Quality and safety graduate competencies in psychiatric mental health nurse practitioner education.

Education of the psychiatric mental health nurse practitioner (PMHNP) is undergoing massive change, partially driven by practice requirements and national certification changes, the development of new nurse practitioner competencies, and the development of the graduate quality and safety in nursing (QSEN) competencies. We are in the middle of a paradigm shift of expectations, not only just from these new competencies but also from the context of care and the impact PMHNP graduates will have on policy and health care delivery in the future. In this review article, the authors will discuss the general categories of the graduate QSEN competencies and how they relate to PMHNP education, competency development, and the application to curricular development in PMHNP programs across the United States. Importantly, these changes into PMHNP education, while remaining true to the fundamental tenants of advanced practice psychiatric nursing, prepare the PMHNP to meet the challenges of health care reform and service delivery.

Substance abuse interface with intimate partner violence: what treatment programs need to know.

This article provides suggestions for skill development for substance abuse (SA) treatment agencies and providers for implementing Treatment Improvement Protocol number 25: Substance Abuse Treatment and Domestic Violence. Methods for detecting, screening, intervening, and referring victims and perpetrators of intimate partner violence enrolled in SA treatment are presented. Evidence-based brief intervention is presented. A 2-minute screen for domestic violence as well as danger assessment for lethality of abuse and the Conflict Tactics Scales 2 are reviewed. A survey of interventions aimed at establishing trust, brief intervention from best practice, guidelines for safety planning, compliance strategies for SA treatment, and community resource development are presented.

Being emotionally abused: a phenomenological study of adult women's experiences of emotionally abusive intimate partner relationships.

The purpose of this study was to explore and describe individual perceptions, meanings, and definitions of emotional abuse through the lived experience of women who identified themselves as being emotionally abused by an intimate partner (IP). To answer the research question, "What is it like to live the life of a woman who is emotionally abused by her intimate partner?" A descriptive, phenomenological research design was undertaken. Unstructured individual interviews with 15 emotionally abused adult women resulted in the discovery of seven essential themes: captivity, defining moments, disassociation from self, fixing, mindful manipulation, relentless terror, and taking a stand. A combination of a hermeneutic approach and Diekelmann's approach to data analysis was used to explore differences in perceptions and develop essential themes that portrayed the essence of a woman's lived experience of being emotionally abused by her IP. The data also demonstrated that (1) IP emotional abuse has no prerequisite for partner rage or obvious emotional manipulation, (2) the absence of caring and respectful partner behaviors was just as powerful in creating an emotionally abusive experience as openly abusive behaviors, and (3) being emotionally abused was a life journey, encompassing multiple culminations, secondary physical and mental health symptoms, and quality of life issues that extended well beyond the immediate abuse experience.

Intimate partner violence, pregnancy and the decision for abortion.

Pregnant women whose lives are affected by intimate partner violence and unintended pregnancy are often faced with the decision for abortion. In this qualitative research, the authors explored women's experiences of unintended pregnancy and intimate partner violence (IPV) from the perspective of adult pregnant women seeking abortion. Women were assessed for intimate partner violence and study inclusion by means of two IPV screening tools. The authors collected data during one-to two-hour semi-structured interviews with eight pregnant women. At the completion of the interviews, all women were assessed for safety using an assessment of danger tool. Safety planning and referrals were provided for all women. Qualitative data collection and data analysis were guided by naturalistic inquiry to identify prevalent themes. Three major themes emerged from the data: (1) It Wasn't That Bad, (2) Then It Got Worse, and (3) If I Have the Baby He'll Come Back. Descriptive statistics were used to tabulate and describe the women's responses to the three tools.

Violent lives of women: critical points for intervention/life charting.

Each year, 5.3 million women are abused and several thousand die at the hands of intimate partners. If family violence were better understood, it could be predicted, described by patterns and prevented. Life charting (LC) is a method developed to explicate complex phenomena, such as bipolar disorder. This study tested the feasibility and usefulness of LC in deriving data about critical points in life when interventions could reduce or prevent family violence. Two research questions guided the study: (1) Does LC yield valid, reliable data when used as a review with women exposed to violence? (2) Is LC feasible for use in research?

Safe family project: a training model to improve care to victims of domestic violence.

Hospitals must implement staff development programs to assure that nurses and other staff have requisite knowledge, attitudes, and skills to provide quality care for patients who are victims of domestic violence. The author describes a community campus partnership designed to improve care through use of a logic model which follows these steps: needs and assets assessment, capacity building, program selection, implementation and assessment, and final evaluation. The analysis has implications for other health institutions.

Increasing physician impact on the prevention of domestic violence.

Physicians in their professional organizations have recognized the tremendous toll of domestic violence on the safety and health of their patients. Effective integration of screening and referral into routine practice has encountered many significant barriers, primarily the syndrome of compassion fatigue. This article describes how physicians can enhance the safety of families. Universal education offers more opportunities for physicians to communicate with survivors and perpetrators of violence. Specific documentation by physicians will enhance patient care and public health surveillance efforts. Safety planning skills offer immediate benefits to patients facing acute dangers. The participation of physicians (individually and collectively) on adult intentional fatality review boards will make available more specific data and tools for the prevention of domestic violence.