Behavioral Health Unit Research Articles

Medication history reconciliation by pharmacists in an inpatient behavioral health unit

The effectiveness of a pharmacy-obtained medication history on the medication reconciliation process in the behavioral health unit (BHU) of a community hospital was studied. Patients admitted to the BHU of a 411-bed, not-for-profit hospital from 6 a.m. on Monday through 12 p.m. on Friday from September 1, 2005, through October 6, 2005, were candidates for the study. Within 18 hours of admission to the BHU and after the medication history had been obtained by a nurse, a pharmacy technician gathered patient demographic and medication information from the chart and the patient's medication bottles. Once the technician completed the documentation, the pharmacist was notified of a new admission. The pharmacist reviewed the collected documentation and patient chart before interviewing the patient. Of the 54 patients who met the study's inclusion criteria, 91% were seen by a pharmacist within 18 hours of admission. The mean +/- S.D. time delay to interview the patient was 11.6 +/- 5.1 hours. Pharmacists spent a mean of 13.9 minutes completing patients' medication histories. The mean +/- S.D. number of medications identified by nursing on admission was 4.0 +/- 3.2, compared with 5.3 +/- 3.7 identified by pharmacists (p < 0.05). The mean number of medication discrepancies identified per patient was 2.9. Of the discrepancies, 48% were related to an omitted or incorrect medication, 31% to an omitted or incorrect dose, and 13% to an omitted or incorrect frequency; 8% were categorized as miscellaneous. Pharmacists' participation in obtaining patients' medication histories through chart review and patient interview increased the effectiveness of the medication reconciliation process in an inpatient BHU.

The Creation of a Behavioral Health Unit as Part of the Emergency Department: One Community Hospital's Two-Year Experience

The Creation of a Behavioral Health Unit as Part of the Emergency Department: One Community Hospital's Two-Year Experience

Testing the Nursing Outcomes Classification in Three Clinical Units in a Community Hospital

The testing of the Nursing Outcomes Classification (NOC) was the focus of a 4-year study to evaluate the use of the outcomes and measurement scales developed by the Iowa Outcomes Project, a research team at the University of Iowa. Three units in a Midwest community hospital collected data as part of the larger (ten) clinical site study to test the reliability, validity, and sensitivity of the NOC. This article focuses on the results of sensitivity testing obtained in a birth center, behavioral health center, and an oncology unit in a midwestern community hospital. Methods used in this study focused on change scores from initial assessment to post-treatment status for the outcomes studied in each unit. Average baseline ratings, average follow-up ratings, average change scores, and range of change are reported. Thirty-five outcomes are reported for the behavioral health unit, 21 outcomes are reported for the Birth Center, and 8 outcomes for the Oncology Unit. The overall average baseline for the behavioral health unit was 1.89 with an average follow-up rating of 3.22. For the Birth Center, the average baseline rating was 3.23 with an average follow-up score of 3.88. For the Oncology Unit, the average baseline score was 3.01 with an average follow-up rating of 3.12. The results of this study suggest that the NOC outcomes are able to identify change in some outcome ratings through time and in a direction expected for the populations studied in these three specialty units.

6. Implementation of an emergency behavioral health unit (EBH)

Clinical Topic: The emergency department experienced an increased volume of behavioral health patients requiring acute intervention. The intent of this project was to create a separate care area that provided consistent clinical practices for the behavioral health patient requiring emergency services.

Testing the nursing outcomes classification in three clinical units in a community hospital.

The testing of the Nursing Outcomes Classification (NOC) was the focus of a 4-year study to evaluate the use of the outcomes and measurement scales developed by the Iowa Outcomes Project, a research team at the University of Iowa. Three units in a Midwest community hospital collected data as part of the larger (ten) clinical site study to test the reliability, validity, and sensitivity of the NOC. This article focuses on the results of sensitivity testing obtained in a birth center, behavioral health center, and an oncology unit in a midwestern community hospital. Methods used in this study focused on change scores from initial assessment to post-treatment status for the outcomes studied in each unit. Average baseline ratings, average follow-up ratings, average change scores, and range of change are reported. Thirty-five outcomes are reported for the behavioral health unit, 21 outcomes are reported for the Birth Center, and 8 outcomes for the Oncology Unit. The overall average baseline for the behavioral health unit was 1.89 with an average follow-up rating of 3.22. For the Birth Center, the average baseline rating was 3.23 with an average follow-up score of 3.88. For the Oncology Unit, the average baseline score was 3.01 with an average follow-up rating of 3.12. The results of this study suggest that the NOC outcomes are able to identify change in some outcome ratings through time and in a direction expected for the populations studied in these three specialty units.

Unrecognized medical disorders in older psychiatric inpatients in a senior behavioral health unit in a university hospital.

Medical disorders may cause psychiatric symptoms. This study investigated the frequency and nature of previously unrecognized medical disorders associated with behavioral disturbances in acute geriatric psychiatry inpatients. Data came from a chart review of 79 consecutive admissions to the University of California, San Diego, Senior Behavioral Health Unit from May 1999 to October 1999. The most common Axis I admission diagnoses were depression and psychosis. At admission, 27 of 79 cases (34%) had unrecognized medical disorders. Comparison of these cases with the cases that did not have unrecognized medical disorders found no differences in age, education, gender, or cognitive abilities. The group with unrecognized medical disorders had more medical disorders (mean 5.0 vs 3.6; P = .002). Unrecognized conditions (n) included constipation (7), urinary infection (7), and hypothyroidism (5). Elderly psychiatric patients are more likely to have physical comorbidity. A large number of medical disorders should alert clinicians to look carefully for unrecognized medical disorders.

Putting feeding back into the hands of patients.

At the Behavioral Health Unit of Baton Rouge General Medical Center, the author and registered dietitians of the Clinical Nutrition Department developed "utensil-less" diets for patients with acute psychiatric conditions. Initially, the diet was developed for patients with dementia; however, the staff quickly realized that the diet would be appropriate for patients with many acute psychiatric disorders, or for those patients with physical limitations. The "Dementia Diet" includes five nutritionally balanced, small meals each day, consisting of finger foods such as sandwiches, vegetable sticks, fruit slices, and other items that patients can eat on their own without feeding assistance or utensils (Figure). After introducing the diet on the Behavioral Health Unit, the staff found that 7 of 10 patients on the diet improved their food intake and gained weight. Not only were nutritional needs met, but mealtimes became more enjoyable for the patients, families, and staff (Table). Unit safety advanced, and most importantly, quality of life and self-esteem were cultivated by helping adult patients regain some of their independence associated with meal times.