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Building Success on Strong Foundations - PNA

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<str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong>Str<strong>on</strong>g Foundati<strong>on</strong>sPsychiatric Nurses Associati<strong>on</strong>of IrelandHoratio: European Psychiatric Nursing


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sC<strong>on</strong>tents1 Foreword2 Mental Health Nursing in Primary Health CareVocati<strong>on</strong>al Training for Service Users.The Role of Mental Health Nursing.3 Soluti<strong>on</strong>s Focused Recovery GroupPromoting Recovery and Facilitating SocialInclusi<strong>on</strong> Within South Lee Mental HealthServices HSE - South.4 Collaborative Care Planning - Carraig MórPsychiatric Intensive Care Unit Cork MentalHealth Services5 Mental Health in Primary Care - The Role ofthe Community Mental Health Nurse6 Refocusing Acute PsychiatrySoluti<strong>on</strong> Focused Therapy in Acute MH Care(part of the Irish “Refocusing” initiative)7 The use of children’s literature and film toenhance the therapeutic relati<strong>on</strong>ship in Child& Adolescent mental health nursing.An evaluati<strong>on</strong> of the reas<strong>on</strong>s undergraduatestudents choose mental health andintellectual disability nursing as a career inDublin, Kildare & Wicklow.8 Clinical Learning Manual for UndergraduateNurse Students in a Mental Health DayHospital FacilityA Recovery focused post registrati<strong>on</strong> mentalHealth/Psychiatric Nursing Programme9 Promoti<strong>on</strong> of Intellectual Disability Nursing asa Career of Choice ( October 2007 to April2008)The Role of the Clinical Nurse Specialist(C.N.S). in the Provisi<strong>on</strong> of Outreach BasedAssessment and Interventi<strong>on</strong> for People withan Intellectual Disability Whose BehaviourChallenges.10 Developing the nursing c<strong>on</strong>tributi<strong>on</strong> tointellectual Disability. The educati<strong>on</strong>alresp<strong>on</strong>se in Scotland11 Recovery within a Teamwork c<strong>on</strong>textMusic in Mental Healthcare12 Audit of Core AssessmentsEarly Interventi<strong>on</strong> in Psychosis- PerspectivesFrom A Clinical Nurse Specialist13 Client experiences of being in a nurse ledsoluti<strong>on</strong>-focused group.Treating Adults with Eating Disorders in theCommunity14 Developing an Advanced Nurse practiti<strong>on</strong>er(ANP) post in Addicti<strong>on</strong> and Mental HealthNursing and Midwife Prescribing in Ireland15 Nurse Empowerment within theMultidisciplinary Team.Physchiatric Mental Health Nursing16 Administering Depot Injecti<strong>on</strong>s:– Best Practice GuidelinePlanning Client Care in the Addicti<strong>on</strong> Services,Dublin Mid-Leinster’ – A Nursing Resp<strong>on</strong>se17 Nursing Health Promoti<strong>on</strong> Initiative in theAddicti<strong>on</strong> Services HSE Dublin Mid-Leinster.Your Mental Health18 Integrated Care and Treatment PlanFlagging The Problem -A new approach to mental health19 An examinati<strong>on</strong> of the services provided by aPsychiatric C<strong>on</strong>sultati<strong>on</strong> Liais<strong>on</strong> Nurses in ageneral hospital.20 Developing the Role of an Advanced NursingPractiti<strong>on</strong>er in Therapeutic Interventi<strong>on</strong>s forAdults with an Intellectual Disability and Co-Existing Mental Health DisorderCrisis Interventi<strong>on</strong> Service– A Nurse Led ApproachRecent Irish Publicati<strong>on</strong>s


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sForewordThe (<strong>PNA</strong>) Psychiatric Nurses Associati<strong>on</strong> is a majorIndependent registered Trade Uni<strong>on</strong> for nurses workingin Mental Health, Intellectual Disability and otherSpecialist Services in Ireland.With in excess of 6,500 members it aims to enhancethe standing of nursing both in the Nati<strong>on</strong>al andInternati<strong>on</strong>al c<strong>on</strong>text and is recognised and c<strong>on</strong>sultedas an authoritative body <strong>on</strong> all matters germane tomental health and other specialist areas. The <strong>PNA</strong>endeavors to provide a highly professi<strong>on</strong>al andcomprehensive Industrial Relati<strong>on</strong>s package for IrishNurses as well as a myriad of other benefits and arecommitted to progressing the agenda of equality andintegrati<strong>on</strong> for those with mental health problems goingforward.As a professi<strong>on</strong>al representative body, we are pleasedto assert that our members are eager to embrace anenhanced role which will resp<strong>on</strong>d holistically toidentified need for the service user across their lifespanwith locally based flexible and easily accessibleservices.It is within this c<strong>on</strong>text the <strong>PNA</strong> has produced thisbooklet “<str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>s” inan effort to showcase innovative and shifting c<strong>on</strong>textsof psychiatric /ID nursing clinical practice. It providesan overview and identifies some examples ofinnovative best practices in Psychiatric / IntellectualDisability Nursing in the Irish c<strong>on</strong>text.importance of co operative inter organisati<strong>on</strong>alnetworking with our colleagues and sharing newinsights and new informati<strong>on</strong> empowers us to resp<strong>on</strong>dwith initiative, innovati<strong>on</strong> and creativity to the needs ofour clients. Ultimately it is within all our interests asservice deliverer’s to promote the strategic role ofnursing in the future of our mental health / ID servicesand underpin service and organisati<strong>on</strong>al developmentsto raise standards and meet the needs of c<strong>on</strong>sumers.From c<strong>on</strong>cept to publicati<strong>on</strong> this booklet is the result ofa collaborative effort, all c<strong>on</strong>tributors played a part andby doing so have c<strong>on</strong>tributed towards thestrengthening of nurse leadership and dem<strong>on</strong>stratednursing’s capability, agility and flexibility in leadingstrategic change in our health services .In publishing this booklet we hope to stimulate debatesand to encourage Nurses from other countries to sharetheir innovative Nurse led experiences with us.I am also aware that throughout Ireland there are otherexamples of best practice which have not yet beenwritten up. This publicati<strong>on</strong> is a first draft. We expect toadd more examples in our final publicati<strong>on</strong>; all of thesewill be carried <strong>on</strong> our website www.pna.ie.My colleague Aisling Culhane our Research andDevelopment Advisor will lead a str<strong>on</strong>g delegati<strong>on</strong> ofparticipants at the festival. We would be delighted tohear from you, about your experiences____________________Des KavanaghGeneral Secretary Psychiatric Nurse’sAssociati<strong>on</strong> IrelandPresident HoratioEuropean Associati<strong>on</strong> forPsychiatric Nurses.The title “<str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>s” isintended to pay tribute to those champi<strong>on</strong>s and driversof good practice from whom we have previouslylearned and to build <strong>on</strong> what we believe to be a str<strong>on</strong>gnursing foundati<strong>on</strong> going forward. Our aim therefore isto replicate and mainstream those initiativesthroughout Ireland and indeed to share some of ourexperiences with our internati<strong>on</strong>al colleagues throughthe forum of Horatio the European Associati<strong>on</strong> forPsychiatric Nurses.As President of Horatio, it gives me great pleasure andindeed h<strong>on</strong>our to share with you some of our Irishnursing experiences, initiatives and services currentlydeveloped or in progress within the professi<strong>on</strong>. The1


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sMental Health Nursing in Primary Health Care(HSE) Health Service ExecutiveBreedge C<strong>on</strong>l<strong>on</strong>Civic Offices, Ballymun, Dublin,11Ph<strong>on</strong>e: 8467114Email: breedge.c<strong>on</strong>l<strong>on</strong>@hse.ieIn 2006, a Community Mental Health Nurse joined the core Primary Health Care Team in Ballymun, Dublin, an areaof high social deprivati<strong>on</strong>.A range of presentati<strong>on</strong>s including mild-mood depressi<strong>on</strong>, anxiety disorders, adjustment reacti<strong>on</strong>s, post traumaticsyndromes were seen. The accessibility and management of c<strong>on</strong>diti<strong>on</strong>s in PHC by a CMHN has impacted <strong>on</strong>services:· Waiting list to psychiatric services reduced by 50%· Waiting times for Psychiatry reduced from 10 to 4 weeks· Feedback from G/P’s report reduced burden of care.· Health workers access to c<strong>on</strong>sultati<strong>on</strong>.· Demand for service indicates that stigma may be lessened for mental health problems.Vocati<strong>on</strong>al Training for Service Users.The Role of Mental Health Nursing.Hospitaller Order of St John of God/Cluain Mhuire ServiceGerry FahyAvila House, Blackrock Business Park, Carysfort Ave., Blackrock, Co DublinPh<strong>on</strong>e: 01 2791713Email: gerry.fahy@sjog.ieThis is a service for people with severe mental health problems from the ages of 16-65 and is of 21 weeks durati<strong>on</strong>from the hours of 9.15-16.15, M<strong>on</strong>-Friday. It comprises of 10 modules covering aspects of pers<strong>on</strong>al development,computer skills, work experience and vocati<strong>on</strong>al explorati<strong>on</strong>. On completi<strong>on</strong> of programme the trainees willreceive a major FETAC(Further Educati<strong>on</strong> Training Awards Council) award at level 3 in ‘Vocati<strong>on</strong>al EmploymentSkills’. The programme focuses <strong>on</strong> the ‘Recovery Model’ of care and progressi<strong>on</strong> to work or further educati<strong>on</strong> andtraining is encouraged. The programme is research based and uses standardised methods, trainee feedback andFAS/FETAC reviews as a means of evaluati<strong>on</strong> of the programme. The nursing input provides the support,encouragement and understanding necessary for trainee progressi<strong>on</strong>.2


