Early Nursing and Social Work Interventions for Patients with Psychosocial Vulnerabilities in Acute Care Settings
DOI:
https://doi.org/10.22399/ijcesen.4763Keywords:
Psychosocial vulnerabilities, acute care settings, nursing interventions, social work interventions, early identification, interdisciplinary collaborationAbstract
Early nursing and social work interventions for patients with psychosocial vulnerabilities in acute care settings are essential for equitable and effective healthcare. These interventions, grounded in biopsychosocial, trauma-informed, and social determinants of health frameworks, involve systematic screening, therapeutic communication, crisis de-escalation, family support, and proactive resource linkage. Implemented through collaborative models like embedded social work and interdisciplinary rounds, they aim to stabilize crises, engage patients in care, and facilitate safe transitions. Despite facing systemic barriers such as understaffing and reimbursement challenges, advancing these practices through policy reform, interprofessional education, and technology integration promises to transform acute care into a more humane, holistic, and cost-effective system that addresses the full spectrum of patient needs.
References
[1] Hansen J. T., Slevin C. (1996). The implementation of therapeutic community principles in acute care psychiatric hospital settings: An empirical analysis and recommendations to clinicians. Journal of Clinical Psychology, 52, 673–678.
[2] Bowers L., James K., Quirk A., Simpson A., Stewart D., Hodsoll J. (2015). Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial. International Journal of Nursing Studies, 52, 1412–1422.
[3] Eklund M., Hansson L. (2001). Ward atmosphere, client satisfaction and client motivation in a psychiatric work rehabilitation unit. Community Mental Health Journal, 37, 169–177.
[4] Baumgardt J., Jackel D., Heber-Bohlen H., Stiehm N., Morgernstern K., Voigt A., Schöppe E., McCutcheon A-K., Velasquez Lecca E. E., Löhr M., Schulz M., Bechdolf A., Weinmann S. (2019). Preventing and reducing coercive measures—an evaluation of the implementation of the Safewards model in two locked wards in Germany. Frontiers in Psychiatry, 10, 340.
[5] Colla J. B., Bracken A. C., Kinney L. M., Weeks W. B. (2005). Measuring patient safety climate: A review of surveys. Quality & Safety in Health Care, 14, 364–366.
[6] Jorgensen K. N., Romma V., Rundmo T. (2009). Associations between ward atmosphere, patient satisfaction and outcome. Journal of Psychiatric and Mental Health Nursing, 16, 113–120.
[7] Itoh K., Abe T., Andersen H. (2002). A survey of safety culture in hospitals including staff attitudes about incident reporting. In: Glasgow: Proceedings of the workshop on the investigation and reporting of incidents and accidents.
[8] Gebhardt R. P., Steinert T. (1999). Should severely disturbed psychiatric patients be distributed or concentrated in specialized wards? An empirical study on the effects of hospital organization on ward atmosphere, aggressive behavior, and sexual molestation. European Psychiatry, 14, 291–297.
[9] Kirstensen S., Sabroe S., Bartels P., Mainz J., Christensen K. B. (2015). Adaption and validation of the safety attitude questionnaire for the danish hospital setting. Clinical Epidemiology, 2015(7), 149–160.
[10] Bowers L. (2002). Dangerous and severe personality disorder. reaction and role of the psychiatric team. London: Routledge.
[11] Clarke S., Freestone M. (2013). SOCRaTEs: A measure of the social climate in therapeutic environments. In The consortium of therapeutic communities’ annual conference, Windsor, 22–24 October 2013.
[12] Kaissi A., Johnson T., Kirschbaum M. S. (2003). Measuring teamwork and patient safety attitudes of high-risk areas. Nursing economic$, 21(5), 211–218.
[13] Haller E., McNiel D. E., Binder R. L. (1996). Impact of a smoking ban on a locked psychiatric unit. Journal of Clinical Psychiatry, 57(8), 329–332.
[14] Hallett N., Huber J., Sixsmith J., Dickens G. L. (2018). Measuring the violence prevention climate: Development and evaluation of the VPC-14. International Journal of Nursing Studies, 88, 97–103.
[15] Jung T., Scott T., Davies H. T. O., Bower P., Whalley D., McNally R., Mannion R. (2009). Instruments for exploring organizational culture: A review of the literature. Public Administration Review, 69, 1087–1096.
[16] Corey L. J., Wallace M. A., Harris S. H., Casey B. (1986). Psychiatric ward atmosphere. Journal of Psychosocial Nursing and Mental Health Services, 24(10), 10–16.
[17] Ekvall G., Arvonen J., och Waldenstrom-Lindblad I. (1983). Creative organizational climate. Construction and validation of a measuring instrument, Report 2, Stockholm FArAdet.
[18] Carnevali D. L., Patrick M. (2015) Nursing management for the elderly 2nd ed. Lippincott, Ph.
