Center for Psychiatry (CFP)

Nurse of the Year 2009
Marryann Merriman, RN

Location:

The Center for Psychiatry (CFP) is a Baker Act Receiving Facility for Polk County, providing care for patients 18 years of age and above. It is located in the Strang Building.

# Beds:

This unit accommodates 28 inpatients and up to 4 patients in the Transitional Care Area (TCA), in holding for placement or transfer to other facilities. The TCA is an extension of the Emergency Department designated for psychiatric patients who do not meet criteria for CFP.

Director:

Lou-Ann Martinez, RN, MS, PMHCNS, BC

Asst. UM:

Lynne Harty, RN

Program Supervisor:

Judith Whaley, MSW

Type of unit:

Designated Baker Act Receiving Facility – Locked Adult Inpatient Psychiatric Unit

Typical staffing:

The staffing pattern is based on nursing care need, acuity, and census. Care at the Center for Psychiatry (CFP) is based on Winter Haven Hospital’s Professional Model of Care. All care is patient-centered which incorporates healthcare benchmark staffing parameters to ensure that staffing is consistent with standards used within the industry. Patient care is provided by RNs, LPNs, Lead Mental Health Associates, Mental Health Associates, Mental Health Technicians, Nursing Techs, Certified Nursing Assistants, and students during clinical rotations. Nurse to patient ratio varies according to the acuity.

Typical pt diagnosis:

For admission to CFP, patients must meet Baker Act criteria. Examples of patients meeting inpatient admission criteria include but are not limited to the following:

1. Substantial likelihood of harm to self without treatment
2. Substantial likelihood of harm to others without treatment
3. Acute symptoms of a major mood or thought disorder
4. Cognitive impairment, disorientation, or memory loss due to an Axis 1 disorder, when this presents a substantial threat to the well being of the patients and others.
5. Inability to be stabilized in a less restrictive setting.

An interdisciplinary approach is used to provide a comprehensive combination of services including twenty-four hours a day of psychiatric supervision and intervention, intensive nursing care, psycho-therapy, psycho-education and therapeutic recreational group treatment. Patients presenting with only substance abuse disorders or dangerousness due to criminal behavior, and patients who are severely medically compromised, are all referred to the setting that best meets their clinical needs.

Common skills utilized:

As described in the ANA Psychiatric-Mental Health Nursing Scope and Standards of Practice, "Psychiatric-Mental Health Nursing is a specialized area of nursing practice committed to promoting mental health through the assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders." CFP nurses utilize the nursing process to deliver care (assessment, diagnosis, outcome identification and planning, implementation, and evaluation). Standards of practice incorporated into patient care delivery at CFP are also derived from the ANA Standards of Practice and the Florida Nurse Practice Act.

Most common meds / those nurses must be familiar with:

Antipsychotics, antidepressants, anticonvulsants, antianxiety agents, mood stabilizers, antiparkinson agents, antihistamines, hypnotics

Care extenders used:

Patient care needs are assessed with input of an interdisciplinary team of nurses, physicians, social workers, Lead Mental Health Associates, Mental Health Associates, and Mental Health Technicians. CFP staff communicate with other departments through the Patient Safety Committee, Patient Services Management Committee, Risk Management, Performance Improvement, Meeting of the Minds, Psychiatric Subsection, Nurse Pharmacy, Shared Governance, and independent meetings as necessary to provide optimum care and service. Daily CFP Treatment Team meetings are held with patients in order to provide them with the opportunity of participating in treatment and discharge planning.

CFP staff work closely with Emergency Department staff and the Access Team to ensure efficient and appropriate disposition of psychiatric patients. The Access Team reports to the CFP chain of command and they see ED patients who may be referred for assessment of a mental illness.

Certification for Differential:

Psychiatric/Mental Health Nursing certification is encouraged (RN, BC).

Selling points for Unit:

Experienced and diverse leadership, experienced and knowledgeable staff, cohesive interdisciplinary team, full time medical director, low assault rate, low restraint and seclusion rate, low staff turnover rate, BSN education encouraged, shared governance participation, patient safety and staff safety are high priorities.