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sSoluti<strong>on</strong>s Focused Recovery GroupEast Galway Mental Health Services-Ballinasloe Day HospitalBrendan Barrett/ D<strong>on</strong>na O’D<strong>on</strong>oghueBallinasloe Day Hospital, Health Centre, Brackernagh, Ballinasloe, Co. Galway.Ph<strong>on</strong>e: 0909646257 / 251Email: brendanbarrett@hse.ie/d<strong>on</strong>nad<strong>on</strong>oghue@hse.ieSoluti<strong>on</strong>s Focused Recovery GroupThis group was set up in April 2007 to address theneeds of service users aged 18-35 that have a dualdiagnosis (mental health problem and addicti<strong>on</strong>problems). The groups are facilitated by a ClinicalNurse Specialist in Addicti<strong>on</strong>s and a ClinicalPsychologist <strong>on</strong> Tuesday evenings and run from 6pmto 7.30pm, at the Day Centre, Ballinasloe. Initially, thegroup was offered to existing service users from theAddicti<strong>on</strong>s and Psychology services. Twelve (12)individual sessi<strong>on</strong>s were initially offered, covering thefollowing topics:· Goal Setting· Assessing my problems· Coping techniques· Crisis Management· Problem Solving· Coping with feeling Suicidal· Grieving· Alcohol and Drug issues· Self Esteem· Negative Patterns that limit life choices· Relati<strong>on</strong>ship with others and self· Somatics/Body Awareness and relaxati<strong>on</strong> workPromoting Recovery and Facilitating Social Inclusi<strong>on</strong>Within South Lee Mental Health Services HSE- SouthSouth Lee Mental Health Services, HSE South, Unit 4A, SouthRing Business Park, Kinsale Road, CorkMary Brown Clinical Facilitator /Mary Kerrisk A.D.O.NDeclan McCarthy. CNM 2South Lee Mental Health Services, HSE South, Unit 4A, South Ring Business Park, Kinsale Road, CorkPh<strong>on</strong>e: (MB) 0879845483, (MK) 0876692124, (DMcC)0879054640Email: Mary.kerrisk@hse.ie - Maryt.brown@hse.ie - Declan.McCarthy1@hse.ieBackground:A Visi<strong>on</strong> for Change (DOH&C 2006,MHC 2007)highlights the importance of partnerships recovery andsocial inclusi<strong>on</strong>. Recovery is a process not an end pointor destinati<strong>on</strong>.The critical c<strong>on</strong>cept is that what peoplewith mental health problems are able to achieve in theirlives in the presence or absence of support. Recoveryis not a linear process and whilst it is important tominimise relapse and exacerbati<strong>on</strong> of symptoms it isequally important for professi<strong>on</strong>als and clients to seerelapse as part of the recovery process (Perkins 2008).This initiative addresses the challenges in supportingand facilitating recovery and social inclusi<strong>on</strong>. Keyoutcomes relate to the specific aims of the project.· To change the way nurses practice to reflect acollaborative approach with users of the services· Respecting Diversity/PartnershipPopulati<strong>on</strong> needs within South Lee identified highsocial deprivati<strong>on</strong> areas (SAHRU 2002). High morbiditylevels of schizophrenic and depressive related illnesswere identified.C<strong>on</strong>clusi<strong>on</strong>: This initiative occurred in abackground of organisati<strong>on</strong>al change and therequirement to meet the needs of service users. Theprinciples endorsed the ethics and accountability ofpsychiatric nursing.· Aims To give people hope and opportunityto gain c<strong>on</strong>trol of their lives.3


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sCollaborative Care Planning - Carraig Mór PsychiatricIntensive Care Unit. Cork Mental Health ServicesTom McSweeney, Cathal Keohane, Denis L<strong>on</strong>g, John Kelleher,Una Howe, Claire Forrest, Alice O’Brien, David Hickey, Keren Lilley, Martin LawlorTom McSweeney c/o Centre for Recovery& Social Inclusi<strong>on</strong> CorkPh<strong>on</strong>e: 0872530573 / 021 4921689Email: info@crsi-cork.com - www.crsi-cork.comIntroducti<strong>on</strong>:The Carraig Mór care plan is named after the unitin which it was c<strong>on</strong>ceived and developed, a 19bed psychiatric intensive care unit (PICU) basedin Cork, southern Ireland, delivering care toindividuals with serious mental illness andcomplex needs (primarily psychotic illness andchallenging behaviour). The level of physicalsecurity as a PICU is less than 'secure services'as provided in the Central Mental Hospital,Dundrum, or in Medium or High Secure units inother jurisdicti<strong>on</strong>s (Beer et al. 2001).In the current climate of professi<strong>on</strong>aldevelopment, and in order to satisfy governmentpolicy such as “A Visi<strong>on</strong> for Change” (Departmentof Health and Children 2006) it was felt that theRoper, Logan & Tierney model (1996) requiredupdating to facilitate patients participating in theirown care and recovery. Further scope wasneeded to reflect the complex and varied natureof nursing activity in caring for patients as part ofa multidisciplinary team in a Psychiatric IntensiveCare Unit (PICU). Periera and Clint<strong>on</strong> (2002, p.3)describe working in a PICU service thus: “Careand treatment offered must be patient-centred,multidisciplinary, intensive, comprehensive,collaborative and have an immediacy of resp<strong>on</strong>seto critical situati<strong>on</strong>s.”A working committee made up of keystakeholders came together to devise a new careplan to meet the requirements for a client centredmodel of nursing, that would be bothrehabilitati<strong>on</strong> and recovery based. The MentalHealth Commissi<strong>on</strong> (2005) and the Tidal Model(Phil Barker and Poppy Buchanan-Barker 2005)were c<strong>on</strong>temporary influences in our desire to berecovery-orientated. Carraig Mór PICU aspires tobeing a learning organizati<strong>on</strong>, where employeesexcel at “creating, acquiring and transferringknowledge” (Garvin et al 2008, p.109), so formalmeetings were arranged with nursing staff and themulti-disciplinary team, and a sample of currentservice-users were c<strong>on</strong>sulted. A qualitative reviewof the findings identified the following themes asbeing key to care planning in Carraig Mór.Aims & ValuesReflect existing practice· It has been historically difficult to quantifythe range of duties and interacti<strong>on</strong>sundertaken by nurses· The previous model was deemedineffective in recording nurses day-to-dayduties and interacti<strong>on</strong>s· The guiding principle of the Carraig MórCare Plan was to record existing goodpractice <strong>on</strong> the unit Promote collaborativecare planning with patients and stafPromote collaborative care planning withpatients and staff· To involve patients in their own care· To support patients with goal setting· Allows patients to assess what staff canoffer towards their recovery· Allows patients to assist in their own careplanning· Laid out in a user friendly form:- Questi<strong>on</strong> and answer format- Objective and subjective informati<strong>on</strong>recorded- Includes the patient’s own lifeexperiencesDevelop therapeutic nurse patientrelati<strong>on</strong>ship· With the collaborative approach, the nurseand patient spend more time together· This in turn promotes a therapeuticrelati<strong>on</strong>ship· Positive working envir<strong>on</strong>ment may reducethe risk of incidents Promote multidisciplinaryworking relati<strong>on</strong>shipsPromote multi-disciplinary workingrelati<strong>on</strong>ships· Incorporated in the Carraig Mór care planis a social care profile· To promote c<strong>on</strong>tinuity of care· Optimise patient care and recovery· To promote integrated care pathwayEffective risk management· The incorporati<strong>on</strong> of risk management intocare planning· Initially a risk indicator checklist devised byDeborah Mountain of the Royal EdinburghHospital (2001)· On review we devised our own riskmanagement plan (available atwww.crsicork.com)Promote research based practice· The development of the Carraig Mor careplan was based <strong>on</strong> relevant researchliterature.· On-going research in-house will informfuture developments.Optimize patient recoveryThe committee undertook the development of theCarraig Mór Care Plan with the expressed hopeof:· Improving patient care· Promoting a collaborative care envir<strong>on</strong>ment· Assisting with patients’ recovery· Providing client centred care principlesDevelopmentUsing these points to aid development a finaldraft was produced, which was approved forprinting from September 2006, with a review dateof January 2008. The care plan was thenintroduced <strong>on</strong> a phased basis; this c<strong>on</strong>sisted ofcompleting a new type care plan for newadmissi<strong>on</strong>s, and two transiti<strong>on</strong>s a week for thosewho were inpatients at the time of the changeover, allowing different members of staff to beorientated to the care plan gradually under thesupervisi<strong>on</strong> of members of the workingcommittee. Initial resp<strong>on</strong>se from the client groupwho were already inpatients during the transiti<strong>on</strong>was encouraging, with clients reporting approvalthat they had an input to their own care plan.There was also positive feedback from nursingstaff in relati<strong>on</strong> to new admissi<strong>on</strong>s, with reportsthat the new care plan allowed them to get toknow the client during a much shorter space oftime. They also reported to the workingcommittee that the new care plan was a muchbetter tool for assessing client’s needs bothmentally and physically. The introducti<strong>on</strong> of therisk indicator in the care plan was also welcomedas it allowed easier security planning.C<strong>on</strong>clusi<strong>on</strong>In January 2008 the Carraig Mór care plan wasreviewed and amended in a number of areas,including social work practice and riskassessment, as part of its <strong>on</strong>going developmentand improvement. There have since beenupdates to incorporate new legislati<strong>on</strong> andguidelines, such as the Department of Health andChildren’s report (2008) “<str<strong>on</strong>g>Building</str<strong>on</strong>g> a Culture ofPatient Safety”.In order to enable mental health services to pooltheir resources, further revisi<strong>on</strong>s of this evolvingcare plan will be published <strong>on</strong> our website atwww.crsi-cork.com. We would welcomefeedback and encourage others to make theirown local adaptati<strong>on</strong>s – provided they includeattributi<strong>on</strong> to the copyright holders, and a copy ofthe new adapted document is sent back to us.AcknowledgementsWe wish to acknowledge the support of HSEadministrati<strong>on</strong> and the multi-disciplinary seniormanagement team, particularly Ms PaulineO’D<strong>on</strong>ovan, Director of Nursing, and Dr Eam<strong>on</strong>nMol<strong>on</strong>ey, Clinical Director. We also want to thankDr Anne Schofield.Development c<strong>on</strong>tributors were Helena O’C<strong>on</strong>nor(Risk Management) and Sinead Lawless (SocialWork).ReferencesBarker, P. & Buchanan-Barker, P., 2005. The TidalModel: a guide for mental health professi<strong>on</strong>als.L<strong>on</strong>d<strong>on</strong>: Brunner-Routledge.Beer, M.D. Pereira, S.M. & Pat<strong>on</strong>, C., 2001.Psychiatric intensive care. L<strong>on</strong>d<strong>on</strong>:Greenwich Medical Media.Department of Health and Children, 2006. Avisi<strong>on</strong> for change: report of the Expert Group <strong>on</strong>Mental Health Policy. Dublin: Stati<strong>on</strong>ery Office.Department of Health and Children, 2008.<str<strong>on</strong>g>Building</str<strong>on</strong>g> a culture of patient safety: report of theCommissi<strong>on</strong> <strong>on</strong> Patient Safety and QualityAssurance. Dublin: Stati<strong>on</strong>ery Office.Garvin, D.A. Edm<strong>on</strong>ds<strong>on</strong>, A.C. & Gino, F., 2008. Isyours a learning organizati<strong>on</strong>?Harvard Business Review, 86(3):109-16, 134.Mental Health Commissi<strong>on</strong>. 2005. A visi<strong>on</strong> for arecovery model in Irish mental health services:discussi<strong>on</strong> paper. Dublin: Mental HealthCommissi<strong>on</strong>.Mountain, D., 2001. Risk Indicator Checklist.Edinburgh: Royal Edinburgh Hospital.Roper, N., Logan, W.W. & Tierney, A.J., 1996. Theelements of nursing. 4th ed. NewYork: Churchill Livingst<strong>on</strong>.Periera, S. & Clint<strong>on</strong>, C. eds., 2002. Nati<strong>on</strong>alminimum standards for general adult services inpsychiatric intensive care units (PICU) and lowsecure envir<strong>on</strong>ments: mental health policyimplementati<strong>on</strong> guide. L<strong>on</strong>d<strong>on</strong>: Department ofHealth.4


