Delirium upon admission to Swiss nursing homes: a cross-sectional study.

QUESTIONS UNDER STUDY: We wished to investigate the prevalence of delirium in patients upon admission to nursing homes and whether or not the previous place of residence predicts delirium. METHODS: The Resident Assessment Instrument Minimum Data Set (RAI-MDS) and the Nursing Home Confusion Assessment Method (NHCAM) were used to determine whether the previous place of residence (community, nursing home, acute care, psychiatric, rehabilitation hospital) predicted the prevalence of sub-syndromal or full delirium in nursing home residents in three Swiss cantons (n = 11745). RESULTS: 39.7% had sub-syndromal and 6.5% had full delirium. Lower cognitive performance and increased depressive symptoms were significant predictors of higher NHCAM values independent of previous residence. Age, civil status, continence, newly introduced drugs, and basic activities of daily living were predictors in some resident groups. The variance of NHCAM scores explained varied between 25.1% and 32.3% depending on previous residence. CONCLUSIONS: Sub-syndromal and full delirium are common upon nursing home admission. Increased dependence and depression are consistently associated with higher NHCAM scores. Patients from psychiatric settings have an increased risk of delirium. Although factors associated with delirium depend on a patient's previous residence, all patients must be carefully screened for sub-syndromal and full delirium.

Delirium upon admission to Swiss nursing homes

QUESTIONS UNDER STUDY: We wished to investigate the prevalence of delirium in patients upon admission to nursing homes and whether or not the previous place of residence predicts delirium. METHODS: The Resident Assessment Instrument Minimum Data Set (RAI-MDS) and the Nursing Home Confusion Assessment Method (NHCAM) were used to determine whether the previous place of residence (community, nursing home, acute care, psychiatric, rehabilitation hospital) predicted the prevalence of sub-syndromal or full delirium in nursing home residents in three Swiss cantons (n = 11745). RESULTS: 39.7% had sub-syndromal and 6.5% had full delirium. Lower cognitive performance and increased depressive symptoms were significant predictors of higher NHCAM values independent of previous residence. Age, civil status, continence, newly introduced drugs, and basic activities of daily living were predictors in some resident groups. The variance of NHCAM scores explained varied between 25.1% and 32.3% depending on previous residence. CONCLUSIONS: Sub-syndromal and full delirium are common upon nursing home admission. Increased dependence and depression are consistently associated with higher NHCAM scores. Patients from psychiatric settings have an increased risk of delirium. Although factors associated with delirium depend on a patient's previous residence, all patients must be carefully screened for sub-syndromal and full delirium.

Assessing Nursing Assistants' Knowledge of Behavioral Approaches to Mental Health Problems

Nurse's aides are the primary caregivers in nursing homes, a major receiving site for elders with behavioral and psychiatric problems. We describe the development, psychometric properties, and utility of a brief instrument designed to assess aides' knowledge of three specific mental health problems (depression, agitation, and disorientation) and behavioral approaches to them. The instrument was administered to 191 nurse's aides and 21 clinicians with training in behavioral management and experience with older residents. The nurse's aides averaged 11 of 17 correct answers, and the clinicians averaged 15 of 17 correct answers. Implications for staff training and consultation activities in nursing homes are discussed.

The Relationship of Antipsychotic Drug Use, Resident Behavior, and Diagnoses Among Nursing Home Residents

Nursing homes have been criticized for frequent use and possible misuse of psycho-active agents. These issues are of clinical concern and policy relevance, especially since the passage of the Omnibus Budget Reconciliation Act (OBRA) of 1987. Using a sample of 419 residents, the authors examined the relationships among antipsychotic drug (AP) use, behavior, and mental health diagnoses. Only 23.2% of the residents were administered APs on a routine and/or "as-needed" basis. Based on the Multidimensional Observation Scale for Elderly Subjects (MOSES) ratings, AP users were more irritable, disoriented, and withdrawn than were nonusers. Also, AP users demonstrated agitated behaviors more frequently. Notably, AP users and nonusers differed significantly in terms of documented mental health diagnoses. Among AP users, 70.1% had documented dementia, 8.3% were psychotic or had other psychiatric disorders, and 21.6% had no mental health diagnoses. In contrast, the majority of nonusers had no mental health disorders. Logistic regression revealed that diagnostic factors, frequency of agitation, level of withdrawal, and marital status were significant predictors of AP use.

