The Milieu Enhancement Model: a nursing practice model, Part I

Judgement days: developing an evaluation for an innovative nursing model

This paper reports on the process and outcomes of the evaluation of an innovative nursing model (the Tidal Model). In relation to process, the study has been used to refine the methodology in terms of defining important variables to take as outcome measures to be analysed both descriptively and inferentially. In relation to outcomes, the pre-post-test design has generated significant findings in relation to improved patient care.

The tidal model: developing a person-centered approach to psychiatric and mental health nursing

TOPIC

Overview of the theoretical and practical basis of a new model of psychiatric and mental health nursing practice.

PURPOSE

To illustrate the history of the development of the model and some of the processes that aim to re-empower the patient and develop genuinely collaborative approaches to care.

SOURCES

Literature review, author's research, and related clinical experience.

CONCLUSIONS

The Tidal Model provides a practice framework for the exploration of the patient's need for nursing and the provision of individually tailored care.

The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing

Nursing theories and nursing models have a low profile within psychiatric and mental health nursing in the United Kingdom. This paper describes the philosophical and theoretical background of the Tidal Model, which emerged from a 5-year study of the 'need for psychiatric nursing'. The Tidal Model extends and develops some of the traditional assumptions concerning the centrality of interpersonal relations within nursing practice. The model also integrates discrete processes for re-empowering the person who is disempowered by mental distress or psychiatric services or both. The paper reports briefly on the ongoing evaluation of the model in practice.

Psychiatric Hospitalization and Process Description: WHAT WILL NURSING ADD?

1. Inpatient treatment programs operating in the managed care environment must clearly articulate their treatment outcomes and the processes of care that are connected to these outcomes. 2. The work of inpatient psychiatric nurses can be organized and articulated through the therapeutic processes of the Four S Model: Safety, Structure, Support, and Symptom Management. 3. Nurses are vital contributors to the inpatient treatment process, but will be marginalized if they are unable to articulate how their interventions contribute to the positive treatment outcomes.

Milieu therapy: a therapeutic loophole

TOPIC

The confusion over, and ultimate demise of, milieu therapy.

SOURCE

Literature review.

GOAL

To chronicle the conceptual problems and other events leading to the decline in the use of milieu therapy.

CONCLUSION

Inpatient nurses would do best to leave the concept of milieu therapy behind and focus on clarifying how specific nursing interventions are operationalized and tied to patient outcomes.

Psychiatric nursing outcome research: the state of the science

A review of the nursing literature from 1989 to 1994 indicates that few psychiatric nursing studies are published in the major nursing research journals. The psychiatric specialization literature includes a large number of studies that are classified as either outcome studies or could serve as building blocks for future outcome studies. Few studies build on prior research, resulting in a weak scientific basis for evaluating the outcomes of psychiatric nursing care. Strategies for increasing the quantity and quality of psychiatric nursing outcome research are presented.