Kirstyn Kameg

The Impact of High Fidelity Human Simulation on Self-Efficacy of Communication Skills

Communication is a critical component of nursing education as well as a necessity in maintaining patient safety. Psychiatric nursing is a specialty that emphasizes utilization of communication skills to develop therapeutic relationships. Nursing students are frequently concerned and anxious about entering the mental health setting for their first clinical placement. High fidelity human simulation (HFHS) is one method that can be used to allow students to practice and become proficient with communication skills. The purpose of this study was to compare the effectiveness of two educational delivery methods, traditional lecture and HFHS, on senior level nursing students self-efficacy with respect to communicating with patients experiencing mental illness. The results of this study support the use of HFHS to assist in enhancing undergraduate students’ self-efficacy in communicating with patients who are experiencing mental illness.

Communication and Human Patient Simulation in Psychiatric Nursing

Communication is an integral component of nursing education and has been shown to improve health outcomes, patient compliance, and patient satisfaction. Psychiatric nursing emphasizes knowledge and utilization of communication skills. Nursing students often express anxiety and lack of confidence regarding communicating with patients diagnosed with psychiatric illnesses. Human patient simulation is one method that may be used for students to practice and become proficient with communication skills in a simulated environment. The authors of this article provide an overview of communication and psychiatric nursing as well as review of the current research related to the use of human patient simulation in nursing education.

Critical incident stress debriefing: implications for best practice

Critical incidents disrupt peoples lives by creating strong emotional reactions, which may range from normal stress reactions to post-traumatic stress disorders. Critical incident stress debriefing (CISD) has been used since 1983 as a component of Critical Incident Stress Management. The processes are intended to help individuals manage their normal stress reactions to abnormal events. Although used extensively, research findings to date yield mixed results. Meta-analyses of research studies are reviewed to identify the methods, results, strengths, and weaknesses of the studies that can be used for evidence-based practice.

Fusion of Psychiatric and Medical High Fidelity Patient Simulation Scenarios: Effect on Nursing Student Knowledge, Retention of Knowledge, and Perception

High fidelity patient simulation (HFPS) has become an increasingly popular teaching methodology in nursing education. To date, there have not been any published studies investigating HFPS scenarios incorporating medical and psychiatric nursing content. This study utilized a quasi-experimental design to assess if HFPS improved student knowledge and retention of knowledge utilizing three parallel 30-item Elsevier HESITM Custom Exams. A convenience sample of 37 senior level nursing students participated in the study. The results of the study revealed the mean HESI test scores decreased following the simulation intervention although an analysis of variance (ANOVA) determined the difference was not statistically significant (p = .297). Although this study did not reveal improved student knowledge following the HFPS experiences, the findings did provide preliminary evidence that HFPS may improve knowledge in students who are identified as “at-risk.” Additionally, students responded favorably to the simulations and viewed them as a positive learning experience.

Music Therapy as a Nonpharmacological Intervention for Anxiety in Patients with a Thought Disorder

ABSTRACT Music therapy has been identified as a non-pharmacological adjunct therapy to treat anxiety. This QI project aimed to assess the effects of music therapy on anxiety in a sample of patients hospitalized with a thought disorder. Participants were assessed pre- and post-group using a visual analog scale for anxiety. The intervention significantly reduced VAS scores from 3.1 pre-intervention to .897 immediately post-intervention (p = 0.008). This data suggests that music therapy may be beneficial in the short term for this population and is a low risk intervention that provides positive outcomes without the risks associated with medications, seclusion, and restraint.

Impact of Social Support on Symptoms of Depression and Loneliness in Survivors Bereaved by Suicide

According to the latest statistics from the American Association of Suicidology, there were approximately 41,000 suicides in the United States, accounting for 112 suicides per day or one every 12.8minutes (Drapeau & McIntosh, 2015). Survivors bereaved by suicide often experience complicated grief and feelings of social isolation. The study was a secondary data analysis from a study which involved 44 participants over the age of 18 from Southwestern Pennsylvania. Symptoms of depression and loneliness were assessed in relation to reported social support available to participants. The findings support the notion that increased availability of support can decrease symptoms of depression.

Identifying and managing nonsuicidal self-injurious behavior in the primary care setting

Purpose To provide an overview of nonsuicidal self-injurious behavior (NSSIB) for nurse practitioners (NPs) who see patients with this complex phenomenon in primary care settings. Data sources Selected research and clinical reviews. Conclusions NSSIB is characterized as a low-lethality, repetitive act that can alter or cause damage to the body tissue. Among researchers and those who work directly with young people, there is a general consensus that NSSIB is increasing in prevalence. Unfortunately, NPs often view self-injuring patients negatively, likely because of a lack of knowledge as to how to help this special patient population. Implications for practice Appropriate treatment can be initiated in the primary care setting; however, NPs must be aware of how and when to refer to specialty mental health services. Those with psychiatric comorbidities such as mood lability, anxiety, chronic emptiness or depersonalization, dysphoria, loneliness, anhedonia, or borderline personality disorder require management by mental health specialists. Patients experiencing NSSIB in response to command auditory hallucinations need immediate medical attention.Purpose To provide an overview of nonsuicidal self‐injurious behavior (NSSIB) for nurse practitioners (NPs) who see patients with this complex phenomenon in primary care settings. Data sources Selected research and clinical reviews. Conclusions NSSIB is characterized as a low‐lethality, repetitive act that can alter or cause damage to the body tissue. Among researchers and those who work directly with young people, there is a general consensus that NSSIB is increasing in prevalence. Unfortunately, NPs often view self‐injuring patients negatively, likely because of a lack of knowledge as to how to help this special patient population. Implications for practice Appropriate treatment can be initiated in the primary care setting; however, NPs must be aware of how and when to refer to specialty mental health services. Those with psychiatric comorbidities such as mood lability, anxiety, chronic emptiness or depersonalization, dysphoria, loneliness, anhedonia, or borderline personality disorder require management by mental health specialists. Patients experiencing NSSIB in response to command auditory hallucinations need immediate medical attention.