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sMental Health in Primary CareCommunity Mental Health Nurse in Primary CareTeresa LallyCoolock Primary Care TeamCoolock Health CentreCromcastle Road D 5Ph<strong>on</strong>e: 816 0318 - Mobile: 086 3805233Email: teresa.lally3@hse.ieThe Community Mental Health Nurse in Primary Care isa new development in the Primary Care Team. Manycomm<strong>on</strong> mental health problems can be treatedsuccessfully within the primary care setting withadequate supports. The CMHN in Primary Care MentalHealth will support and work with other healthprofessi<strong>on</strong>als in providing a more accessible mentalhealth service.Aim of ServiceTo provide people with access to specialist mentalhealth nursing within the primary care setting.· One way this can be d<strong>on</strong>e will be by facilitatingearly assessment or triage of mental healthproblems. Early interventi<strong>on</strong> can improve theprognoses of many mental illnesses and preventothers from developing.· The CMHN can provide expert professi<strong>on</strong>alinformati<strong>on</strong> <strong>on</strong> mental health and <strong>on</strong> availabletreatment opti<strong>on</strong>s to other health professi<strong>on</strong>als,agencies, patients and families.· If there is need for psychiatric or other specialisedreferral your CMHN in Primary Care Mental Healthcan support you while you are waiting for your firstappointment.· Will engage in crisis interventi<strong>on</strong> liaising betweenprimary care and psychiatric services or otherappropriate services.· Promote positive mental health in the communitythrough the facilitati<strong>on</strong> of pers<strong>on</strong>al developmentand mental health educati<strong>on</strong> groups strengtheningthe development of self management within thecommunity populati<strong>on</strong>.· To provide holistic care the CMHN in Primary CareMental Health will liaise with other disciplines andagencies to promote the mental health of peoplewith a physical illness or other vulnerabilities.· In additi<strong>on</strong> the CMHN in Primary Care MentalHealth will promote the physical health of mentallyill patients through liais<strong>on</strong> between psychiatric andprimary care services.Referral ProcedureThe CMHN in Primary Care Mental Health will takereferrals from other health professi<strong>on</strong>al within thePrimary care team and will also take self referrals.At present there is CMHN cover in Primary Care areasCoolock, Edenmore and Darndale.· The CMHN in Primary Care Mental Health can alsowork directly with individuals who are betweenages of 16 and 65 with a mental health problemproviding an opportunity for them to addressdifficulties and search for soluti<strong>on</strong>s in a supportiveand therapeutic way.5


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sRefocusing Acute PsychiatrySouth Lee Mental Health Services CorkAnn CoughlanNurse Practice Development Co-ordinator (NPDC)Unit 4a,South Ring Business Park,Kinsale Road CorkPh<strong>on</strong>e: 021 – 4927288 - 087 2996018Refocusing Acute PsychiatryRefocusing Acute Psychiatry is a structured approachto practice development and project managementwithin an acute admissi<strong>on</strong> envir<strong>on</strong>ment.It is based up<strong>on</strong> work strain theory and soluti<strong>on</strong>focused approaches in order to improve the quality ofworking lives of staff, to improve the quality of patientcare and to develop the “specialism” of acutepsychiatry. This Model was developed by Mr. NickBowles, based <strong>on</strong> his observati<strong>on</strong> of best practice inBradford, West Yorkshire, his participati<strong>on</strong> in thedevelopment of UK acute mental health policy and thematch between practice, policy and organisati<strong>on</strong>alpsychology.Refocusing is a highly specific series of interventi<strong>on</strong>sand is based up<strong>on</strong> psychological and organisati<strong>on</strong>altheory most importantly “the job strain” model(Karasek & Theorell). Two Cork sites have beeninvolved with this work since 2004, some of thepractice development themes include leadershippers<strong>on</strong> centred/recovery, purposeful admissi<strong>on</strong>, clearstructured and wellboundaried wards, engagement,therapeutic activity, audit and managerial support.The fundamental principles and some of the structuralelements of refocusing are in keeping with theemergent views of the mental Health Commissi<strong>on</strong> andour policy document “A Visi<strong>on</strong> for Change”Soluti<strong>on</strong> Focused Therapy in Acute MH Care (partof the Irish “Refocusing” initiative)Preferred Futures (Nick Bowles)Nick Bowles1 Pecket Well Mill, Hebden Bridge, W Yorks, HX7 8QY EnglandPh<strong>on</strong>e: 0044 7977 038302Email: preferredfutures@gmail.comDescripti<strong>on</strong> of training programme delivered in Ireland,defines SFT and role in acute MH care, in-pt andcommunity, summarises evidence base, shows howsix simple tools can be used in wards to performancemanage engagement.engagement, therapeutic activity,audit and managerial support.6


