1. Assessment: subjective & objective data
2. Diagnosis: nursing & medical; NANDA list
3. Planning: goals/outcomes-NOCs
4. Implementation: Interventions
5. Evaluation: and re-assessment
6. Documentation: SOAPIE; SBAR, etc.
7. QSEN (quality & safety education in nursing): 6 competencies:
1. teamwork & collaboration
2. evidence-based practice (EBP)
3. quality improvement (QI)
4. healthcare informatics (HCI)
5. safety
6. patient-centered care
8. incidence: in 12 months, at least 1 person will develop a diagnosable mental
health disorder
9. annual prevalence: 1 in 3 people affected in a 12 month period
12 month prevalence of any disorder: 32.4%
,10. lifetime prevalence: 1 in 2 individuals will be affected by a psychiatric disorder
over their lifetime
lifetime prevalence of any disorder: 57.4%
11. self-care, self-management: starts with nursing assessment of symptoms
12. symptom management: starts with assessment, but involves patient in their
own care.
13. Who started the idea of public health?: Florence Nightingale: 1st nurse epi-
demiologist
-clean air, clean water
-statistical analysis related to poor sanitation, associated w/cholera & dysentery
(resulted in improvements in health)
-decreased mortality rates within first 6 months of changes
14. History of MH treatment: -derived from prevailing beliefs of times about causes
of mental illness.
-custody was often left to families, which lead to abuse & neglect
-social stigma was widespread, lead to inhumane treatment, practices, & isolation
15. History of MH treatment continued: -1800-1950s: state mental hospitals;
"Ware Houses", social control; same treatment for all
-1954: intro of psychotropic medications (Thorazine)
,-Post WWII: deinstitutionalization
, -1960s: civil rights/community mental health movement-noble concept/poor imple-
mentation
-1970s-80s: significantly reduced inpatients...but a faulty system w/new prob-
lems-homelessness, crack cocaine, HIV...
NOW: chronic homelessness
1980s - present: explosion of biological psychiatry, focus is more EBP, some treat-
ments still hard on patients, barriers to access; budgeting/funding, etc.
16. Deinstitutionalization: taken from being warehouse and let free to live in the
community (believed they were not longer psychotic)
-community was not prepared
-20-30% will relapse in the 1st year on thorazine
17. Hospital Based Treatment: -expensive care, focused on safety, & stabilization
-only very ill who meet strict admission criteria: (danger to self, danger to others,
grave disability)
-very low functioning
18. Community Based: -family-centered 'illness care' to manage acute & chronic
conditions in the community
Example: ambulatory care, outpatient, home care, residential/longterm settings)
19. Community Oriented: This is the GOAL