งานการพยาบาลผู้ป่วยทั่วไป โรงพยาบาลมหาราชนครเชียงใหม่

Psychiatric Ward (Adult)

 Nursing Service Division, Maharaj Nakorn Chiang Mai Hospital

Faculty of Medicine ,Chiang Mai University,THAILAND.

 

The psychiatric ward (Adult) of Maharaj Nakorn Chiang Mai Hospital is situated on Boonruangrit road,  Amphur Muang, Chiang Mai , 50,200 THAILAND. It accommodates 16 patients .

Type of patients who attend this ward

This ward accommodates patients aged 11 up, both male and female who may present for admission with one or more of the follow symptoms:

      

Delirium	Mood disorder	Substance abuse
Dementia	Panic disorder	Psychotic disorder
Phobic disorder	Adjustment disorder	Personality disorder
Suicide	Somatic disorder	atypical
Mental disorder due to General medical   condition
Neuro – Symptoms related to aspects of AIDS/HIV

Ward philosophy

The psychiatric ward believes that:

     The patient and relative have ability to take care themselves and rights to get a quality nursing care

       The primary nursing model and nursing process assists the nurse in providing continuous quality care in response to physical, mental and spiritual needs of the patients.

       Promote co-operation between both patient and service providers in a safe and secure environment to enhance timely intervention and support for the patient and their significant others. To develop a sensitive work environment that instills a professional approach to providing nursing care for the patient appropriately and efficiently for the improvement in their mental health development.

 

Focusing on the aim of the hospital in the administration of this Unit:

    1.Organizational strength: The Psychiatric Patient Care Team has a role in guiding the treatment planning.

 2.Patient safety: focus on proactive risk management.

 3. Services quality: A continuous quality improvement.

 4.Personnel health: health promotion throughout all consultations and procedures and monitoring of / for any risks and complications that may arise, both preventatively and unforeseen during their course of treatment.

 

 

 

Top 5 diagnoses  

1. Schizophrenia                        

       2. Bipolar I disorder (Manic episode)           

       3. Substance abuse                          

       4. Major depressive disorder               

       5. Adjustment disorder

Type of service

       There are 3 kinds’ in-patients who attend this ward

      1. 24 hour care

      2. Office hours 8.30 AM - 4.30 PM

      3. Night time 4.3 PM- 8.30 AM

 

The treatment period

       These times vary depending upon the individual development of each patient.

Staff of Psychiatric Patient   Care Team   ( Neo – Psyche team )

       To provide efficient treatment it is necessary to have several teams taking care of the patients. The teams consist of

    1.A Psychiatrist who is responsible for mental status examination, diagnosis, medication, ECT treatment, group / individual psychotherapy, family therapy.

    2.A Psychiatric nurse who takes care of milieu therapy , general basic need , general – special nursing care , comfortable , security , supportive – growth group psychotherapy , social skill training , relaxation , group health education , coordinate the team and deals with other departments.

    3.A Psychologist who administers the psychological test, IQ test and group therapy.

    4.Social worker whose duty is researching problems from family, office, school, dealing with patients and concerned department providing on economic evaluation and group therapy.

    5.An Occupational therapist responsible for activity planning base on the patient abilities while being in hospital, visiting home and group therapy.

Nursing personnel

       Head Nurse                         1

       Register nurses                   8

       Practical nurses                   3

       Nurse   Aide                        2

 

Human resource development

    1.Encourage register nurses to study in a post graduate in mental health and psychiatric nursing program.

    2.Short course training such as motivational interviewing, family therapy and other related staff development courses for better skill development of nursing staff.

    3.Uplifting courses such as individual – group psychotherapy, milieu therapy etc.

    4.Present a case study and journal every 3 months

    5.Post –update knowledge in the field of mental health and psychiatric nursing twice a week .

 

Nursing service

    1.Care related to the basic needs of a person: personal care, dressing, appearance, nutrition, relaxation, exercise, sleeping routines, spiritual and emotional development.

    2.The highly structured schedule of hospital life provides another avenue of therapy; termed "milieu" therapy in which benign and beneficial order is imposed upon patients who cannot generate this order themselves (such as making sure patients eat and sleep on a regular schedule)

    3.Medication administration, monitoring, adequate fluids, electrolyte and other treatment management skills identified in the nursing care planning for the patient in this ward.