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sThe use of children’s literature and film toenhance the therapeutic relati<strong>on</strong>ship in Child &Adolescent mental health nursingUniversity College DublinColman NoctorSchool Of Nursing, Midwifery & Health Sciences, UCDPh<strong>on</strong>e: 0860854588Email: colman.noctor@ucd.ieThis paper outlines how nurses in the area of child andadolescent mental health can utilise the narrative oftheir young service users in order to enhance theengagement in the therapeutic relati<strong>on</strong>ship. The paperoutlines two initiatives where nurses exercised aninnovative strategy of discussing the topics of the‘Harry Potter’ and the movie ‘Annie’ to overcome initialresistance with children in their care. Thesediscussi<strong>on</strong>s led to a number of revelati<strong>on</strong>s about thechild’s inner world and their identificati<strong>on</strong>s with ficti<strong>on</strong>alcharacters as a form of coping.This initiative shows the value of aborting <strong>on</strong>e’s ownclinical agenda in pursuit of the truth and insteadallowing the child to bring you there via their view of theworld.An evaluati<strong>on</strong> of the reas<strong>on</strong>s undergraduatestudents choose mental health and intellectualdisability nursing as a career in Dublin, Kildare &Wicklow.Regi<strong>on</strong>al Promoting Nursing & Midwifery as a Career Groupchaired by the NMPDUSusanna ByrneNursing and Midwifery Planning & Development Unit(NMPDU) HSE, Mill Lane, Palmerstown, Dublin 20.Ph<strong>on</strong>e: 01 6201713Email: Susanna.byrne1@hse.ieOne of the resp<strong>on</strong>sibilities of the promotingnursing/midwifery as a career group is that promoti<strong>on</strong>alstrategies being implemented are evaluated for theireffectiveness.In order to meet this remit, the regi<strong>on</strong>al groupc<strong>on</strong>ducted a survey am<strong>on</strong>gst all 1st yearundergraduate nursing/midwifery students whocommenced their degrees in Autumn 2007.The survey sought to obtain views about whatinfluenced them to choose nursing/midwifery as acareer, their percepti<strong>on</strong> of current promoti<strong>on</strong>alstrategies and suggesti<strong>on</strong>s for alternative methods ofpromoting nursing/midwifery.The findings will assist the group to:-· Review the success or otherwise of currentpromoti<strong>on</strong>al strategies· Identify what strategies are most useful andeffective in promoting nursing/midwifery as afuture career am<strong>on</strong>g school leavers and maturecandidates.· Plan new and innovative promoti<strong>on</strong>al methodsbased <strong>on</strong> feedback· Help adequately inform potential candidates whata career in nursing/midwifery entails prior toselecti<strong>on</strong>7


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sClinical Learning Manual for UndergraduateNurse Students in a Mental Health Day HospitalFacilityEast Galway Mental Health Services-Ballinasloe Day HospitalGerard GrehanBallinasloe Day Hospital, Health Centre, Brackernagh,Ballinasloe, Co. Galway.Ph<strong>on</strong>e: 0909646256Email: gerardgrehan@hse.ieThe aim of this Clinical Learning Manual, developed in 2008, is to facilitate nursing undergraduate learning, whilst<strong>on</strong> clinical placement, within Ballinasloe Day Hospital. It augments Learning Objectives for undergraduates, alreadyin place, within Ballinasloe Day Hospital. The manual includes topics with a professi<strong>on</strong>al, legal, biopsychosocialand interpers<strong>on</strong>al focus, with each nurse having worked <strong>on</strong> a specific number of topics.The aim of clinical practice is to enable students develop domains of competence (An Bord Altranais, 2000) andbecome safe, caring, competent decisi<strong>on</strong>-makers willing to accept pers<strong>on</strong>al and professi<strong>on</strong>al accountability forevidenced based nursing care. In this regard, each registered nurse has a duty to provide students with clinicalsupport to help them questi<strong>on</strong>, analyse, reflect up<strong>on</strong> their practice and develop aut<strong>on</strong>omy in decisi<strong>on</strong>making toenable them to become safe, caring, competent nurses.A Recovery focused post registrati<strong>on</strong> mentalHealth/Psychiatric Nursing ProgrammeSchool of Nursing, Dublin City University, Dublin & HSE Nth Eastand Mid Leinster Regi<strong>on</strong>sDenise Proudfoot, Programme DirectorSchool of Nursing, Dublin City University, Glasnevin, Dublin 9.Ph<strong>on</strong>e: 00 353 1 700 8544 / 700 5947Email: denise.proudfoot@dcu.ieThis <strong>on</strong>e year programme aims for students (all who are already registered nurses) to become competent,compassi<strong>on</strong>ate and critically aware psychiatric/mental health nurses. The philosophy of the programme is based<strong>on</strong> the Visi<strong>on</strong> for Change (DOH& C 2006) This policy document provides a comprehensive blueprint for thedevelopment of resp<strong>on</strong>sive and dynamic mental health services in Ireland for all. It foregrounds the followingprinciples:· The adopti<strong>on</strong> of the recovery model within mental health service;· The importance of societal resp<strong>on</strong>ses to mental health issues;· The lifespan approach to mental health care whilst c<strong>on</strong>sidering the needs of the wholepopulati<strong>on</strong> in relati<strong>on</strong> to mental health activities;· Involvement of service users and their carer’s in every aspect of service developmentand nurse educati<strong>on</strong>al programmes;· Mental health promoti<strong>on</strong>This is a <strong>on</strong>e year course and student spends 36 weeks in practice settings and 12 weeks in college.8


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sPromoti<strong>on</strong> of Intellectual Disability Nursing as aCareer of Choice (October 2007 to April 2008)St Joseph’s Intellectual Disability Service, PortraneCo DublinPaul Gorman (Clinical Placement Co-ordinator)Practice DevelopmentSt Joseph’s Intellectual Disability Service, PortranePh<strong>on</strong>e: 01 883 6024Email: Paul.gorman1@hse.ieThis was the first time a career in intellectual disabilitynursing had been promoted in the sec<strong>on</strong>dary schoolsand colleges in the Dublin, Kildare and Wicklow regi<strong>on</strong>.Its aim was to promote and enable the recruitment intointellectual disability nursing as a first choice careeropti<strong>on</strong>.Over a six m<strong>on</strong>th period, a clinical placement coordinator (CPC) visited and made approximately 97presentati<strong>on</strong>s to over 3,000 young people regarding acareer in Intellectual Disability nursing Over the sixm<strong>on</strong>ths he visited 84 schools,17 colleges of furthereducati<strong>on</strong> providing Further Educati<strong>on</strong> & TrainingAwards Council (Fetac ) level 5 health care courses fora variety of students. He also visited 7 services someof whom were running Fetac courses through theircentres of nurse educati<strong>on</strong>.The success of the project will ultimately be measuredin the services as new groups of students take up theiroffer of intellectual disability nursing over the nextcouple of years, the whole process will most certainlyhelp to raise awareness of people with intellectualdisability for sec<strong>on</strong>dary school students.The Role of the Clinical Nurse Specialist (C.N.S.)in the Provisi<strong>on</strong> of Outreach Based Assessmentand Interventi<strong>on</strong> for People with an IntellectualDisability Whose Behaviour Challenges.HSE-Dublin North-East. Regi<strong>on</strong>al Disability Services.Una Tumany CNM 3 Dermot Courtney CNSI<strong>on</strong>a House, Drumillard, Castleblayney, M<strong>on</strong>aghanePh<strong>on</strong>e:0868074606 Dermot Courtney0871212506 Una TumanyEmail: Dermot.Courtney@hse.ie - una.tumany@hse.ieThe service provided is an assessment andinterventi<strong>on</strong> service for people with an I.D who engagein physically assaultive behaviour.The service provided by the Clinical Nurse Specialist(C.N.S) in this area of specialist practice draws <strong>on</strong> hisqualificati<strong>on</strong>s as an instructor in The Professi<strong>on</strong>alManagement of Aggressi<strong>on</strong> and Violence (PMAV) andPositive Behaviour Support, coupled with his practicalexperience of working in this area, resulting in a veryservice specific, needs assessed resp<strong>on</strong>se to difficultsituati<strong>on</strong>s for both service users and staff.The framework for the delivery of this service in theNorth-East of Ireland was developed in the c<strong>on</strong>text ofMultidisciplinary Team (M.D.T.) working and a templatefor CNS work in this area. It is acknowledged that thedevelopment of CNS posts throughout the disabilitysector is very much influenced by service need, andthis in itself, results in the role and scope of these postsdiffering from <strong>on</strong>e area to another. However, thetemplate outlined and discussed does have thepotential to be adapted and used for individual CNSwork across different settings.9