Psychiatrists' and Psychiatric APRNs' Views of the Adolescent Mental Health Nurse's Role In the Inpatient Setting

Current perceptions about nurses’ roles and responsibilities are examined in this study, specifically relating to adolescent inpatient MHNs. Psychiatrists and psychiatric advanced practice registered nurses (APRNs), who work with MHNs and have also published scholarly psychiatric articles, were contacted to request their participation in an anonymous survey hosted by SurveyMonkey.com. This research was conducted to examine the stereotypes that exist against nurses within the health care profession itself, as compared to the pre-existing stereotypes displayed by the media’s view of nurses. Due to investigator time constraints, only six subjects participated in the study. Analysis of survey responses revealed four overarching themes. First, MHNs are a critical component of the health care team, emerging as rigorous, independent leaders, although still classified as female and sociable. Second, MHNs complete a wide range of daily activities, many of which go unnoticed by observers, often resulting in mixed feelings regarding whether MHNs are given the respect and recognition deserved. Third, MHNs treat each patient as a person with unique thoughts, feelings, and physical make-up. Fourth, MHNs act as a coordinator of care between various health professionals to provide the patient with a holistic approach to healing.

School of Nursing Class of 1977

Top Row: Cathy Agree, Carol Bass, Nancy Bernadic, Barbara Bettman, Wendy Bittker, Judy Brown, Barbara Cassavoy, Nacy Cohen, Julie Coon, Mary Dawson, Susanne Dean, Barbara Diebolt, Joan Dzenowagis

Row 2: Donna Dziyba, Marla Erbin, Frederick Fiedler, Megan Forester, Lynn Babington, Keverne Popma, Barbara Cloutier, Catherine Doele, Barbara DeBenham, Alta Gaines, Susan Grant, Edward Greca, Pamela Griesbach

Row 3: Karen Haske, Janis Harris, Cherisse Hoffman, Wendy Jelinek, Judy Jenks, Barb Kakenmaster, Karen Kitchen, Kay Klass

Row 4: Kathryn Laing, Rachel Lapinski, Cheryl Marinett, Marta Monroe, Jackie Mrlik, Susan Mulkiten, Michele Olzack, Carol Osborn

Row 5: Deborah Parker, Linnae Pierskalla, Mary Prather, Terry Proctor, Karen Rech, Nancy reddaway, Nancy Reynolds, Mary Ridley

Row 6: Catherine Rhodes, Patricia Roggenbeck, Barbara Ruppal, Victoria Russum, Suzanne Sanders, Elizabeth Saviano, Diane Scarpace, Nola Schramm, Paula Schroeder, Carolyn Schroth, Barbara Scott

Row 7: Deborah Scullon, Denise Shough, Belvayuna Simpson, Joyce Smith, Barbara Stang, Elizabeth Sullivan, Molly thibault, Debbie Varney, Margaret Walters, Desiree White, Janice Winfree, Meg Williams, Nancy Zuelch

School of Nursing Class of 1979

Top Row: Jane Alcala, Katherine Atkin, sandra Shea Baer, Dee Baker, barbara Barnes, Rhonda Baruch, Adrien Beregsasy, Sally Bidol, Kathleen Birchmeier, Maureen Bishop, Julia Blanchard, Theresa Boyd, Janice Brown, Deborah Budde, Genevieve Burns, Mary Kaye Busch, Laurie Carroll

Row 2: Bonnie Cesak, Mary christensen, Julie Colegrove, Susan coleman, Cheryl coney, William cophenhaver, Wendy Culbertson, Angela Dade, Renee Damm, Lynn Darin, Michele DeMaria, Julie DeFouw, Martha Deming, Mary Dent, Michelle Diepenhorst, Janice Dietrich, Catherine Dilworth

Row 3: Barbara Dusseau, Fancine Eagle, Carolyn Eames, Janeen Ellis, Lisa Fandell, Melissa Fear, Michelle Revis, Barbara Ross, Thomas Bissonnette, Michele Henderson, Susan barnes, Catherine Foley, Marica Fosnaugh, Leana Fox, Carol Frens, Debra Furlette, Denise Garden

