No Disclosures Creating an Innovative Inpatient Program for - - PDF document

APNA 29th Annual Conference Session 2023: October 29, 2015 Pingitore 1

Creating an Innovative Inpatient Program for Pediatric Medical Psychiatric Patients

Francine Pingitore, PhD, RN, PCNS-BC Jenifer LaRose, BSN, RN, CPN

No Disclosures

The speakers have no conflicts

• f interest to disclose

Learning Objectives

• 1. Describe an innovative program for pediatric

patients with medical and psychiatric illness

• 2. Discuss the role of the nurse in this program

and identify implications for nursing education/research

• 3. Illustrate program through case study

Program History

 Opened in response

to an unmet community need

 8 bed unit opened

October 4, 2012

 Expanded to 16 beds

in December 2014

 To date, more than

500 patients/families have been treated

Hasbro 6 Patient Population

 Patients with a combination of medical and

psychiatric illnesses

 6 to 18 years of age  Male & female  New England region and East Coast, with

referrals from across the country and internationally

APNA 29th Annual Conference Session 2023: October 29, 2015 Pingitore 2

Mission and Philosophy

The mission

• f

the Hasbro Inpatient Medical Psychiatric Program is to provide family based integrated care to children and adolescents with complex medical and psychiatric illness. Interdisciplinary acute care is aimed at diagnostic clarification and medical psychiatric stabilization of safety and functioning to support transition to longer term follow-up, ranging from outpatient to residential care.

Psychiatrists Pediatricians Nurses Mental Health Workers Advanced Practice Nurses Volunteers Psychologists Nutrition Child Life Specialist Social Workers Consulting Physicians PT/OT

Integrated Care Model

Patient & Family

Multidisciplinary Staff

Program Schedule



7:00-7:30 wake up



7:45-8:15 breakfast



8:30-9:00 community meeting



9:00-10:00 community activity



10:00-10:15 snack



10:30-12:00 school



12:00-12:30 lunch



12:30-1:00 free time



1:00-2:00 group therapy



2:00-2:45 community activity



2:45-3:00 snack



3:00-4:00 reflection time



4:00-4:30 day in review



4:30-5:00 community activity



5:00-5:30 dinner



5:30-7:30 open activity



7:30-8:00 reflection time



7:45-8:00 snack



8:30-9:30 bedtimes/lights out visiting hours 2:30p-4p & 6p-8p

Program Highlights

Cartoonist Massage Therapy Pet Therapy Zumba Yoga

Program Highlights

Special Visitors

APNA 29th Annual Conference Session 2023: October 29, 2015 Pingitore 3

Therapeutic Modalities

 Individual therapy  Group therapy  Family therapy  Milieu therapy

Implications for Nursing

 Practice  Education  Research

Practice Research Education

Nursing

Nurses in the Milieu

 Expert Pediatric Nurses by training  Received comprehensive psychiatric nursing

education

 Uniquely qualified

Advanced Practice Nurses

Child & Adolescent Psychiatric CNS

 Provides therapy  Prescribes  Consultant  Educator

Pediatric Nurse Practitioner

 History & Physicals  Examinations  Prescribes  Educator

Nursing Education

• Initial education prior

to unit opening

• Yearly nursing

competencies

• Ongoing educational
• pportunities

Nursing Research

Many possibilities of areas to investigate!

 Nursing education  Nursing practice  Patient outcomes  Patient experience

APNA 29th Annual Conference Session 2023: October 29, 2015 Pingitore 4

Case Study

Previously healthy & physically active 12 y.o. male:

• Contracted a GI illness in November 2014
• Comprehensive medical work up negative
• Progressively worsening physical symptoms:
• Severe abdominal pain
• Sensitivity to light and temperature
• 13 pound weight loss
• Inability to walk
• Multiple episodes of fainting/non-epileptic seizures

Case Study

Presented to Hasbro 6 in April 2014 with a diagnosis of conversion disorder:

 Wheelchair bound  Multiple fainting episodes-requiring mechanical lifts

throughout the day

 Wearing sunglasses & covering face with clothing  Unable to hold a spoon or pencil  Unable to attend to basic self-care activities: eating,

toileting, hygiene

Case Study

Course of treatment lasted 4 months:

 Including inpatient & partial hospital program  Intensive patient/family therapy & education  Individualized multidisciplinary behavior plan  Frequent phone conferences with parents  Multidisciplinary services involved:

• Neurology
• Physical & Occupational Therapy
• Pain Team
• Integrative Therapies

Case Study Case Study Thank You!

Jenifer LaRose, BSN, RN, CPN Clinical Manager Hasbro 6 jlarose@lifespan.org (401) 444-6068 Francine Pingitore, PhD, RN, PCNS-BC Child & Adolescent Psychiatric Clinical Nurse Specialist fpingitore@lifespan.org (401) 444-5636