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sDeveloping the nursing c<strong>on</strong>tributi<strong>on</strong> to intellectualDisability. The educati<strong>on</strong>al resp<strong>on</strong>se in ScotlandNapier University Edinburgh. NHS Educati<strong>on</strong> for ScotlandElaine KwiatekNapier University, Comely bank Campus, 13, Crewe Rd South, Edinburgh, EH4 2LDPh<strong>on</strong>e: 0131 455 5364Email: e.kwiatek@napier.ac.ukAim:In 2002 the Scottish Government publishedPromoting Health, Supporting Inclusi<strong>on</strong> that set out thepolicy directi<strong>on</strong> to support the c<strong>on</strong>tributi<strong>on</strong> of nursesand midwives to improve the health of people withintellectual disabilities. Major recommendati<strong>on</strong>s weremade regarding educati<strong>on</strong> and practice developmentissues that required to b e addressed. The aim of thispaper is to detail the educati<strong>on</strong> and practicedevelopments that have occurred since the publicati<strong>on</strong>of Promoting Health, Supporting Inclusi<strong>on</strong> and theirimpact.Method:Two evaluati<strong>on</strong>s were undertaken to identify the impactof nursing and midwifery educati<strong>on</strong> and practicedevelopment initiatives. Evaluati<strong>on</strong> <strong>on</strong>e involved aScotland-wide collecti<strong>on</strong> of evidence of developmentand evaluati<strong>on</strong> two reviewed the impact ofundergraduate nurse educati<strong>on</strong> developments.Results and C<strong>on</strong>clusi<strong>on</strong>s:Data was analysed to identify the key educati<strong>on</strong> andpractice developments that have occurred acrossScotland. Significant developments have occurredincluding the commissi<strong>on</strong>ing of new educati<strong>on</strong>materials, the establishment of new curriculumframeworks and educati<strong>on</strong> collaborati<strong>on</strong>s. Despite thenati<strong>on</strong>al focus and evidence of educati<strong>on</strong>developments, challenges remain and there is a needto c<strong>on</strong>tinue to promote and develop the educati<strong>on</strong> andpractice development focus in the future.Recent Irish Publicati<strong>on</strong>:Nursing and Midwifery in IrelandA Strategy for Professi<strong>on</strong>al Development in aChanging Health ServiceAuthor: Yv<strong>on</strong>ne O’Shea10


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sRecovery within a Teamwork c<strong>on</strong>textEast Galway Mental Health Services-Ballinasloe Day HospitalGerard GrehanBallinasloe Day Hospital, Health Centre, Brackernagh,Ballinasloe, Co. Galway.Ph<strong>on</strong>e: 0909646256Email: gerardgrehan@hse.ieEffective teams are cohesive, self supporting, and arevery clear about their core purpose (Barker,2003).Within Ballinasloe Day Hospital, ‘recovery’ forms anintegral part of service provisi<strong>on</strong>, within a teamworkc<strong>on</strong>text.Within mental health services, the ‘recovery model’emphasises the expectati<strong>on</strong> of recovery from mental illhealth and promotes both enhanced self-managementfor mental health service users and the development ofservices which facilitate the individuals pers<strong>on</strong>aljourney towards recovery(MHC,2005).Accordingly, nurses role within the multidisciplinaryteam involve: Advocacy; Audit; Liais<strong>on</strong>;Intensive Community Treatment Programme (ITPC);Informati<strong>on</strong> & Support; Domiciliary visits; Physiologicalstatus m<strong>on</strong>itoring; Educati<strong>on</strong> from a social &psychological perspective and Detoxificati<strong>on</strong>m<strong>on</strong>itoring.Music in Mental HealthcareWaterford Healing Arts TrustKevin O’ ShanahanC/O Derrylugga, Skibbereen, County CorkPh<strong>on</strong>e: 028 51661 / 087 7767318Email: kevinoshanahan@hotmail.comKevin O' Shanahan is a psychiatric nurse based in theWest Cork Mental Health services. Kevin is also amusician with extensive experience of using music asa tool of social inclusi<strong>on</strong> and self expressi<strong>on</strong>. Since2006, he has worked with Waterford Healing Arts Trustin developing Music in Healthcare (MIH).This approach uses music as a therapeutic tool byencouraging self expressi<strong>on</strong> and has beendem<strong>on</strong>strated to c<strong>on</strong>tribute to social inclusi<strong>on</strong> andholistic health.MIH complements the empowerment ethos, whichunderpins the Recovery model of Mental Health care.The input of the nurse, due to their close workingrelati<strong>on</strong>ships and knowledge of service users has beenshown to be critical to the success of this approach.Kevin has recently facilitated training days using thisapproach for nurses in St. Otterans Hospital, Waterfordand in various mental health settings in Cork.11


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sAudit of Core AssessmentsEast Galway Mental Health Services-Ballinasloe Day HospitalGerard GrehanBallinasloe Day Hospital, Health Centre, Brackernagh,Ballinasloe, Co. Galway.Ph<strong>on</strong>e: 0909646256Email: gerardgrehan@hse.ieThese were initially carried in February, July andOctober 2007 by a Staff Nurse and the Clinical NurseManager (CNM2) respectively. The first two auditsidentified deficits in relati<strong>on</strong> to completi<strong>on</strong> of CoreAssessments, completi<strong>on</strong> of Risk Assessment tool,and completi<strong>on</strong> of and returning letter to ReferringAgent. Deficits in relati<strong>on</strong> to clarificati<strong>on</strong> of Key Workingissues were also identified. Following discussi<strong>on</strong> ofthese outcomes with the CNM2, C<strong>on</strong>sultantPsychiatrist and Assistant director of Nursing(A.D.O.N), it was agreed that Core Assessmentscarried out each week, would be discussed at thefollowing weeks Case Management meeting, eachTuesday.This is current practice. Audits are <strong>on</strong>going.Early Interventi<strong>on</strong> in Psychosis- PerspectivesFrom A Clinical Nurse SpecialistDETECT - Dublin and East Treatment anEarly care TeamLaoise Renwick - Clinical Nurse SpecialistAvila House, Block 5, Blackrock Business Park, Carysfort Avenue,Blackrock, Co. Dublin.Ph<strong>on</strong>e: 01 2791700Email: laoise.renwick@sjog.ie: info@detect.ieEarly Interventi<strong>on</strong> in PsychosisThere are 75,000 sufferers of psychosis in Ireland with1,300 new cases annually. Including families,psychosis affects five times this amount of people.Every year 7,800 people are diagnosed with apsychotic illness. Recent research has shown thatpeople who are diagnosed with a psychotic illness aretypically unwell for 1-2 years before receiving effectivetreatment.To combat this delay early interventi<strong>on</strong> in psychosisservices have been established and proven effectiveinternati<strong>on</strong>ally. Two important results have been found1. This delay can be reduced so that people canget effective and timely treatment2. People who receive treatment earlier haveimproved outcomesDETECT (Dublin East Treatment and Early Care Team)is Irelands first Early Interventi<strong>on</strong> in Psychosis Servicewhich aims to reduce delays in accessing treatmentand provide comprehensive interventi<strong>on</strong>s to aidrecovery. DETECT is committed to evaluating theimpact of this service for the people whom it serves.For more informati<strong>on</strong> log <strong>on</strong> to www.detect.ie12


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sClient experiences of being in a nurse ledsoluti<strong>on</strong> focused group.HSE Dublin North EastJames Lynch.Regi<strong>on</strong>al Centre of Nurse Educati<strong>on</strong>, C<strong>on</strong>nolly Hospital,Blanchardstown, Dublin 15.Ph<strong>on</strong>e: 01 6465457Email: james.lynch@hse.ieEffective soluti<strong>on</strong>-focused nursing interventi<strong>on</strong>s areshortterm goal-focused therapeutic approaches whichhelp people change by c<strong>on</strong>structing soluti<strong>on</strong>s ratherthan dwelling <strong>on</strong> problems.The growing evidence <strong>on</strong> the effectiveness of suchapproaches is short <strong>on</strong> exploring people’s experiencesof having the therapy. Accordingly, this Heideggerianhermeneutical analysis reveals the meaning for peopleof being in a nurse-led soluti<strong>on</strong>-focused group. Thefocus of enquiry for this study was the experiences ofclients in a mental health day centre who participatedin a soluti<strong>on</strong>-focused group work programme whichwas facilitated by mental health nurses.Treating Adults with Eating Disorders in theCommunityCommunity Integrated Eating Disorder Programme (CIEDP)Carlow Kilkenny Mental Health ServiceSean Boland / Willie HackettSt Canices Hospital, Dublin Rd, KilkennySt Dympnas Hospital, Athy Rd, CarlowPh<strong>on</strong>e: 056 7784401 / 059 9136302Email: Sean.Boland@hse.ieThe (CIDEP) is an integrated model of treatment forpeople who have an eating disorder and their families& significant others.The programme c<strong>on</strong>sists of a number of strands:A. Individual assessment & therapy.B. Family assessment & therapy.C. Psychiatric assessment & treatment.D. Family/Significant others support &educati<strong>on</strong> meeting.E. General Practiti<strong>on</strong>er medical reviews.This is an exciting and innovative out-patientstreatment programme that has been developed by twoCNS in Family Therapy, al<strong>on</strong>g with other professi<strong>on</strong>alsover the last eight years.It is a particularly good model of multi-disciplinaryworking, with regards to eating disorders, and relevantto nurses working in multi-disciplinary teams attachedto Mental Health services. As it looks at the challengespeople face when setting up and managing innovativeprojects within the above c<strong>on</strong>text.13