Row 4: Mary Lois Gardner, Jeanetter Giroux, Stephanie Glanton, Beverly Goodman, Debra Giffin, Laurie Guyton, Bobbie Hafford, Linda Haggerty, Cindy Hammelef, Kim Hand, Patricia Hartman, Susan Hepker

Row 5: Jayne Hetzner, Diana Hill, Sandra Hirsch, Margaret Howard, Carol Huebel, Beverly Jackson, Christine Jacobson, Dennis Johnson, SerVonia Jones, Kathleen Kadlec, Pamela Katz, Kim Kittle, Mary Jo Klepser, Cheryl Kole

Row 6: Julie Konkle, Mary Anne Kosek, Mary Kowalski, Kathryn Krawec, Cynthia Krc, Kathryn Leinberger, Linda Lewandowski, Deborah Lobert, Karen Lyon, Mary Beth McGowan, Deborah Mclnerney, Douglas McLellan, Mary McDonald, Donna Macksood

Row 7: Bruce macnee, Pamela Mandelkorn, Debra Mast, Constance Maynard, Carol Meach, Karen Meyer, Linda Moore, Robert Morgan, Lynn Murray, Cindy Nestell, Carol O'Dell, Christine Ostrowski, Jeanne Palmer, Frances Palms, Diane Parrish, Jennifer Patton, Cathy Plachetka

Row 8: Dawn Rhoades, Carolyn Riegling, Jill Rodammer, Michael Romej, Ann Rondi, Cindy Salesin, Cynthia Sapsford, Russsell Savage, Angela Schaefer, Lee Anne Schaefer, Debra Schafer, Paula Schelp, Sandra Schlump, Cindy Schneider, Brenda Schroeder, Laurie Schultz, Wanda Scott

Row 9: Michael sseator, Kimberley Sherman, Vicki Singer, Ingrid Smith, Mary Alice Smith, Kathy Snyder, Karen Staudt, Kathy Steinke, Sue Stevens, Kimberly Stone, Sheri Sutherland, Ann Marie Swiderski, Jane Sydlowski, Debra Thelen, Deborah Thompson, Phyllis Toney, Jill Triick

Row 10: Tara Trinrud, Kay Tupala, Rosemary Turckes, Richard Urbanski, Lynn VanDenBerg, Brenda VanDervoort, Catherine VanWagnen, Ellen Victor, Mary Anne Vitalis, Celia Wald, Anne Weber, Jurlean White, Martha White, Judith Wilcewski, Lynda Wood, Susan Wroblewski, Victoria Zielinski

School of Nursing Class of 1983

Top Row: Barbara A. Fleckenstein, Anne M. Phelan, Julie-Ann Gersin, Laura E. Kemper, Mary Ann McCulloch, Meryl I. Faber, Karen E. Morton, Jennifer S. Miller, Catherine A. Chichester, Dana R. Piper, Harold K. Lohwasser, Michelle A. Lyons, Julia C. Kelly, Deborah L. Rossman, Amy L. Keskey, John F. Nama, Linda Borucki, Michelle M. Bradley, Caroline M. Fischer, Lisa A. Kuhnlein

Row 2: Karen M. Pardo, Laura L. Price, Mollie A. McDonald, Jan M. Grable, Janna S. Nichols, Laura A. Quain, Patricia M. Battel, Claudia J. Koch, Maureen G. D'hondt, Trudy J. Tervo, Linda A. Walz, Cheryl K. Ebling, Patricia A. Merte, Lauri R. Klock, Maria A. Lomibao, Mary E. Eisenhauer, Ellen B. Malvern, Josephine A. Polesnak

Row 3: Yvonne D. Krisel, Rosemary T. Coyne, Janey A. Porterfield, Deborah A. Mulawa, Janet E. Lovelace, Susan P. O'brien, Margaret T. Perrone, Brenda K. Luckhardt, Terry A. Layher, Sharon A. Potonac, Susan K. Watson, Janet A. Servatowski

Row 4: Vivian A. Reeves, Tracey A. Weeks, Marilyn K. Morgan, Terrilynn Phillips, Susan S. Kirk, Robert J. Ziola, Fred Roberts, Karen S. Myron, Pamela M. Przybylski, Mary Jo F. Lafata, Janet A. Scapini, Mary J. Swails

