Specific Core Nursing Content # 5: Clinical Decision Making


Clinical Learning Outcomes

  • Apply taxonomy structures to patient specific situations including the development of nursing diagnosis.
  • Identify signs and symptoms characteristic of each major disorder.
  • Evaluate the degree of evidence-base available to support common psychiatric nursing actions.
  • Implement evidenced-based care for patients with psychiatric disorders.
  • Plan and implement nursing interventions appropriate to patients’ needs that reflect etiological factors and standards of nursing care.
  • Prioritize crisis intervention care practices with patients with psychiatric disorders.
  • Assess patient potential for violence including suicide and homicide.
  • Develop and implement suicide prevention strategies.


Teaching Strategies


Classroom Teaching Strategies

  • Team Based Learning Approach- allows students to discuss and test their views in smaller groups as they hone their decision making skills.
  • “Flipped Classroom”; Individual Readiness Assurance Test (IRAT) and Team Readiness Assurance Test (TRAT)
  • Voice Recorded PPT to prepare for class content, use of classroom time for application.
  • Review the ANA Psychiatric-Mental Health Nursing: Scope and Standards of Practice (2014)
  • Evidence-based care principles for psychiatric disorders
  • Discuss essential Taxonomy systems commonly used in care of psychiatric disorders
  • Videos
    • Animated Minds (2009). This multi-award-winning collection of eight 3- to 6-minute micro-documentaries attempts to communicate the subjective experience of abnormal psychological states by blending edgy animation with narration by people who live each day with debilitating mental conditions. Schizophrenia, Bipolar, Agoraphobia, OCD, Eating Disorders, Autism, and Self Harm. (Can be purchased, or accessed through “Films on Demand”).
    • When the Devil Knocks (2010) – Dissociative Identity Disorder (Films on Demand)
    • Introduction to 12 Step Groups (2006) (Films on Demand)
    • Bipolar Disorder: Shifting Mood Swings (2002)
    • Faces of Drug Addiction Video http://addictionrehabvideos.com/ (A great conversation starter)

Clinical Teaching Strategies

  • Nursing Care Plans [see appendix 1]
  • Concept Mapping
  • Can use Mental Status Exams to evaluate subjects in Nottingham Psychiatric Interview Teaching Videos, available at www.youtube.com

Case Studies 

Assessment Tools 


Assessment Strategies


Simulation

  • Depression Assessment and Suicide Assessment and Suicide Precautions Implementation Mental Health Issues (Junior Level) Proudfoot, M. (2013). Retrieved from http://collaborate.uw.edu/educators-toolkit/mental-health.html
  • Assessment Interview & Medication Administration for a Client with Clinical Depression & Alcohol Abuse.Gambel, S. (2013). Retrieved from /files/public/AC2013/1024-Lintner-Handout1.pdf
  • Scenario for Alcohol Withdrawal – Clinical Institute Withdrawal Assessment (CIWA)
  • Scenario for Opiate withdrawal – Clinical Opiate Withdrawal Scale (COWS)

Clinical Skills Checklist

  • Collects health data using appropriate assessment tools (Standard 1. Assessment)
  • Uses evidence based assessment tools to determine nursing diagnosis (Standard 2. Diagnosis)
  • Identifies expected outcomes (Standard 3. Outcomes Identification)
  • Works with client to develop a plan to attain expected outcomes (Standard 4. Planning)
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The American Psychiatric Nurses Association is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.