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sDeveloping an Advanced Nurse Practiti<strong>on</strong>er(ANP) post in Addicti<strong>on</strong> and Mental HealthSt. Vincent’s Hospital, Fairview / HSE Dublin North CentralClódagh O’Sullivan / Phil Burke DONThe Lodge, St. Vincent’s Hospital, Fairview, Dublin 3Ph<strong>on</strong>e: 01-8842401 Clódagh O’ Sullivan01-8842445 Phil BurkeEmail: clodaghosullivan@svhf.ie / philburke@svhf.ieBest practice in relati<strong>on</strong> to alcohol services indicates that provisi<strong>on</strong> of alcohol detoxificati<strong>on</strong> should occur intandem with the initiati<strong>on</strong> of psychosocial treatments (Carroll, 1997) The experience of the Substance AbuseService is that due to (1) extensive waiting lists and (2) detoxificati<strong>on</strong> being within the medical domain andpsychosocial treatments within the (specialist) nursing domain, these two events happen quite separately, withthe c<strong>on</strong>sequential ‘loss’ of clients between both events.In order to address this and to provide expert care at point of client c<strong>on</strong>tact, the ANP post has been developed.The ANP will meet the client when they first present, assess the client for detoxificati<strong>on</strong> and organise* same.The ANP follows up the client <strong>on</strong> an <strong>on</strong>going basis to c<strong>on</strong>tinually assess progress <strong>on</strong> detoxificati<strong>on</strong> and toinitiate psychosocial treatments. The client c<strong>on</strong>tinues to meet with the ANP until (a) discharge or (b) a placebecomes available for l<strong>on</strong>ger term counselling.(*Future plans include nurse prescribing)Nursing and MidwifePrescribing in IrelandFollowing legislative amendments to allow nurses and midwivesprescriptive authority in Ireland in May 2007, the prescribinginitiative c<strong>on</strong>tinues to gain momentum, led nati<strong>on</strong>ally by theHealth Service Executive HSE. Through the Office of theNursing Services Director.Currently there are 21 nurses and midwives registered as NursePrescribers with An Bord Altranais and the number is set toincrease further - 56 organisati<strong>on</strong>s are in the process ofimplementing the initiative across 46 clinical specialities.You Can Download This publicati<strong>on</strong> Atwww.ncnm.ie/files/prescribing/Intro_prescribing_oct07.pdf14


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sNurse Empowerment within theMultidisciplinary Team.Loughrea/ Athenry Community Mental Health Services.Ann Cleary /Francis WalshLoughrea Day Hospital, Barrack Street,Loughrea, Co Galway.Ph<strong>on</strong>e: 091 847003Email: Anneg.cleary@hse.ieNurses’ role and input in service development in a ruralmental health service in County Galway has enhancedand redefined the c<strong>on</strong>tributi<strong>on</strong> of nursing as adiscipline within the MDT team.Prior to 2004 the role of nurses outside of the medicalprofessi<strong>on</strong> was mainly around the provisi<strong>on</strong> of care<strong>on</strong>ce assessment was completed by the medicalprofessi<strong>on</strong>, this effectively meant under utilisati<strong>on</strong> ofnursing expertise. Multidisciplinary subgroups wereestablished comprised of all team members andchaired by nurses focused <strong>on</strong> the followinginitiatives:· Generic Biopsychosocial Assessment· Care-Coordinati<strong>on</strong>· Recovery Care Planning.Yearly audits, undertaken by nurses havedem<strong>on</strong>strated an improvement in service deliverybetween 2005-2008. Major advances were recorded interms of access to the service with a significantreducti<strong>on</strong> in hospital admissi<strong>on</strong>s.Nurses now c<strong>on</strong>duct the initial assessments of serviceusers and in 2008 from the 294 new referrals to theservice nurses have assessed 220 people. This hassignificantly impacted <strong>on</strong> waiting times bringing abouta reducti<strong>on</strong> from 6-8 weeks for medical assessment tosame day biopsychosocial assessment.All nurses carry a caseload and coordinate the care ofservice users <strong>on</strong> this caseload including assessing,planning care, liaising with primary care, working withfamilies and carers in delivering a truly biopsychosocialholistic recovery focused service.Currently nurses are care coordinating the largestnumber of service users.Following these changes a number of benefits haveoccurred for nursing. Nurses feel empowered asclinicians with increased levels of aut<strong>on</strong>omy withproper support and supervisi<strong>on</strong>.Nurses are actively involved in audit/ research andc<strong>on</strong>tinuing educati<strong>on</strong> and play an active part inpromoting the invaluable c<strong>on</strong>tributi<strong>on</strong> of the nursingprofessi<strong>on</strong> <strong>on</strong> nurse academic programmes and atnati<strong>on</strong>al c<strong>on</strong>ferences. Our governing body An BordAltranais <strong>on</strong> inspecti<strong>on</strong> in 2006 acknowledged theservice as a centre of nursing excellence in their annualreport.Psychiatric Mental Health NursingAn Irish PerspectiveEds: Jean Morrissey, Brian Keoghand Louise Doyle· Includes a chapter <strong>on</strong> the physical assessment ofclients with mental health problems, and a chapter<strong>on</strong>physical treatments and pharmacology.Foreword by Prof. Phil Barker· A new and unique textbookshowcasing psychiatricmental health nursing from anIrish perspective.· C<strong>on</strong>tributi<strong>on</strong> from keypsychiatric mental healthnursing academics, cliniciansand experts.· Introduces and details thenew Mental Health Act2001 in Ireland.· Discusses all the main illnesses in a nursing carec<strong>on</strong>text, providing an overview of the treatmentsavailable, with an emphasis <strong>on</strong> the nursing careand management of these illnesses.· Provides a detailed account of a number ofc<strong>on</strong>temporary issues impacting <strong>on</strong> the practice ofpsychiatric and mental health nursing; including serviceuser involvement, sexuality and mental health, clinicalsupervisi<strong>on</strong>, liais<strong>on</strong> psychiatric nursing and transculturalmental nursing.· Uses scenarios and reflective questi<strong>on</strong>s at the endof each chapter to facilitate student learning andrevisi<strong>on</strong>.· Suitable as a core text for all students of mentalhealth nursing across all years and has relevancefor postgraduate mental health nursing students.This book is also suitable as a resource for practisingclinicians.15


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sAdministering Depot Injecti<strong>on</strong>s:Best Practice GuidelineSchool of Nursing, Dublin City University,Glasnevin, Dublin 9, Ireland.Angela CocomanSchool of Nursing, Dublin City University,Glasnevin, Dublin 9,Ireland.Ph<strong>on</strong>e: 00 353 1 7007809E-mail: angela.cocman@dcu.ie.John MurrayCommunity Mental Health Nurse, Brook House,Cork Road, Waterford,Ireland.Ph<strong>on</strong>e: 00 353 1 7007809E-mail: murrayjt@eircom.netThis initiative involved a review of practice in the areaof Intramuscular Injecti<strong>on</strong>s (I.M.) an everyday activityfor nurses. The authors addressed the administrati<strong>on</strong>of neuroleptic depot injecti<strong>on</strong>s within the adult mentalhealth envir<strong>on</strong>ment and examined the evidence baseforthis practice and found that despite been a verycomm<strong>on</strong>place nursing activity there is a dearth ofresearch-based guidelines for nurses in this area.The published papers and nursing texts <strong>on</strong> injecti<strong>on</strong>sites and techniques were evaluated toassess their quality and relevance and their overallbenefit to improving clinical practice. Much of theliterature was in the form of opini<strong>on</strong> pieces without asound research/evidence base. There was howeverenough c<strong>on</strong>sensual evidence to form an evidencedbased clinical guideline for the administrati<strong>on</strong> ofintramuscular injecti<strong>on</strong>s.Reference:Cocoman, A & Murray, J (2008) Intramuscularinjecti<strong>on</strong>s: A review of best practice for mental healthnurses. Journal of Psychiatric and Mental healthNursing, 15: 5 pp 424-434Planning Client Care in the Addicti<strong>on</strong> Services,Dublin Mid-Leinster – A Nursing Resp<strong>on</strong>seAddicti<strong>on</strong> Services, HSE Dublin Mid-LeinsterMembers of the Care Plan Committee:Stephanie Mal<strong>on</strong>ey, Staff Nurse; Maura Maye, Staff Nurse; Rose Sheppard,CNM II; Julie Ward, Staff Nurse.Rose SheppardBridge House, Cherry Orchard Hospital, Ballyfermot,Dublin 10.Ph<strong>on</strong>e: 01-6206486 / 086-3806658Email: nursemanager.bri@hse.ieAimTo review current Care Plans to create a genericsystem of nursing documentati<strong>on</strong> for the Nursingdepartment.Launched Feb ’08, following five m<strong>on</strong>ths of use.Questi<strong>on</strong>naires re likes and dislikes of the care planswere circulated to nurses and a documentati<strong>on</strong> auditwas carried out.ResultsThirteen questi<strong>on</strong>naires were distributed and sixreturned (46.15%) outlining how nurses liked that thecare plans were short, clear and easy to use, however,some nurses found them l<strong>on</strong>g and repetitious. Thedocumentati<strong>on</strong> audit showed an overall improvementin how nurses document patient care.MethodRoy’s Adaptati<strong>on</strong> Model was chosen and adapted toaddress the biological and psychosocial needs ofclients.16


