MHA Forms
form 1
admission certificate
1 = good for 24hrs
2 = good for 1 month
requires one of the physicians be a psychiatrist
d/c AMA
discharge against medical advice
form 11
certificate of incompetence to make treatment decisions
requires physician makes a plan for what nurses do when patient refuses meds (ie. restraint, IM)
patient has the right to appeal
sertraline
anxiety, depression
your patient's medication is not on the unit
pharmacy
form 10
apprehension by peace officer for patient to be seen by a physician
active until patient is seen by a physician
AWOL
absence without leave
form 13
notice of hearing before review panel
must be given to patient before panel
lorazepam
anxiety, agitation
your computer is frozen
IT
form 2.1
cancellation of certification by physician
required to discharge a formal patient
i&o
intake and output
form 19
issuance of community treatment order
bupropion
antidepressant
patient is screaming and throwing objects in the common area
security, charge nurse
form 3
order to return formal patient to a facility
filled out usually in the event of patient AWOL
police will look for patient in community
CBC
complete blood count
form 8
warrant filled out by a judge to police to convey a person to a facility for mental health treatment
invega sustenna
long acting injectable antipsychotic
your patient wants to know why they were prescribed a certain medication
physician, pharmacy, charge nurse
form 12
application for review panel hearing
patient believes they do not need formal hospitalization
form 11s are held until review panel hearing
NG tube
nasogastric
form 1 criteria to be certified (4)
- suffering from a mental disorder
- has the potential to benefit from treatment
- harm to self or others in the community in a reasonable amount of time
- not suitable for voluntary status
clomipramine
OCD, anxiety, depression
your patient is seen self-harming
charge nurse, buddy nurse, physician, security