Conference Call Scheduling and Note

Conference Call Scheduling and Note.

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Conference Call Scheduling and Note

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Participant’s current status

When the patient was admitted, she was despondent, suicidal, and fearful. She described a recent drop in her sleep requirement, an ecstatic attitude, and racing thoughts. She had poor hygiene, unkempt look; restless motor activity; agitated affect; sad and worried mood; soft speech; circumstantial mental process; judgment inadequate impulse control, maladaptive; insight inadequate. Her Intelligence was on the bottom end of the spectrum, she couldn’t concentrate. 

Significant diagnoses

The doctor did physical examination to rule out any medical abnormalities that might have caused those symptoms. Laboratory testing too was done that included screening for alcohol and drug use. Psychological assessment where the physician discussed symptoms, thoughts, feelings, and behavioral patterns with the patient. With these assessments the doctor identified the type of mental illness the patient was suffering from as schizophrenia. 

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Summary of the care history

Family history of mental illness; mother suffered from schizophrenia and alcoholism, and her niece committed suicide. Hospitalization—at the time of admission, the patient was sad and expressed emotions of powerlessness, suicidal thoughts, and paranoia. Patient was put on Risperdal and Wellbutrin was withdrawn since it was suspected that it was stimulating the patient and generating mixed symptoms in addition to mania. Additionally, the patient was prescribed Zoloft for depression and kept on Depakote. Her mood has improved, her affect has remained stable, and her paranoid symptoms have subsided. The patient stayed on the medical-surgical floor during her 13-day hospitalization. On the unit, she was well-managed and did not demonstrate any behavioral concerns. She saw a mental nurse practitioner, nurses, and her primary care physician. According to the nurses, they were uninformed of her sickness and were fearful of caring for her.

A 65-year-old lady who had previously been diagnosed with bipolar illness presented to the emergency room with suicidal thoughts. She had jumped from a second story window and sustained injuries to her back and ankles. At the time of her admission to the ED, she was conscious and focused, but combative. Handcuffed to stretcher and wearing a C-collar. "I was lying on the floor and my spouse attempted to hurt me, so I leaped." "I intended to cause harm to myself and to my marriage." According to the police report, the patient was angry against her spouse with scissors and attempted to cut herself on the wrists. A restraining order has been issued against the patient's husband. She indicated that she had been physically abused by her partner over the years and that he had even threatened to kill her recently.  According to the partner the patient has been getting worse over the last five weeks, becoming agitated, hostile, unable to sleep, and drunk with wine, among other things.

Summary of the event

With this conference call, participants will explore the possibility of providing patients with home-based mental health care; An essential component of this endeavor is the education of caregivers on mental health promotion and care, as well as the need of sustaining family togetherness while expanding community engagement in the promotion of mental health of persons with psychiatric diseases. The patient suffered from frequent stress, which frequently impairs her capacity to perform. However, with good management, her symptoms can be managed with proper medications and psychotherapy.

Immediate actions taken

The IDT begins by establishing and keeping a solid connection with the customer. Present stresses, triggering events, personal and family medical histories are all collected at this point. We can figure out what the patient's problem is based on this record. We next devise a course of action for the patient's treatment. For emergency crisis situations, we prioritize our clients' requirements and produce a nursing diagnosis based on that information. This is followed by an evaluation of the patient's own strengths, as well as the patient's available support system and external resources, and then the necessary nursing action is taken." Actions are then taken in accordance with the plan. A problem-solving method is used in which the client's own problem-solving efforts are actively involved. If the mental nurse is well-received by the patient, this phase will be more successful. The psychiatric nurse assesses the patient's progress based on the patient's goals. Reassessment is performed for both accomplished and unachieved goals, and if required, a new course of action is devised.

IDT team’s main concerns related to participant prior to event:

IDT team’s concerns revolved around patients who often struggle to maintain ongoing treatment, with many dropping out. They also pointed out poor engagement resulting in symptom relapse and rehospitalization. There is also the difficulty in determining what tools and approaches to use to increase treatment involvement. 

Precipitating/contributing factors:

Social isolation, loneliness and discrimination; severe or long-term stress; drug or alcohol addiction; domestic violence as an adult were all factors that contributed to the patient's mental health issues in their younger years. At least two of her marriages have ended in divorce.

Participant’s involvement/actions surrounding the event

The patient was Involved in making decisions concerning her mental illness. The IDT emphasized the value of such a participatory approach. The team strived to gain her trust by establishing concrete goals to be achieved and identify barriers and solving their problems.

Participant’s degree of involvement in PACE program:

The patient was given homecare treatment; she and her caregiver expressed satisfaction; effectiveness and safety of staff was guaranteed every time they made a visit to the participant and; finally, there was significant reduction in the grievances from the patient.

Compliance with organization’s established policies and procedures:

Patients with mental health problems require serious treatment and ways should be found of identifying issues and working with the medical staff to resolve them. That way here will be expanded access to mental Healthcare and support to mental care patients. Equity in access to quality healthcare will also be achieved. Access to Crisis Care and Suicide Prevention services will also be offered. 

Identification of risk points and their potential contribution to the event:

The patient was a 65-year-old with low education with a past case of schizophrenia and alcohol abuse and several hospitalizations in the recent past.

As appropriate, proposed improvements in policies, training, procedures, systems, processes, physical plant, staffing levels, Etc. to reduce future risks

Setting up of family psycho-education groups that will help to minimize the effects of the obligations of the caregivers that take care of patients at home.

Initial improvements:

IDT proposes person-centered care as a style of therapy that focuses on an individual's unique objectives and living circumstances, implying that adopting person-centered care in mental health treatment models produces positive results. Individuals struggling with mental illness and substance abuse, as well as homeless individuals, have historically been difficult to engage.

Additional improvements:

In addition to psychoeducation programs, functional family therapy groups, educational lectures, and physical and recreational activities for care givers should be established to assist avoid or mitigate the consequences of burden in this population.

Quality improvement project initiated:

We should work to increase the uptake of psychiatric treatments for newly referred patients from general care, counseling, and post-discharge care. To improve patient outcomes, data should be gathered and evaluated. Goals must be established and a long-term commitment to their accomplishment made. Access to improved healthcare is crucial for the success of mental healthcare, as is an emphasis on patient participation and connecting and cooperating with other stakeholders.

Conclusion

Domestic care provides several mental health advantages, including companionship; motivation; and intellectual stimulation. Caregivers provide companionship, which helps to mitigate the risk of loneliness. It is frequently the case that when someone lives among people, they are motivated to live, improve their capacity to do, and hope for a better future. Engaging in meaningful conversation, doing puzzles, jigsaw puzzles, and simply commenting on a radio program are all methods for a caregiver to interact with an older person and keep the brain busy. This is critical in assisting older adults in retaining their faculties as long as feasible. Depression, anxiety, and dementia are frequently overlooked in their early stages, when adequate therapy may be beneficial. A caregiver can detect warning indicators that everything is not well, allowing for prompt expert aid. While caregivers are critical in maintaining physical health, they are also crucial facilitators of mental health and are frequently the first to recognize when something is wrong. Domestic caregivers are therefore an integral element of every older person's well-being team.