Row 5: Julie E. Reitz, Julie A. Symons, Ave M. Reagor, Catherine A. Regan, Marsha A. Glass, Susan M. Derubeis, Judy L. Goode, Jennifer P. Wylie, Janet L. Nowak, Karen M. Ulfig, Cynthia E. West, Carol A. Czarnecki, Gloria J. Verdi, Lisa D. Singleton

Row 6: Cynthia Wiggins, Monica L. Babyak, Gail M. Ray, Karen S. Desloover, Ladonna L. Christian-Combs, Deborah J. Dunnaback, Deborah A. Cecchini, Nancy A. Neville, Julia H. Grove, Wendy A. Weinfurtner, Susan M. Twigg, Jolynne Vanotteren, Lori A. Clark, Susan T. Savidge

Row 7: Marianne Ojeda, Ann M. Tucker, Lisa A. Valiquette, Sharon J. Bergmann, Elizabeth A. Rice, Marjorie R. Hovis, Laura I. Berry, Janice B. Lindberg, Rhetaugh G. Dumas, Susan B. Steckel, Helen L. Erickson, Kathleen M. Oshea, Tricia A. Richardson, Cheryl L. Sanders, Ann L. Shcoene, Anita M. Bargardi, Constance S. Siler, Anne L. Scott

Row 8: Gassenie Thomas, Victoria L. cadagin, Sheryl A. Strace, Joyce I. Sourbeck, Mary S. Donald, Cindy Tollis, Miriam L. Allis, Julie J. Watson, Patricia A. Shefferly, Nina M. Squire, Carol J. Debrodt, Jennifer A. Dreps, Cynthia B. Stone, Martha A. House, Elizabeth A. Hull, Laurie J. Bommarito, Erin A. Swain, Lisa D. Davis

Row 9: Lisa W. Barak, Charlotte L. Allport, Karen J. Baker, Julie M. Sweet, Pamela R. Armfield, Kathleen A. Hornick, Marcianna M. Davis, Joann L. Holdridge, Barbara A. Black, Scott L. Baker, Lawrene S. Gardipee, Julie A. Hemsteger, Mary Ann Barz, Carla L. Arnett, Danielle L. Bonam, Janice S. Brady, Karen L. Eischer, Amy A. Hing, Marcia L. Hassig, Heidi G. Henn

School of Nursing Class of 1988

Top Row: Clare L. Allen, Kathryn M. Antekeier, Debra Ayanian, Kristin E. Baker, Lynn A. Bluck, Linda A. Bochenek, Samatha Brennan, Julie A. Coburn, Anne E. Cooksey, Susan L. Cross, Kimberli S. Darvishian, Natalie, J. Dichtiar, Joanne M. Dork

Row 2: Mary K. Emerson, Marion A. Ferguson, Amy S. Fuhst, JAckie Vicari, Patti Geiman, Denise B. Sorenson, Lisa Maastricht, Karen L. Bloom, Natalie R. Geiss, Elizabeth A. Hamann, Liesl M. Hintermaier

Row 3: Cynthia M. Hubert, Mercedes Castro, Irene Hundt

Row 4: Kris A. Hurley, Katherine A. Jeffery, Kathy M. Jhung, Rebecca J. Kantor, Denise J. Kehrer, Colleen E. Kelly

Row 5: Judy A. Kettenstock, Rhonda L. Kinney, Kimberly Klarich, Kimberly J. Kdning, Dianne M. Kraft, Brenda M. LaChapelle

Row 6: Lavonne L. Lang, Laurie A. Langwerowski, Rebecca S. Leak, Sally Sample, Violet Barkauskas, Rhetaugh G. Dumas, Shake Ketefian, Janice B. Lindberg, Elisabeth Pennington, Sharon A. Libby, Bonnie M. McDonald, Patricia A. Mehall

Row 7: Kristen K. Miller, Kelley L. Ong, Alice I. Paik, Michelle L. Pardee, Edith H. Price, Anke Winkler-Prins, Lori L. reisig, Camille A. Rogell, Mindy A. Rosenberg, Richard E. Ross, Julie A. Sarotte, Laura A. Schippers, Rose M. Schliska, Marilyn H. Schwartz