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sNursing Health Promoti<strong>on</strong> Initiative in theAddicti<strong>on</strong> Services HSE Dublin Mid-LeinsterHealth promoti<strong>on</strong> committee members:Anita C<strong>on</strong>nor. Noreen Geoghegan, David Spiro. Gail Hawthorne.Philip JamesAnita C<strong>on</strong>nor (Staff Nurse)Addicti<strong>on</strong> Services, H.S.E., Fortune House, UpperBallyfermot Rd, Dublin 10.Ph<strong>on</strong>e: 01 6206034Email: nursesfortunehouse@hse.ie• Addressing the complexity of drug misuse is <strong>on</strong>e of thekey challenges in providing effective treatment andcare. Flexible resp<strong>on</strong>sive interventi<strong>on</strong>s are needed.• Health promoti<strong>on</strong> is becoming an integral part of thehealth-care process and is related to clinical,educati<strong>on</strong>al, behavioural and organizati<strong>on</strong>al issues(Groene & Garcia- Barbero 2005).• This nurse led health promoti<strong>on</strong> programme had animportant and positive impact <strong>on</strong> service users, withthe use of health promoti<strong>on</strong> boards in waiting areasand the creati<strong>on</strong> of health promoti<strong>on</strong> leaflets <strong>on</strong> issuessuch as cocaine, overdose and motivati<strong>on</strong>.C<strong>on</strong>sequently circulati<strong>on</strong> of the leaflets has beenexpanded to other agencies that encounter drug userssuch as pris<strong>on</strong>s, general practiti<strong>on</strong>ers and communityagencies• There are twelve topics, and the topics stay up for <strong>on</strong>em<strong>on</strong>th per year.• These topics and their presentati<strong>on</strong>s and informati<strong>on</strong>are reviewed <strong>on</strong> a regular basis, in order to improveand update their c<strong>on</strong>tent. Comment cards andsuggesti<strong>on</strong> boxes are available and are reviewedregularly by the committee members.• The topics are presented in a clear c<strong>on</strong>cise and legibleformat <strong>on</strong> the notice boards in a strategically locatedpositi<strong>on</strong> in patients waiting roomsReferences:Groene, O. Garcia-Barbero, M. (2005) Health Promoti<strong>on</strong> inHospitals. Evidence and Quality Management.Copenhagen.WHO Regi<strong>on</strong>al Office for Europe.• The Health Promoti<strong>on</strong> Boards have informati<strong>on</strong>regarding a health topic, placed <strong>on</strong> the Board <strong>on</strong> am<strong>on</strong>thly basis.Your Mental HealthGroups frequently offering advice and help <strong>on</strong> mentalhealth issues. The challenge for the ‘Your MentalHealth’ awareness campaign is to make it okay to talkabout mental health in everyday life in Ireland.These booklets have been produced as part of the‘Your Mental Health' awareness campaign, which aimsto improve awareness and understanding of mentalhealth and well-being in Ireland. The PsychiatricNurses Associati<strong>on</strong> (<strong>PNA</strong>) sits <strong>on</strong> Nati<strong>on</strong>al SteeringBoth booklets aim to:· highlight some of the things we can do to lookafter our mental health· encourage us to look out for the people around us· and give an overview of some comm<strong>on</strong> mentalhealth problemsThey can be downloaded at http://www.nosp.ie/17


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sIntegrated Care and Treatment PlanSt John of God HospitalPeter D<strong>on</strong>nelly,Nursing Practice Development ManagerPh<strong>on</strong>e: 01-2771575E-mail: peter.d<strong>on</strong>nelly@sjog.ieIntroducti<strong>on</strong>:Prior to May 2008 hospital in-patient care and treatmentinformati<strong>on</strong> was held in separate discipline specific files.The project was undertaken to provide a detailed medical,nursing, multi-disciplinary assessment and, for the firsttime, formally including the patient in formatting andagreeing a plan of care; (including risk assessment and selfassessment by the service user) and establishing serviceuser's requirements of in-patient treatment.Methodology:Review of existing documentati<strong>on</strong>, Literature review ofbest practice and review of other services documentati<strong>on</strong>.Small working team of several disciplines, 1st generati<strong>on</strong>of ICTP - pilot <strong>on</strong> <strong>on</strong>e ward, c<strong>on</strong>sultati<strong>on</strong> process (patients& users -) questi<strong>on</strong>naires and feedback), evaluati<strong>on</strong>,modificati<strong>on</strong>, launch hospital wide and reviewResults:Integrated Care and Treatment PlanC<strong>on</strong>clusi<strong>on</strong>s/Implicati<strong>on</strong>s:The completed document complies with Mental HealthCommissi<strong>on</strong> and Accreditati<strong>on</strong> recommendati<strong>on</strong>s,provides service user input and <strong>on</strong>e MDT integrated filec<strong>on</strong>taining assessment, treatment & discharge plan andreports.Flagging The Problem -A new approach to mental healthAuthor: Dr Harry BarryFlagging the Problem uses a brand newway of identifying and dealing with mentalhealth problems using colour coded flagsby a medical doctor with extensiveexperience and interest in the treatment ofpeople with mental health issues.ReviewsIt's that rare thing - a medical book thatcan be read by lay people and healthprofessi<strong>on</strong>als alike. Dr Barry demystifiessubjects that touch so many of our livesand he does so with compassi<strong>on</strong>, wisdom and vastprofessi<strong>on</strong>al knowledge.Cathy KellyHave you ever come across a book that fundamentally changedyour understanding of a subject? Flagging the Problem: A newapproach to mental health is such a rarity. It is a superb book.It explains mood disturbances in a fresh and accessible way. Icannot recommend it highly enough, in particular to thosetravelling the l<strong>on</strong>ely journey of mental illness, and their families.(The Irish Times)Having read Flagging the Problem, I now have a much betterunderstanding of why Niall died. This book is written in verysimple terms, exploring the complex nature of depressi<strong>on</strong> andsuicidal tendencies. It is a 'must read' for every parent,informing them of the tell-tale warning signs of depressi<strong>on</strong> andsuicide.John, father of Niall, who died by suicide in2002About the BookAs Irish society undergoes rapid change and the pace ofmodern life seems everfaster, it is unsurprising that the issue ofmental health has become more prominent and, thankfully,somewhat more openly discussed - and the provisi<strong>on</strong> oftreatment better and more widely available. Flagging TheProblem : A New Approach to Mental Health. is made up of fivemain secti<strong>on</strong>s. Each secti<strong>on</strong> marked with a coloured flagrepresents a particular mental state or area of c<strong>on</strong>cern:Green Flag explains the normal mood system, the Red Flagdeals with depressi<strong>on</strong>, the Yellow Flag addresses anxiety, thePurple Flag deals with addicti<strong>on</strong> and the White Flag whichaddresses the issue of suicide. There is a technical secti<strong>on</strong>, andextra appendices at the end of the book including informati<strong>on</strong><strong>on</strong> self-help groups, and a list of comm<strong>on</strong>ly used medicines.About the AuthorDr Harry Barry is medical doctor based in County Louth. He hasa particular interest in the area of mental health and hasextensive experience in his practice of dealing with issues suchas depressi<strong>on</strong>, addicti<strong>on</strong> and anxiety. Dr. Barry was moved towrite the book following a particularly tragic death by suicide ina local family and is absolutely committed to seeking tocounteract the disruptive effects of mental illness both locallyand nati<strong>on</strong>ally.18


