Implenmentation of a Nurse Led Psychiatric Consultation Service in a Long-term Care Facility in Switzerland
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Susan Fischer (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Lori Lupe
Abstract: Background: Demographic changes in Switzerland highlight the increasing number of people needing care and entering nursing homes as the population ages. Prevalence of depression, dementia and delirium among nursing home residents is estimated to be up to 50%. These conditions lead to behavioral problems in the nursing home, putting staff and other residents at risk for physical harm and the resident at risk for depression. Action is needed to manage age-related mental and neurological disorders, focusing on depression, delirium, and dementia. Psychiatric consultations (PC) by advanced practice nurses (APNs) show the potential to address these challenges with the help of systematic screening. Purpose: This quality improvement (QI) project aimed to implement a psychiatric nurse-led consultation service in a 130-bed nursing home in the rural region of the canton of Bern in Switzerland over a three-month period. Systematic screening of newly admitted residents for signs of depression and delirium was implemented as part of this process.Methods: The project was implemented using the PDCA cycle. The PEPPA framework guided the steps for implementing the new APN role. Baseline data were collected from newly admitted residents. Two weeks after admission, trained on-site nursing staff assessed for signs of delirium (Delirium Observation Scale [DOS]) and depression (Geriatric Depression Scale [GDS]). In parallel, data collection began with long-term residents who were referred for a medical-psychiatric consultation and were additionally visited by the APN.Results: Among the newly admitted residents, approximately fifty percent showed signs of depression, and more than thirty percent showed signs of delirium within two weeks of admission. A total of fifteen residents had referrals for psychiatric consultation. The main reasons for referral were behavior problems associated with the progression of dementia (47%), development of delirium (27%), signs of depression (20%), and social problems (7%). In an average of three consultations per case, individualized multimodal interventions were recommended by the APN under the supervision of the chief of geriatric psychiatry.Recommendations and Conclusion: The implementation of the psychiatric consultation service conducted by an APN shows promising improvements on early detection and management of depression and delirium, supports individualized care, and includes educational benefits for the nursing staff.
Implenmentation of a Nurse Led Psychiatric Consultation Service in a Long-term Care Facility in Switzerland
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Created on 6/20/2024
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Additional Information
- Publication
- Other
- Language: English
- Date: 2023
- Keywords
- psychiatric consultation, nursing home, advanced nursing practice, depression, delirium, dementia