J Psychosoc Nurs Men
-
With the March 2010 passage of the health care reform law, the Patient Protection and Affordable Care Act, the U. S Congress completely transformed the health care industry and fundamentally altered how hospitals will deliver and receive payment for care. ⋯ Key components of health care reform ( i.e., measuring and benchmarking quality patient care outcomes; payment reform; and the reorganization of the health care delivery system to ensure accountable, accessible, patient-centred, coordinated care) are reviewed with regard to their impact on behavioral health. The challenges, opportunities, and implications of health care reform are examined for the nursing field in general and psychiatric nursing practice specifically.
-
J Psychosoc Nurs Men · Apr 2012
CommentA question about the potential cardiac toxicity of escitalopram.
Previous reviews have focused on the potential cardiac toxicity of the racemic drug citalopram (Celexa(®)). Evaluating the safety of escitalopram (Lexapro(®)) is an important issue to consider, since it is the S-enantiomer of citalopram. Escitalopram has a small effect on the QTc interval. ⋯ Whether the escitalopram minor metabolite S-DDCT has this effect is not known. Concentrations of S-DDCT are lower than DDCT, but for a broad range of doses of escitalopram and citalopram, the S-DDCT and DDCT concentrations are well below the QTc prolonging concentrations reported in dogs. There is no strong evidence from human and animal studies that the cardiac safety of escitalopram is significantly superior to that of citalopram.
-
Compulsive hoarding is a debilitating disorder that is only recently becoming understood. Hoarding has been studied primarily in the general population, with only a few researchers focusing on hoarding in older adults, even though the prevalence and severity of the disorder appears to increase with aging. ⋯ Established treatments for hoarding are relatively new and often need to be extended over a long period of time. Nurses can play an important role in helping identify the problem of hoarding in older adults, determining the types of safety and health hazards that need to be addressed, and contacting the appropriate community agencies.
-
Psychoactive bath salts are a relatively new group of designer drugs sold as tablets, capsules, or powder and pur-chased in places such as tobacco and convenience stores, gas stations, head shops, and the Internet. Bath salts are stimulant agents that mimic cocaine,lysergic acid diethylamide, methamphetamine, or methylenedioxymethamphetamine (ecstasy). The most common bath salts are the cathinone derivatives 3,4-methylenedioxypyrovalerone(MDPV), 4-methylmethcathinone(mephedrone), and 3,4-methylenedioxy-N-methylcathinone (methylone). ⋯ S. Drug Enforcement Administration recently exercised an emergency authority to name three key ingredients in bath salts as Schedule I, thereby making them illegal to possess or sell in the United States. Nursing implications related to both clinical and educational settings are discussed.