Tools of the Trade – Mental Health Nursing

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Assessment or screening tools are key to gathering a whole wealth of information from a client and they can often lead to them opening up about other or underlying issues that may be impacting on their health. How and what they answer can give you insight into their current feelings about things as well as provide a baseline of presentation to record any future changes and used to point towards treatment required. Being able to monitor someone’s recovery progress can help staff encourage and motivate a person, just as being able to monitor someone’s deterioration can help staff adapt treatment and interventions appropriately.

Tools are not always perfect and we have to work with them openly and carefully using them as a guideline to help support the treatment or diagnosis we provide. Below is a short list of the some of the assessment tools you might come across on placement;

The Hospital Anxiety and Depression Scale (HADS) – Used for Anxiety & Depression can be used in community as well as hospital. It is a 14 question Psychological screening tool assessing the severity of symptoms.

Generalised Anxiety Disorder Questionnaire (GAD-7) – Screening tool used to measure the severity of Generalised Anxiety Disorder. 7 questions that can be administrated by a health care professional or self-administrated by the client themselves.

The Mini Mental State Examination (MMSE) – Commonly used short assessment used for screening for any dementia or cognitive impairment concerns are suspected. It measures cognitive functioning, and can be used to monitor change. 11 item tool taking around 10 minutes to administer making it a quick and useful tool to use.

The Addenbrooke’s Cognitive Examination (ACE) –  Well validated assessment tool for clinic setting assessment of cognitive functioning. This measures cognitive domains including language, visuospatial, memory and attention.  Usage is usually in part with other screening tests such as blood test, ECG and MRI scan to inform a diagnosis.

The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) – Is a self-assessment tool for measuring the side-effects of antipsychotic medications. Red herrings are included to check the accuracy of the results. The 51 questions are based on true side effects with 10 being false  ones aim to help patients Identify, understand and gain awareness of side effects they could be experiencing.

The Alcohol Use Disorders Identification Test (AUDIT) – A basic screening tool used to pick up the early signs of hazardous and harmful drinking and identify mild dependence and highlight if a need for assisted withdrawal is required.

There are many varied tools assessing risk used by health care professionals in all fields and in  a wide variety of settings. It is important practitioners should take care to always explain what is involved,  how long it will last and how they can help a patient and their treatment.

Using an assessment tool can help uncover more information about a patients situation and help to encourage conversation that could provide valuable information to inform their care is more personalised and help reduce risk.

Keep your assessment tool box handy and help patients access all areas in health care support.smile

Dementia

forget me notAs an adult nurse, dementia is something that you will come across potentially on a daily basis. As the population is ageing dementia is becoming more prevalent. Here are a few tips about caring for patients with dementia.

Whilst caring for patients with dementia it is vitally important to maintain their dignity. Patients with dementia often have no inhibitions and will not think twice about taking their clothes off in a crowded ward. It is therefore important to have eyes like a hawk in order to decrease the frequency of these moments!

Another important factor is supporting the families of the patient. Often, a lot of families do not understand the condition and they can find it quite frightening. Also, the patient may need extra help on discharge so this is important to sort out.

You need to get to know the patient and get to know their personalities. This will ensure you can work out the best tactics to approach the patient and ensuring they are not startled. Find out about their lives and families so if they keep repeating a name you know who they are referring to!

Hospitals have a document called ‘Forget Me Not’ that has areas for families to fill in about the patients’ lives, families, likes and dislikes among many other things. This is a really useful document.

It may also be useful to get patients’ families to bring in photos for the patient to look at or their favourite activity. This will help to keep the patient occupied.

Also make sure the patient is wearing the correct glasses and hearing aid (if applicable) as the patient may not remember they wear them! This may be the reason why they are shouting!