Row 8: Heidi Simonelli, Victoria J. Sizemore, Diane L. Sorenson, Deborah R. Sproul, Katherine Stewart, Kim M. Strong, Barbara J. Sullivan, Pamela S. Taukert, Kristin A. Treash, Kimberly Vander Heuvel, Sherry Vanootighem, Annmarie Veraldi, Idella A. Wesselman

School of Nursing Class of 1990

Top Row: Mary D. Acosta, Stephanie A. Alexovich, Lisa K. Astalos, Sandra L. Barbish, Jaine Bieda, Jennifer L. Blair, Victoria L. Brace, Debbie R. Brown, Sandra D. Carlson, Timothy J. Cockerham, Polly A. Cook, Suzanne M. Delisio, Jefferey Deloach

Row 2: Susan L. Dill, Tami Dykstra, Roberta E. Figgs, Roberta Jo Franzese, Dianer Szczerowski, Kimberly M. Schymik, Michelle F. Bingham, Lynnette A. Golen, Paola G. Pieri, Donna L. Fordanich, Teri L. Freedman, Kara L. Gathmann

Row 3: Marilyn S. Granner, Ann Marie Hartmus, Melissa Hoheb, Susan M. Hutchins

Row 4: Amy S. Jacobs, Renee M. Jannette, Wendy J. Jenuwine, Lori B. Kantor

Row 5: Kristine E. Karfis, Jenny G. Kist, Susan M. Kistka, Kaye M. Kowalske, Marilyn A. Krage, Roberta E. Kumm

Row 6: Ianya A. Lattimore, Andrea S. Lipian, Wendy J. Lipinski, Wendi M. Lisman

Row 7: Susan E. Little, Donna M. Markos, Rita S. Mayle, Lynn M. Mccall, Nancy J. Montange, Aimee J. Myers

Row 8: Clare H. Nagle, Michelle L. Noble, Janice B. Lindbers, Violet Barkauskas, Rhetaugh G. Dumas, Beverly Jones, Shake Kettfian, Elisabeth Pennington, Joyce V. Perry, Darlene L. Phelps

Row 9: Donna M. Piccolo, Lisa A. Richmond, Lisa A. Rowlison, Brent E. Runyon, Rebecca A. Seiffert, Lucinda E. Smith, Amy E. Spangler, Dan C. Steele, Beth Stephens, Kim D. Tiedrich, Lisa J. Wallace, Jennifer P. York, Christine C. Zielke

School of Nursing Class of 1993

Top Row: Kristen Clark, Katherine Grinenko, Shinyi Tang, Troy Tann, Kelly Pasanen, Barbara Loson, Dennis Lake, Lisa Mancuso, Elizabeth Kim, Linda Dengate, Linda Morse, Stacey Horner, Juliet McKeone, Laura Schenk, Corrie Boguth

Row 2: Valerie Straka, Jamie T. Mose, Robert VanCamp, Cary Johnson, Laura Chamberlain, Kenyatta A. Paige, Kevin T. Sprecher, Jean L. Novak, Amanda Sue Niskar, Lisa Oliverio, Rosalyn Baumann, Elaine Schultz, Jennifer Lee Bastress, Kristen Hedge

Row 3: Jennifer Joh, Jennifer Monroe, Marion Tauriainen, Anne Chesky, Michael Fournier, Amy Sebright, Brian Simmons, Ann Luciano, Robin Van Eck, Beth Hart

Row 4: Jacqueline weibel, Dawn Garrett, Vicki McWalters, Malina Rocoff, Holly Medley, Ann Kosky, Tina L. Kessey, Caesanea A. Smith, Michelle Koch, Julie C. Wolf

Row 5: Robin Wygant, Cynthia Nichols, Susan Worek, Sandi Sassack, Timothy Wright, Bridgette Nichols, Kelly Sheridan, Kristin Sirosky, Kathy Kentala, Susan Oslund, Zaleha Williams, Heidi C. Goiz

Row 6: Kathryn Erdmann, Karen Crandall, Darryl Anderson, Karla Stoermer, Janice Lindberg, Beverly Jones, Rhetaugh G. Duman, Elisabeth Pennington, Violet Barkauskas, Laura Stock, Jacqueline Mickle, Catharine Quinn, Laura Nourse

