The care plan for violent patients from BPRS:PHUA, G-HARD

บทคัดย่อ

Objective  To develop a care plan for violent patients by the Brief Psychiatric Rating Ccale: BPRS (an applied version) performed by psychiatric nurses.

Materials and methods  This study was a routine to research. The first step was the brain storming in the Medical Staff Organization in order to select items of the BPRS.   G-HARD was selected from guilt (G), hallucination (H), agitation (A), retardation (R) and depression (D). PHUA was paranoid (P), hostility (H), uncooperativeness (U) and agitation (A) and also the criteria of re-assessment by attending physician. The second one was the trial out phase in the highest violent incidents ward and then readjusted the criteria of reassessment by nurses and medication as symptoms. Indicators were percentage of reassessment by physicians, treatment changes, the violent incidence and the average length of stay.

Results  The criteria for medication as order and follow-up by nurses and attending physicians were consensus. From the second phase there were 118 cases and PHUA more than 20 for 24 hours were reassessed by physicians for 46 cases. Of these 14 were received ECT for treatment. The average length of stay was 11 days. The violent incidences were more reported but at a low level of severity.

Conclusion  Care plan for violent patients by PHUA, GHARD according to new guideline enhanced safety and proper care in the organization.