Post-traumatic stress: Clinical implications

P ost-traumatic stress disorder (PTSD) is an anxiety disorder that consists of a set of characteristic signs and symptoms (eg, flashbacks; avoidance; detachment; decreased interest in formerly enjoyable events; and physical symptoms such as increased heart rate, insomnia, exaggerated startle response). The physiologic response, risk factors, and symptom clusters were presented in part one1 of this series of 2 articles. This discussion focuses on the assessment and treatment of patients with PTSD. The burden of PTSD on the American health care system is hard to measure. Estimates of the incidence of PTSD vary from 0.2% of postpartum women to 18% of professional firefighters to 67% of prisoners of war.2 PTSD may affect about 1 in 25 adults in the United States.3 No epidemiologic studies have examined the health care costs specifically associated with PTSD. Furthermore, many people with PTSD do not receive adequate treatment and continue to suffer disability. Patients with PTSD often seek care in primary health settings (eg, emergency department, out-patient settings) because of the ease of access and their initial reluctance to seek mental health interventions. They often will complain of vague somatic symptoms that are difficult to readily diagnose in a setting that does not allow for extended contact time. Although their time may be limited, health care professionals can still provide therapeutic care and refer their patients to appropriate mental health providers.

Impact of a standardized patient simulation on undergraduate nursing student knowledge and perceived competency of the care of a patient diagnosed with schizophrenia

Background: Undergraduate nursing students may not have the opportunity to assess and intervene with a patient diagnosed with schizophrenia during their clinical rotation. Provision of a standardized patient simulation experience affords students this opportunity in a safe setting without risk to the patient or student. Methods: A quasi‐experimental design was utilized to explore the impact of the addition of a standardized patient simulation scenario depicting a patient with a diagnosis of schizophrenia on undergraduate nursing student knowledge and perceived competency. Results: The mean values for perceived competence and knowledge increased significantly over the three time periods (p < 0.001). Conclusion: The results suggest that incorporating SP simulation into the undergraduate psychiatric mental health nursing course has the potential to enhance both knowledge and perceived competency of students in caring for patients diagnosed with schizophrenia and ultimately promote better healthcare outcomes. HighlightsPatients with schizophrenia often have multiple medical comorbidities, comorbid substance abuse, and lack of engagement in preventative care that contribute to a reduced life expectancy.During the clinical rotation, nursing students may not have the opportunity to assess and intervene with a patient diagnosed with schizophrenia due to patient acuity.

Pediatric Obsessive‐Compulsive Disorder: An Update for Advanced Practice Psychiatric Nurses

Obsessive-compulsive disorder (OCD) may have an onset in childhood or adolescence resulting in significant functional impairment and disability into adulthood. There are frequently developmental differences in the content of the obsessions and compulsions in youth compared to adults. Lack of insight or shame may result in failure of the youth to seek treatment. This delay in treatment may lead to the development of other psychiatric comorbidities, including suicide. Evidence-based treatments for OCD include cognitive behavioral therapy and exposure/response prevention, and in moderate to severe cases, use of selective serotonin reuptake inhibitors is indicated. Advanced practice psychiatric nurses are in a unique position to provide psychoeducation, psychotherapy, and medications, if indicated, to youth with this condition to improve functioning and reduce morbidity and mortality. This article will provide an overview of the diagnostic criteria for OCD, etiologies, assessment strategies, differential diagnoses, common comorbidities, and evidence-based treatment options.Obsessive-compulsive disorder (OCD) may have an onset in childhood or adolescence resulting in significant functional impairment and disability into adulthood. There are frequently developmental differences in the content of the obsessions and compulsions in youth compared to adults. Lack of insight or shame may result in failure of the youth to seek treatment. This delay in treatment may lead to the development of other psychiatric comorbidities, including suicide. Evidence-based treatments for OCD include cognitive behavioral therapy and exposure/response prevention, and in moderate to severe cases, use of selective serotonin reuptake inhibitors is indicated. Advanced practice psychiatric nurses are in a unique position to provide psychoeducation, psychotherapy, and medications, if indicated, to youth with this condition to improve functioning and reduce morbidity and mortality. This article will provide an overview of the diagnostic criteria for OCD, etiologies, assessment strategies, differential diagnoses, common comorbidities, and evidence-based treatment options.