Row 7: Christopher Kelly, Deborah Zolinski, Victoria Buckles, Pamela Brown, Stephanie Macey, Meredith Muncy, Susan, M. Smashey, Laura Welch, Rene Thompson, Sarah Scott, Juliette Lovell, Diane Ferguson, Deborah Ann Dolasinski, Cynthia Zammit, Lorie Malarney

Row 8: Janet Ingram, Rosemary Stafford, Diane Mayernik, Thea Picklesimer, Hannah Clark, JoyMarie Bruhowzki, Jennifer Beckert, Elizabeth Bryant, Jennifer Voeffray, Jane Perrin, Sophia Jan, Diana apostolou, Deborah Ruzicka, Liesel Culver

Row 9: Lori Wessman, Nicole Kerridge, Julia Oman, Melissa Naser, Jennifer Cole, Elizabeth Brickman, Detria Williams, Kris Haaksma, Alison Flaskamp, Nela L. Humm, Carol Taylor, Dena Mitchell, Karen L. Domke

School of Nursing Class of 1995

Top Row: Abiola Akinwumi, Laura Ambrook, Becky Bail-Salamin, Charlotte Baker, Ronald A. Palas, Jodi Lynn Bamberg, Cindy Bauer, Kimberly Beal, Tina Bednarski-Lynch, Lisa Bennett, Kate Bergsma, Colleen Block, Caroline Bock, Karen Bogan, Michael J. Bologna

Row 2: Julie Boyer, Wilma J. Branch, Stacey M. Quinn, Michelle Archambeau, Monica Patel, Stacey Doorn, Bryn Gerich, Bethany L. Tallon, Shannon Bason, Pete Jennings, Heather Cahill, Tamar Pleasant, Suzanne Shiller, Andrea Caldwell, Lisa Cook

Row 3: Rebecca Cross, Karen Cuevas, Anissa Damrau, Sheila Davis, Stephanie Day, Vikki Dhingra, Laura Doan, Catherine Doud, Tanya L. Dudlay, Ruth Dunlap, Heather Elenbaas, Karie Erskine

Row 4: Julie Everett, Anne Flunder, Melanie Frank, Alexandra Frederick, Michele Fronk, Jennifer garcia, Shamaine Gardner, Robin Gawrych, Celeste Gibson, Patricia Gilhooly, Erin Gill, Rosemary Goins

Row 5: Tonya Grueschow, Christopher Hackett, Kathy Halabicky, Patricia Hanlon, Patricia Hansen, Violet Barkauskas, Beverly Jones, Ada Sue Hinshaw, Janice Lindberg, Nola Pender, Chris Harbough, Patricia Hawes, Laurie Hehne, Katherine Hendershot, Karin Hensley

Row 6: Rebecca Hill, Jennifer Hofmeister, Laura Hurlbert, Carey-Anne Irwin, Elizabeth Jelsone, Jennifer Joscelyn, Keith Keller, Kimberly Killian, Jacqueline Klein, Suzanne Knight, Jennifer L. Knurr, Caroline Kolcheff, Jenna Konarzewski, Julie Kronk, Layla Lahuti, Ellen L. Lapinski

Row 7: Eunice Lee, Jamie Leslie, Jennifer Lofquist, Judith A. Long, Lorelei Manly, Jennifer McEachern, Tamara McLaughlin, Keela McLin, Kelly Moody, Robin R. Moore, Nicole Nestler, colleen Nowicki, Carla Ogundipe, Christa O'Mar, Mychelle A. Overton, Kara Pacis, Vicki Partin

Row 8: MaryAnn Poplawski, Nan Preston, Tiffany L. Raley, Jennifer Rebecca Raub, William Reau, Karen Reeder, Linda Rickard, Karen Salus, Laura Saraent, Darlene Scheper, Joanna Serman, Laura-Jean Siggens, Ann Marie Simonelli, Mary Skilton, Amy Stachowiak, Lorraine Stafford

Row 9: Samantha Stallos, Monica Steplowski, Mary Swager, Victoria R. Taylor, Susan J. Ulman, Rene Urban, Sarah B. Vander Schaaf, Maria P. Vano, Tresa VerMeulen, James Voiland, Johanne C. Walter, Amy K. Warrow, Nicole Weidler, Benjamin Weisenfeld, Marie Wolfer, Marcy Yackish