    4.General – special nursing care such as physical examination, checking vital sign, neurological sign, and observing the alliterative signs and symptoms – possibly related to their condition or a medication side effect.

    5.Individual / group supportive psychotherapy for patients and families.

    6.Encourage and promote patient’s self esteem in activity therapy and outside of the session.

    7.Social skill training such as interpersonal relationship, expression, assertion, coping skill, possessive thinking – orientation to time, place and things.

    8.Develop the knowledge of self care as a supportive process for personal self respect and esteem, awareness of anger management skills and skills to reduce and manage this aspect of their lives.

    9.Consult with other people and other health and welfare departments to assist the patient with continuous care and patient rights both in care and after discharge.

    10.Defend and affirm the patient’s symptoms, during treatment planning provide legal assistance by letting the patients share their opinions and make decisions regarding treatments and outcomes.

Domestic decoration and activity therapy

    The ward is decorated to appear like home.  It allows the patient feel relaxed, supporting self esteem and talking care of themselves in a homely environment. The ward consists of living room , visiting room , kitchen , bed room , shower room , seclusion room ( individual rooms for violent patients , patients who can’t control their behavior by themselves or for patients who require observation from self harm.). There is a outside field for relaxing, gardening, and sport. There is also a flower and fruit garden where sensory skills can be developed and relaxation skills may be incorporated into their care planning. Accommodation also have a fan, radio, television, VCD, VDO equipment, musical instruments, sport equipment, and assorted craft equipment can be provided.

       In addition to the environment there is also health education, self care group and housing cleaning group are activities that are undertaken during therapy to assist and support individuals in taking good quality care of themselves.

       The knowledge activities include reading current newspapers in a group, handicraft groups and cooking groups to further develop and build upon self esteem and self care aspects for a continued holistic perspective of personal growth and development.

       Relaxation activity groups are sports, recreation, muscular relaxing exercises, clay soil sculpture praying, and meditation.

       Every patient will be encouraged as participants of those program activities.

 

Responsibility as a professional nurse, we use a primary nursing system and nursing process in providing continuous and quality care.

       Assessment sheet, the concept set on 11^th health pattern of Marjory Gordon.Problem list, we apply NANDA nursing diagnosis and create nursing intervention and nursing outcomes in line with these guiding principles of care in the Psychiatric ward. Nursing goals - we set together with patient, family and team.

Patient Care Team   Planning & Progress note - we set for communication between team to nurse, nurse to nurse and others such as doctor, specialists and arranged per the patient care planning document.

       Health summary and discharge plan - we discuss the steps forward of a patient in treatment, and plan the action for patient and family after discharge.

 

We believe that all nursing activities that we provide to patients is with an empathetic understanding of the patient as a human being and holistic approach to facilitate them having a quality of life , both in admission and post discharge follow up.

 

Rotjarek   Intachote   Sakamoto

Head nurse   of Psychiatric ward ( Adult )

Psychiatric ward ( Adult )

Nursing Service Division, Maharaj Nakorn Chiang Mai Hospital.

Faculty of   Medicine,   Chiang Mai University

Amphur Muang, Chiang Mai , 50,200 THAILAND

Tel.+ 66(53) 946969 ; + 66(53) 94542

E-mail: rintacho@ mail.med.cmu.ac.th

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACTIVITY SCHEDULE of PSYCHIATRIC WARD (ADULT)

 

 

 

 

  

 

Thank you for your participation and involvement during the time you have been here with all of here at the PSYCHIATRIC WARD I (ADULT)

  

 

 

 

For more information please contact

 

Rotjarek   Intachote   Sakamoto (TOR)                 

Head nurse   of Psychiatric ward ( Adult )             

Psychiatric ward ( Adult )  

Maharaj Nakorn Chiang Mai Hospital.       

Faculty of   Medicine,   Chiang Mai University

Amphur Muang, Chiang Mai , 50,200 THAILAND

Tel.+ 66(53) 946969 ; + 66(53) 945427

E-mail: rintacho@ mail.med.cmu.ac.th