in rural settings. Depression accounts for nearly half the number of patients committing suicide followed by alcohol abuse (34%) and Schizophrenia (13%).³

Parental recognition of Psychiatry Emergencies and its management services is an area of concern for nursing staff working with Psychiatric emergency patients and it’s important to know particularly the guide lines that influence the clinical thinking of Psychiatric emergencies and its management among staff nurses. Although the desire intention of such a setting are to stabilize and provide a safe disposition, the proper clinical teaching offers an opportunity for a therapeutic process on the way to achieving these goals. The psychiatric emergency service is fast – paced, interpersonal, interpersonal interviewing and supportive therapy skills are critical in such an environment. The current study aims to broaden the knowledge regarding psychiatric emergencies and its management among staff nurses working in selected hospitals.

OBJECTIVES:

To assess knowledge regarding nursing management of psychiatric emergencies among staff nurses of selected hospitals at Kolhapur.

MATERIALS AND METHODS:

This study includes quantitative approach with non experimental, descriptive research design. Samples were selected by non probability, purposive sampling technique. The present study consisted of 60 staff nurses working at D. Y. Patil Hospital, Kolhapur. Structured knowledge questionnaire was used for data collection. Data was scheduled on 19/5/2016. The collected data was analyzed using descriptive statistics. Inclusive criteria of the study were staff nurses who were willing to participate in the study, registered staff nurses working in D.Y.Patil hospital Kadamwadi, Kolhapur. The researcher excluded Staff nurses who are not available at the time of data collection & who are at administration level.

RESULTS:

Section 1:

DISCUSSION:

The findings of this study are supported by Mavrogiorgou P, Brüne M, Juckel G’s study on management of psychiatric emergencies.Showed that the frequency of psychiatric emergencies in non-psychiatric settings, such as general hospitals and doctors' offices, and their treatment are poorly documented by the few controlled studies and sparse reliable data that are now available. The existing evidence suggests that the diagnosis and treatment of psychiatric emergencies need improvement. The treatment of such cases places high demands on the physician's personality and conduct, aside from requiring relevant medical expertise.

IMPLICATIONS:

Nursing Practice:

Constant updating and growth are essential to keep abreast of scientific and technological change within the nursing profession. In-service education programs are designed to upgrade the knowledge of employees. The findings of the study could be utilized as basis for orientation programs and in-service education of the nurses so that constant awareness and clear understanding may be created regarding nursing management of psychiatric emergencies. This will increase the knowledge of staff and student nurses regarding Nursing Management of Psychiatric Emergencies.

Nursing Education:

Nursing education helps the student nurses with adequate knowledge, skills to fulfill their duties and responsibilities in the nursing field. The findings of the study can be used by nurse educator to educate the student nurses, which help them to provide an effective nursing care towards Nursing Management of Psychiatric Emergencies to student nurses.In India the existing nursing curriculum includes content regarding Nursing management of psychiatric emergencies, but the updated guidelines and evidenced based practices can be incorporated in the curriculum.

The nurse educators have the responsibility to update the knowledge of staff nurses during clinical teaching and thereby improve their knowledge through various educational programmes.

Nursing Administration:

Nurses are challenged to play the role of efficient administrators as well as practitioners. Administration in both private and government sectors should take initiative action to update the knowledge of health personnel regarding nursing management of psychiatric emergencies by in-service education. Administrators must provide adequate supply of audio visual aids for conducting awareness programmes. After training, the student nurses should be provided with adequate facilities and supervision to maintain the standards of knowledge regarding Nursing Management of Psychiatric Emergencies.

Nursing Research:

The importance of research in nursing is to build the body of knowledge. Today nurses are actively generating, publishing and applying research in practice to improve client care and enhance scientific knowledge base of nursing. The study throws light on the areas of nurse’s knowledge regarding Nursing Management of Psychiatric Emergencies. The findings of the present study serve as the basis for the professionals and the students to conduct further studies.

RECOMMENDATIONS:

1. A similar study on larger and wider sample would be more pertinent in making broad generalizations.

2. A similar study can be replicated with experimental and control group

CONCLUSION:

The major psychiatric emergencies can be one or more such as new psychiatric disorder with acute onset, a chronic psychiatric disorder with relapse, suicide, violence, aggression, self harming. Iatrogenic emergencies, extrapyramidal symptoms (EPS), dystonia, akathesia, lithium toxicity and alcohol or drug dependence. Therefore it is an emergency situation (or) unforeseen circumstances which needs immediate intervention. Majority of staff nurses 66.66% had poor level of knowledge and 33.33% having average Knowledge towards nursing management of psychiatric emergencies.

On the basis of the findings, the investigator concluded that the staff nurses are having poor knowledge regarding nursing management of psychiatric emergencies.

The above diagram reveals majority of staff nurses 66.66% had a poor level of knowledge and 33.33% were having average Knowledge regarding nursing management of psychiatric emergencies.