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Contemporary Psychiatric Nursing Practice. Chapter 6. Biopsychosocial Model. Definition: Three separate, but interdependent, domains—biologic, psychological and social (Figure 6.1) Biologic: Theories that explain neurobiologic changes related to mental disorders
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Biopsychosocial Model • Definition: Three separate, but interdependent, domains—biologic, psychological and social (Figure 6.1) • Biologic: Theories that explain neurobiologic changes related to mental disorders • Psychological: Theories related to psychological processess of thoughts, feelings and behavior • Social: Theories that account for the influence of social forces encompassing the patient, family and community within cultural settings
Professional Practice • Legal authority to practice (license), granted by states and provinces • Professional standards set by professional nursing organizations • ANA • APNA • ISPN
Scope of Psychiatric Mental Health Nursingin the United States • Areas of Concern (Text Box 6.1) • Standards of Care (Text Box 6.2) • Standards of Professional Performance (Table 6.1) • Basic level (Text Box 6.4, Table 6.2) • Advanced level
Canadian Standards of Psychiatric and Mental Health Nursing Practice • Provides competent professional care through the helping role • Performs/refines client assessments through the diagnostic and monitoring function • Administers and monitors therapeutic interventions • Effectively manages rapidly changing situations • Intervenes through the teaching-coaching function • Monitors and ensures the quality of health care practices • Practices within organizational and work-role structures
Tools of Psychiatric Nursing Practice • Clinical Decision Making • Nursing Care Plans • Critical Pathways
Interdisciplinary Approaches • Multidisciplinary • Several disciplines providing different services to patient • Not ideal • Interdisciplinary • Services are not provided independently of each other. • Providers communicate in delivery of patient-oriented care. • Supported by the IOM reports
Challenges of Psychiatric Nursing • Knowledge development, dissemination and application • Overcoming stigma • Health care delivery system issues • Impact of technology
Ethical Frameworks • ANA Code for Nurses (Text Box 6.5) • Canadian Code of Ethics (Text Box 6.6) • Principle of Autonomy: Each individual has the fundamental right of self-determination. • Beneficence: Health provider uses knowledge and skills to develop an environment in which individuals achieve their maximum health care potential.
Psychiatric Nursing Organizations • American Psychiatric Nurses Association (APNA) • International Society of Psychiatric Mental Health Nurses (ISPN)