Objective To form an expert consensus on the implementation and removal of psychiatric protective restraints,and to standardize the related contents of the implementation and removal of psychiatric protective restraints. Methods According to the level of evidence,the evidence-based method was used to retrieve,evaluate and summarize the evidence in the field. The recommendations and research conclusions for the implementation and removal of the psychiatric medical protective restraints were extracted,and the rough consensus was formed. Through 2 rounds of enquiry and 2 experts discussion meetings,the final version of the consensus was formed by combining with the expert opinions,adjusting,modifying and perfecting the first draft. Results The positive coefficients of experts in the 2 rounds of correspondence consultation were 100%;the degree of authority of experts was 0.90;the mean value of importance of each index was>3.5,and the coefficient of variation was less than 0.25,and the expert Kendall harmony coefficient was 0.146 and 0.166,respectively (all P<0.01). Finally,a consensus was reached on the recommendation of 10 parts,including the application group of psychiatric restraints,premise and principle,objective,key points of assessment,basic requirements,record sheet,flow chart,intervention strategies in the implementation process,ethical issues and risks,and suggestions. Conclusion The consensus provides guidance for the practice of psychiatric protective restraints and makes psychiatric restraints more standardized.
Objective To construct a nutritional risk prediction model for elderly inpatients with mental disorders,and to provide a basis for clinical nutritional status assessment. Methods Using the method of cluster sampling,584 elderly patients with mental disorders who were hospitalized in Beijing Huilongguan Hospital from June 2020 to June 2021 were divided into a good nutritional status group(152 cases) and a malnutrition risk group(129 cases) and a malnutrition group(303 cases). The general condition questionnaire,frailty screening scale (FP),mini-nutrition assessment scale(MNA),simplified physical performance scale(SPPB),the Barthel Index(BI) of daily life and Family Care Index(APGAR) for ability evaluation were used for investigation. Logistic regression analysis and Graphpad Prism software were used to draw receiver operating characteristic curve to test the model fit and prediction effect. Results The incidence of malnutrition in elderly hospitalized patients with mental disorders was 51.88%,and advanced age(OR=1.049),frailty(OR=2.578),and BMI(OR=0.629) were independent risk factors for malnutrition risks(P<0.534). 0.05),in which advanced age was the greatest risk factor for malnutrition. Advanced age(OR=1.031),diagnosis(OR=2.150),frailty(OR=2.485),and physical dysfunction(OR=2.123) were independent risks of malnutrition(P<0.05),among which frailty is the greatest risk factor for malnutrition risk to be transformed into malnutrition. The area under the receiver operating characteristic curve(AUC) of the malnutrition risk is 0.732;the Youden index is 0.388;the optimal critical value is 0.473;the sensitivity of the prediction model is 0.736;the specificity is 0.651. Regarding the ROC curve of malnutrition,AUC is 0.808;Youden index is 0.531;the best critical value is 0.581;the sensitivity of the prediction model is 0.865;the specificity is 0.667. Those indicate that the 2 prediction models are accurate and reliable. Conclusion The risk prediction model of nutritional status of hospitalized elderly patients with mental disorders constructed in this study has high accuracy,and provides a basis for risk assessment and prevention of nutritional status of elderly patients with mental disorders in hospital.
Objective To form an expert consensus on suicide nursing interventions for inpatients with depression in psychiatric departments,standardize the contents of suicide nursing interventions for depression patients in psychiatric departments. Methods Evidence-based methods and literature analysis were used to extract recommendations and research conclusions of suicide nursing interventions for inpatients with depression,and the consensus draft was formed. After 2 rounds of expert letter consultation and 2 expert discussions,the draft was adjusted,modified and improved,and the final draft of the consensus was formed. Results The positive coefficients of the experts in 2 rounds of letter consultation were 100%;the authority degree of the experts was 0.924;the mean values of importance of each index were >3.5 points;the coefficient of variation was<0.25;the Kendall harmony coefficients of the experts were 0.182 and 0.260,respectively(P<0.01). Finally,the operational definition,suicide risk assessment,intervention form and time,theoretical basis of intervention,general principles of intervention,suicide impression intervention,suicidal behavior intervention,key points of intervention in special populations,evaluation of intervention effect and post-discharge evaluation of suicide care in hospitalized patients with depression were analyzed. A total of 11 components of the health education program were agreed upon. Conclusion The consensus provides the guidance for the suicide nursing interventions of psychiatric inpatients with depression,so that the suicide nursing intervention of psychiatric inpatients with depression is more standardized.
Objective To summarize and establish a systematic and refined nursing management system of psychiatric specialty during the period of prevention and control of coronavirus disease 2019(COVID-19),so as to provide bases for the prevention and control of COVID-19 in psychiatric hospitals. Methods By combining consensus conference method with expert consultation method,the mental health professional committee of Chinese Nursing Association organized a number of psychiatric hospitals in China with the participation of 43 experts. This expert consensus was formulated with the analysis,discussions and summaries of the protective measures in psychiatric hospitals,combined with relevant national policies,academic guidelines,journal articles and literature. Results The consensus includes requirements for organizational management,environmental management and personnel management of prevention and control of COVID-19. Conclusion The consensus guides the prevention and control of COVID-19 in psychiatric hospitals through organizational management,environmental management and personnel management,with guiding significance for clinical practice.