Assessment And Clinical Decision Making For A Mental Health Patient In Crisis.
Assignment Brief
(1)Demonstrate the following knowledge and understanding:
Critically review and evaluate relevant theories, models and evidence relating to the nature of crisis in people with often complex mental health needs and the services that may be assessed.
(2)Demonstrate the following skills and abilities:
Articulate and critically discuss holistic assessments of the person with a mental health problem, whilst involving the service user and their family/carer, to make evidence-based informed decisions about required interventions for promoting recovery.
Scenario
Chomy was brought in by ambulance to the A&E after taking an impulsive overdose of 150mg paroxetine and 250mg of quetiapine, following multiple mental and social stressors. She is known to Mental health services with a history of psychotic depression and emotionally unstable personality disorder (EUPD). She was struggling to cope following her father’s death, who was her protective factor and she break-up of an online relationship recently, the termination of the home visit with her two young children, and the problem with her house utilities and outstanding repairs. She was experiencing poor sleep, poor appetite, self-neglect, and a lack of motivation to attend to Activities of Daily Living (ADL).
She reported feelings of loneliness and isolation, and she does not know how she feels about the overdose or surviving the suicide attempt. The psychiatric liaison service (PLS) referral document suggested that due to her lack of social support and the interaction between her mental health illnesses and excess alcohol intake, Chomy was referred to the crisis resolution and home treatment teams (CRHTT) for follow-up in the community to manage her current risks and with the view to refer onwards to the community mental health teams (CMHT), Triage, Assessment and Brief Intervention (TABI), Path 2 Recovery (P2R), and Wellbeing Service for, psychological therapies once stability has been achieved.
You will identify a critical event from your mental health nursing practice at the crisis resolution and home treatment team (CRHT) that was necessary to make a team-based decision about the care of a service user in a mental health crisis.
You will critically analyse the decision-making process, reviewing and evaluating relevant theory, models and evidence relating to the assessment and decision making in your chosen scenario.
You should structure the report with the Introduction/ Identify, Situation, Background, Assessment, Recommendation (ISBAR) communication model.
Your critical event analysis will be specific to your practice experiences and is aimed at exploring the impact this has on your development as a student nurse.
You are required to select an example where you observed and/or participated in practice in which the team-based decision was made about a patient or service user.
The assignment scenario should be based around the main topic in the Assessment and Decision-making in Mental Health Nursing listed as follows.
Physical and mental health assessment, social needs assessment, risk assessment and management, Short Term Assessment of Risk and Treatability (START), Shared decision–making in healthcare; theories and models like the DECIDE and SHARE Approach of decision–making. Suicide prevention and self-harm minimisation, principles of person-centred and holistic assessment, safety and care planning. understanding integrated care and co-morbidities, ethical issues relating to complex health and social care, Implementing mental health legislation and policy. Emotional Intelligence and resilience in nursing practice, and conflict resolution.
Others are patient’s consent, family/carer involvement care, principles of biomedical ethics, implementing mental health legislation and policy, emotional Intelligence, resilience, and conflict resolution, safeguarding and supporting vulnerable people with mental health problems, recognize, and responding to the needs of people with mental health illness.
Theories to consider are the information-processing model, intuitive-humanistic decision-making model, and O’Neill’s clinical decision-making model. Some mental health nursing theories that could be relevant to use in this report are Roberts’ seven-stage crisis intervention model, Erickson’s Modelling and Role Modelling theory and King’s Theory of Goal Attainment.
You are required to apply the patient’s crisis scenario to your literature/theories/models throughout the essay.
You are required to critically analyses the decision-making process, reviewing and evaluating relevant theory, models and evidence relating to the assessment and decision making in your chosen scenario.
Your critical event analysis will be specific to your practice experiences and is aimed at exploring the impact this has on your development as a student nurse.
Critically analyse the key issues in the topic you have been selected drawing upon a variety of quality evidence-based sources.
Use a variety of the principle evidence-based literatures to support a critical analysis of the topic. Use at least one relevant theory and model to analyse and critically evaluate the given topic.
An appropriate incident and the decision- making process are analysed systematically using, a wide range of relevant theories, and models. Also, insight into the wider implication and context are shown.
A significant critical understanding of the assessment and decision-making process and how it specifically relates to the person or group is presented within the context of a critical evaluation and models, theories, policies, and evidence.
A clearly expressed critical essay with excellent thorough analysis of relevant the factors relating to assessment in mental health, the specific environment and how the decision process is specific to the person or group, which is clearly grounded in a logical sequence of ideas, evidence, theories, and models.
Demonstrates in-dept critical analysis of the specific critical incident, the assessment and decision process in mental health, with a clear cohesiveness and integration of mental health law and other relevant legislations and regulations.
Clear reference to person- centre aspects and how the decision process demonstrated the requirements for NMC registrants with reference to literature.
Demonstrates critical awareness of the implications for own future practice and articulates coherent approach to personal development needs in relation to the assessment and decision process in mental health and role of the nurse.