[19] Ekvall G., Ryhammar L. (1998). Leadership style, social climate and organizational outcomes: A study of a Swedish university college. Creativity and Innovation Management, 7, 126–130.
[20] Eliassen B. K., Sørlie T., Sexton J., Høifødt T. S. (2016). The effect of training in mindfulness and affect consciousness on the therapeutic environment for patients with psychoses: An explorative intervention study. Scandinavian Journal of Caring Sciences, 30, 391–402.
[21] Gershon R. R., Stone W. P., Bakken S., Larson E. (2004). Measurement of organizational culture and climate in healthcare. Journal of Nursing Administration, 34, 33–40.
[22] Isaak V., Vashdi D., Bar-Noy D., Kostisky H., Hirschmann S., Grinshpoon A. (2017). Enhancing the safety climate in reducing violence against staff in closed hospital wards. Workplace Health & Safety, 65, 409–416.
[23] International Labor, International Council of Nurses, World Health Organization & Public Services International (2002). Framework guidelines for addressing workplace violence in the health sector. Geneva: International Labor Office.
[24] Kerfoot G., Bamford Z., Amelia Jones S. (2012). Evaluation of psychological provision into an acute inpatient unit. Mental Health Review Journal, 17, 26–38.
[25] Hendel T. (1993). The effect of organizational variables on staff nurses’ perception of their professional role. J Nurs Management, 1, 189–194.
[26] Henderson A., Van Eps M. A., Pearson K., James C., Henderson P., Osborne Y. (2007). Caring for’ behaviours that indicate to patients that nurses ‘care about’ them. Journal of Advanced Nursing, 60(2), 146–153.
[27] Kristensen S., Christensen K. B., Jaquet A., Beck C. M., Sabroe S., Bartels P., Mainz J. (2016). Strengthening leadership as a catalyst for enhanced patient safety culture: A repeated cross-sectional experimental study. BMJ Open, 6, e010180.
[28] Hall L. (1969). The Loeb center for nursing and rehabilitation, Montefiore Hospital and medical centre, the Bronx, New York. International Journal of Nursing Studies, 6(2), 81–97.
[29] Hallberg I. R., Welander-Hansson U., Axelsson K. (1993). Satisfaction with nursing care and work during a year of clinical supervision and individualised care. Comparison between two wards for care of severely demented patients. Journal of Nursing Management, 1, 297–307.
[30] Berry K., Haddock G., Kellett S., Roberts C., Drake R., Barrowclough C. (2016). Feasibility of a ward-based psychological intervention to improve staff and patient relationships in psychiatric rehabilitation settings. The British Journal of Clinical Psychology, 55, 236–252.
[31] Caldwell B. A., Gill K. J., Fitzgerald E., Sclafani M., Grandison P. (2006). The association of ward atmosphere with burnout and attitudes of treatment team members in a state psychiatric hospital. American Journal of Psychiatric Rehabilitation, 9, 111–129.
[32] Eklund M., Hansson L. (1997). Relationships between characteristics of the ward atmosphere and treatment outcome in a psychiatric day-care unit based on occupational therapy. Acta Psychiatrica Scandinavica, 95, 329–335.
[33] Bjorkdahl A., Hansebo G., Palmstierna T. (2013). The influence of staff training on the violence prevention and management climate in psychiatric inpatient units. Journal of Psychiatric and Mental Health Nursing, 20, 396–404.
[34] Fröhlich D., Rabenschlag F., Schoppmann S., Borgwardt S., Lang U. E., Huber C. G. (2018). Positive effects of an anti-aggression and de-escalation training on ward atmosphere and subjective safety may depend on previous training experience. Frontiers in Psychiatry, 9, 134.
[35] Cuijpers P., Weitz E., Cristea I. A., Twisk J. (2017). Pre-post effect sizes should be avoided in meta-analyses. Epidemiology and Psychiatric Sciences, 26, 364–368.
[36] Berg A., Hallberg I. R. (1999). Effects of systematic clinical supervision on psychiatric nurses’ sense of coherence, creativity, work-related strain, job satisfaction and view of the effects from clinical supervision: A pre-post test design. Journal of Psychiatric and Mental Health Nursing, 6, 371–381.
[37] Friis S. (1986). Characteristics of a good ward atmosphere. Acta Psychiatrica Scandinavica, 74, 469–473.
[38] Berry K., Barrowclough C., Haddock G. (2011). The role of expressed emotion in relationshipsbetween psychiatric staff and people with a diagnosis of psychosis: A review of the literature. Schizophrenia Bulletin, 37, 958–972.
[39] Duxbury J., Bjorkdahl A., Johnson S. (2006). Ward culture and atmosphere. In Richter D., Whittington R. (Eds.), Violence in mental health settings: Causes, consequences, management (pp. 273–291). Springer.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 International Journal of Computational and Experimental Science and Engineering
This work is licensed under a Creative Commons Attribution 4.0 International License.