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sAn examinati<strong>on</strong> of the services provided byPsychiatric C<strong>on</strong>sultati<strong>on</strong> Liais<strong>on</strong> Nurses in ageneral hospitalHSELouise Johnst<strong>on</strong>Department of Liais<strong>on</strong> Psychiatry, Midlands Regi<strong>on</strong>al Hospital at TullamoreArden Road, Tullamore, Co OffalyPh<strong>on</strong>e: 057 935 8463E-mail: pcln@hse.ieThe political, professi<strong>on</strong>al and ec<strong>on</strong>omic c<strong>on</strong>text in whichmental health care is delivered has witnessed significantchanges in recent times. The movement of psychiatricpatients from instituti<strong>on</strong>s to community settings has seenthe emphasis of the loci of care delivery shifting withincreasing numbers presenting to general hospitals. Thespeciality of the Psychiatric C<strong>on</strong>sultati<strong>on</strong> Liais<strong>on</strong> Nurse(PCLN) has emerged as a bridge between mental healthand general hospital services. A descriptive, n<strong>on</strong>experimentalresearch approach was employed toestablish patient profiles and to provide an overview of thedepth of service provisi<strong>on</strong>.During the study period a total of sixty-six patients wereassessed by the PCLN and within this group 47% wereidentified as new to the mental health services. Thepresentati<strong>on</strong> of new patients in this study dem<strong>on</strong>stratesthat the provisi<strong>on</strong> of a PCLN in the general hospitalprovides a service to patients who previously may nothave received a psychiatric assessment, a view supportedby Callaghan et al. (2001).The most comm<strong>on</strong> reas<strong>on</strong> for referral to the PCLN was forassessment following a parasuicide attempt (41%), ofwhich 86% presented with self-pois<strong>on</strong>ing and theremainder (14%) with a self-injury. The majority of patients’were male (59%), under thirty (56%), discharged by daythree of their admissi<strong>on</strong> (78%) and were referred from <strong>on</strong>eof the medical specialities (63%). This is an importantfinding given the c<strong>on</strong>cerns in Ireland over the alarming risein suicide rates am<strong>on</strong>g young males (Department of Health& Children 2006). Following a presentati<strong>on</strong> of parasuicide,it is well recognised that the patient is at increased risk ofsuicide and mortality from accidental causes (Carter et al.2005). The provisi<strong>on</strong> of a PCLN in assessing and managingpatients with a parasuicide attempt is an essential andkeeps in line with the Government and the World HealthOrganisati<strong>on</strong>s targets of improving mental health care andreducing the rates of suicide.During the study period the most frequent diagnosis <strong>on</strong>c<strong>on</strong>sultati<strong>on</strong> was that of mood disorders (41%). Of thepatients provided with this diagnosis, 48% were admittedto the hospital with a n<strong>on</strong>-psychiatric issue. This isc<strong>on</strong>sistent with the literature and reflects the proclivity ofmood disorders to occur in associati<strong>on</strong> with a physicalillness or as a manifestati<strong>on</strong> of a physical illness (Bolt<strong>on</strong>2001, Yakimo et al. 2004). The evidence from this studysupports the growing acknowledgement of psychologicalfactors influencing physical health. Studies havehighlighted the negative and costly effect of the underrecogniti<strong>on</strong>of psychiatric disorders in medical inpatientsthrough l<strong>on</strong>ger hospital stays, added disability, lessappropriate use of medical procedures and repeatedadmissi<strong>on</strong>s (Baldwin et al. 2004, de Cruppe et al. 2005,Kornfeld 2002, Szigethy et al. 2002). These factors outlinethe growing financial burden of mental ill-health, which arein additi<strong>on</strong> to the negative impact of the pers<strong>on</strong>s’ quality oflife, the human element of suffering caused by thisc<strong>on</strong>diti<strong>on</strong> and the ramificati<strong>on</strong>s for families. Therefore therecogniti<strong>on</strong>, facilitati<strong>on</strong> of an assessment anddevelopment of a treatment plan for these patients is animportant aspect of the PCLN service. Its advantages maybe to reduce financial costs (Roberts 1997), assist patientsin achieving optimal mental health and improve therecovery process from a physical illness (Moore &McLaughlin 2003).Each patient received an individual plan of care followingthe PCLN assessment with almost half being referred tothe psychiatrists’ outpatient clinic (49%). Nineteenpatients were discharged to the care of their GP (29%),while six patients during the study period were admitted tothe psychiatric unit (9%). For those patients admitted tothe psychiatric unit, 83% had a past psychiatric history. Ahigher percentage of patients without a past psychiatrichistory were discharged back to the care of their GP (68%)and of the patients referred to the psychiatrists outpatientclinic, 58% had a past psychiatric history. A small numberof cases (n=4) required the psychiatrist to provide anadditi<strong>on</strong>al assessment <strong>on</strong> request from the PCLN.Thus it is noted that 94% of patients did not receive anassessment from a psychiatrist and the PCLN acted in aprofessi<strong>on</strong>al aut<strong>on</strong>omous mode of practice in terms ofappropriate patient care assessment and referral.The results add further credence to the existing evaluativestudies in presenting the characteristics of patients withinthe Irish c<strong>on</strong>text and further c<strong>on</strong>tribute to the unique bodyof evidence that defines the mental health nurse in anadvancing role.19


Psychiatric Nurses Associati<strong>on</strong> <strong>PNA</strong> - <str<strong>on</strong>g>Building</str<strong>on</strong>g> <str<strong>on</strong>g>Success</str<strong>on</strong>g> <strong>on</strong> Str<strong>on</strong>g Foundati<strong>on</strong>sDeveloping the Role of an Advanced NursingPractiti<strong>on</strong>er in Therapeutic Interventi<strong>on</strong>s forAdults with an Intellectual Disability and Co-Existing Mental Health DisorderSligo/Leitrim Intellectual Disability Services· Catherine Lynch A/Director of Nursing Clo<strong>on</strong>amah<strong>on</strong> Services,· Teresa O’Malley, Practice Development Co-ordinator Intellectual Disability· Winnie C<strong>on</strong>nolly, Clinical Nurse Specialist, Behaviour Therapy.Sligo/Leitrim and West Cavan Intellectual Disability Services.· Patricia Leyd<strong>on</strong>, CNM 11, Clo<strong>on</strong>amah<strong>on</strong> Services· Liz Breslin, Development Officer, NMPDU, D<strong>on</strong>egalTeresa O Malley,Practice Development Coordinator,Intellectual DisabilityNursing Midwifery Planning and Development Unit, I<strong>on</strong>a House, Ballyshann<strong>on</strong>, County D<strong>on</strong>egal.Ph<strong>on</strong>e: 0719822106E-mail: Teresa.Omalley@hse.ieThe Sligo/Leitrim Intellectual Disability service arecurrently developing an Advanced Nurse Practiti<strong>on</strong>er intherapeutic interventi<strong>on</strong>s for people with an intellectualdisability and a co-existing mental health disorders. Thisadvanced nursing role will enhance the service provisi<strong>on</strong>from the perspective of the client, the nurse and themultiprofessi<strong>on</strong>al team and other agencies thatprovide support and care.The role will amalgamate therapeutic interventi<strong>on</strong>soriginating from intellectual disability and mental healthnursing. This Advanced Nurse Practiti<strong>on</strong>er will provideleadership, c<strong>on</strong>duct research and promote clinicalexcellence in pers<strong>on</strong> centred client care through workingcollaboratively with healthcare professi<strong>on</strong>als both inIntellectual Disability and Mental Health Services in SligoLeitrim.Crisis Interventi<strong>on</strong> Service – A Nurse Led ApproachCarlow Mental Health ServicesKevin Behan / Avril NolanC/O Greenbanks House, Athy Road, Carlow.Ph<strong>on</strong>e: 059-9136324E-mail: avril620@hotmail.comGreenbanks house is a 12 bedded unit (8) Crisis bedsand (4) Respite beds, which focuses <strong>on</strong> addressing theneeds of people in a highly integrated way.It is a 24 hour staffed unit, facilitating out of hourspresentati<strong>on</strong> to the service.The unit can be accessed by the Mental Health Team forclients who are deemed to require a brief period toresolve some psychological or social crisis in their livesthus avoiding admissi<strong>on</strong> to hospital.The unit also provides care for clients discharged fromthe acute unit, reducing length of in-patient stays andfacilitating their return to community living.A Respite facility for carer’s and family members is alsoprovided.In line with this, is the Outreach Service whichincorporates intensive follow-up for a number of clients,whom would previously have had a high admissi<strong>on</strong> rate.It is a community-based interventi<strong>on</strong> programme and it’scentral principle is the provisi<strong>on</strong> of individualised,focused and proactive care to clients, to minimize therisk of disengagement and to maximise involvement inthe recovery process.20


NURSING & ALLIED SERVICESNursing and Allied Services,the South East’s leading nursingrecruitment agency, currently requires■Registered General Nurses■Psychiatric Nursesfor agency workRegister with NAS* today and you’ll beentered into a m<strong>on</strong>thly draw for a chance towin a Deluxe Day Spa Package from SamMcCauley ChemistsFOR MORE INFORMATION CALL1890 627 627e-mail: nurses@nas.iewww.nas.ie*Terms and c<strong>on</strong>diti<strong>on</strong>s available <strong>on</strong> www.nas.ieWE CARE BECAUSE YOU CARE

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