Milieu March
Assess April
MH Matters May
Joint Practice June
Practice Pearls
100

Explain the process of the Johnny Search and what to do if a patient refuses

  • Explain the search and its rationale to the patient and guardian to set expectations and promote cooperation.
  • Obtain a johnny and have two staff members (including at least one RN) accompany the patient to the bathroom; the guardian may remain if the patient prefers.
  • Patient changes behind the johnny, removes all clothing including undergarments, and hands clothing to staff.
  • The patient is draped with the johnny while:
    • One staff member thoroughly searches all clothing and belongings for contraband.
    • The RN performs a systematic head-to-toe skin assessment for injuries, concealed contraband, or other concerns while maintaining as much privacy as possible.
  • Once complete, the patient changes back into personal clothing if deemed safe.

Refusal =

  • Immediately initiate 1:1 observation and remove the patient from the milieu.
  • Notify the psychiatrist immediately.
100

Where is the safety checks person located?

in the hallway, walking the corridor the entire time!

100

what are the levels of escalation according to WELLE training

agitation/anxiety

disruptive

destructive

dangerous

lethal

100

Instead of immediately offering solutions, this communication technique involves acknowledging a patient's emotions to help them feel heard.

Validation
100

What are the Practice Pearls sessions coming from?

Directly from the AACN essential nursing domains

200

Explain the proper safety checks handoff protocol and when it should occur

THIS OCCURS AT EVERY CHANGE OF STAFF FOR SAFETY CHECKS!

  • Identify the oncoming staff member assuming safety checks.
  • Complete a joint walk-through of the unit, visually confirming every patient while documenting checks in real time via Vocera.
  • Perform an environmental safety scan, including patient rooms, bathrooms, showers, and other common areas.
  • Transfer the red Safety Checks ID lanyard to the oncoming staff member to signify responsibility for safety checks.
200

When are we documenting patient risk assessments?

- on admission

- every shift

- as needed

- at discharge

200

What are the 3 levels of prevention?

primary, secondary and tertiary

Bonus if you can describe each!

200

who is responsible for creating a therapeutic milieu?

EVERYONE

200

Which AACN Essential Domain involves the integration and application of both established and evolving nursing knowledge, along with insights from other disciplines.

Knowledge for Nursing Practice

300

What is the name for:

A structured psychiatric environment in which staff use the physical and social setting, limit-setting, role modeling, and therapeutic activities to promote safety, positive interactions, coping skills, socialization, self-management, and achievement of treatment goals.

Milieu Therapy

300

what communication style is this describing:

A purposeful, patient-centered style of communication used by healthcare professionals to establish trust, gather accurate information, promote healing, and support patients emotionally while maintaining professional boundaries.

Therapeutic Communication

300

What is completed following a difficult event with a patient or in the milieu?

staff and patient debrief

300

What is the key principle of milieu therapy?

every interaction is an opportunity for a therapeutic intervention

300

Which AACN Essential Domain involves holistic, individualized, respectful, and evidence-based care that places the patient at the center of all decisions.

Patient-Centered Care

400

What are the 3 tier 1 interventions of PBIS?

Praise, Prompt and Precorrection

400

Name 3 social determinants of health (SDOH)




  • Socioeconomic status
  • Education and health literacy
  • Employment
  • Housing and transportation
  • Food security
  • Healthcare access
  • Community
  • Social supports
  • Safety
  • Legal status
  • Culture and language
  • Technology access
  • Childcare and caregiving
  • Discrimination
  • Stress and coping
  • Substance use

many more!

400

List 3 common triggers for behavioral dysregulation

- overstimulation

- unclear expectations 

- noise level

- peer conflict

- abrupt transitions 

- the "unknown"

400

What is the name for:

The process of working together with others toward a shared goal by combining each person's knowledge, skills, and perspectives to achieve the best possible outcome.

Collaboration

400

Which AACN Essential domain is being described:

Focus on prevention, health promotion, and the social determinants of health that impact mental health outcomes.

Population Health 

500

What is:

An approach that recognizes the impact of stressful life events and provides care that emphasizes safety, trust, collaboration, empowerment, and choice while actively working to avoid re-traumatization and promote healing.

Trauma Informed Care

500

name 2 examples of early warning signs of escalation

Early signs may include:

  • Pacing, withdrawal, irritability
  • Tone/volume changes
  • Body tension, restlessness

Escalation is predictable and preventable

  • Intervene during trigger/agitation phase, not crisis
  • Small interventions early = major prevention later
  • Goal: decrease intensity, not control behavior
500

behavior is a form of ______________

COMMUNICATION

500

What are the shared expectations across the inpatient psychiatric services (5W and Bader)

Safe

Patient

Accepting

Communicating

Engaging

500

Which AACN Essential Domain involves creating, using, improving, and sharing knowledge to improve patient care.

Scholarship For the Nursing Discipline

M
e
n
u