School of Nursing Class of 2002

Top Row: Robyn Albrecht, Brea Anne Aldorfer, Elizabeth Andersen, Jamie Anderson, TaNea Andrews, Julie Badgero, Margarita Barrientes, Jessica Barton, Jennifer Baughman, Catherine Baxter, Jeff Bell, Jessica Bellardi, Sarah Bethel, Melissa Black, Sherese Black

Row 2: Daniela Bordei, Hannah Burgess, Tonya Melton, Patricia Kelly, Tanina Media, Lenette Whitehead, Suzanne Begeny, Jasmine Beale, Martha Richard, Stephanie A. Shafer, Sarah Wilson, Staci Byrd, Jennifer Cheng

Row 3: Rebecca Cohrs, Jeana Cox, Regina Cox, Emalee Danforth, Susan Daron, Kara Dazarow, Marites de la Fuente, Abigail Devine, Carrie Dickson, Christopher Ducher

Row 4: Jennifer Flynn, Elizabeth Foster, Nicole Gatesy, Michelle Gaudreau, Melissa Hagan, christa Hamilton, Christina Hazergian, Crystal Herwat, Rebecca Hunnicutt, Emily Johnston

Row 5: Valerie Jons, Rani Khan, Anne Konczak, Teresa Konopka, Joanne Pohl, Nola Pender, Carol Loveland-Cherry, Ada Sue Hinshaw, Margaret Calarco, Judith Lynch-Sauer, Jan L. Lee, Jill LaDronka, Shane LaGore, Melanie LaPierre, Stacy lamb

Row 6: Kathleen Laughlin, Holly Leupp, Emily Lewellen, Victoria Lilga, Bethany Lusher, Nancy Ma, Lindsay Mahlstedt, K. Luba Manko, Beverley Marchant, Anne Marlatt, Martha Mason, Deborah McConnell, Robin Meganck, Jill Messina

Row 7: Patricia Milne, Yvonne Moran, Melissa Myer, Bradley Niese, Brooke Oakley, Kristy Opasik, Amanda O'Reilly, Elisabeth Paulson, Nancy Pavelek, Johnnie Peoples, Melissa Perry, Elissa Pocze, Michelle Ponikvar, Victoria Portman, Shelley Reeves

Row 8: Michael Rempel, Jill Richert, Jennifer N. Rish, Rebekah Royce, Kristan Schoenfeld, Shawn Schofield, Holly Setterington, Heidi Sprunk, Emily Staugaard, Rachel Stevens, Linda Suh, Tiffany Sylvertooth, Kimberly Taylor-Vincent, Arik Theeke

Row 9: Kim Thomas, Stephanie Thompson, Patricia Tillman, Leigh Tooman-Letson, Ryan Upson, Nicole Vance, Jacquelynne Walsh, Jill Weirich, Monica White, Anthony Worley, Heide Wright, Kelly Yager, Marichal Young

Epidemiological analysis of electroconvulsive therapy in Victoria, Australia

Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998-1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment. Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age-sex specific utilization rates were calculated using this statutory data for the 1998-1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population. Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age-sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex. Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.

Effects of patient-focused care on seclusion in a psychiatric intensive care unit

The objective of the study was to evaluate whether the introduction of patient-focused nursing care affected the number of seclusions and the length of time patients spent in seclusion, in an acute psychiatric unit. The study used a pre-intervention–post-intervention design and was conducted in an eight-bed locked unit within a large regional general hospital in Queensland, Australia. The medical records of all people who were secluded as part of their management while in hospital, during two 6-month periods, were retrospectively reviewed. Changes to the ways in which nurses conducted their daily activities were implemented during the time between the data collection periods. There were no differences between the groups with respect to the number of times a patient was secluded. However, following implementation of patient-focused care, there was a reduction in the length of time for which patients were secluded. The only change in medication administration was that post-implementation, Haloperidol was used in fewer seclusion episodes. The findings indicate that changes to nursing practice may result in closer monitoring of patients and a reduction in the time patients spend secluded in acute inpatient psychiatric settings.