Mental health nurses’ views of ward readmission: A focus group study in Brunei Darussalam

Background: Readmission becomes inevitable with the vast development of mental health services worldwide and the challenges faced by mental health services. This readmission is often caused by a relapse from an illness whereby the psychiatric patient needs nursing care. Objective: This study aimed to explore psychiatric nurses’ perceptions of reasons for readmission and nurses’ further role in reducing readmission. Methods: In this descriptive qualitative study, thematic analysis of five focus group discussions (n= 24 nurses) in one psychiatric department in Brunei Darussalam was identified through purposive sampling. Results: The nurses perceived the role of family and non-adherence to medication as a significant reason for psychiatric readmission. Simultaneously, nurses viewed that it was necessary to implement systematicchoeducation to strengthen the role of family and community service support to curb readmission rates. Conclusion: The phenomenon of mental health readmission impacts psychiatric nurses due to many stressful challenges with nurses wishing to respond personally, humanely and professionally. These challenges require suitable interventions, such as debriefing to ensure that nurses continuously strive to deliver quality care to psychiatric readmission patients.

Quantifying Psychopathology in Rapid Readmissions

Psychiatric readmissions contribute to a significant cost and healthcare burden to physicians, hospitals, and the healthcare system as an entity. Furthermore, as part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) began to reduce financial coverage to hospitals with overwhelming rehospitalization rates. The purpose of this study was to do a systematic analysis on inpatient psychiatric readmission data and identify co-morbidities and risk factors that lead to high readmission rates. The data collection includes 163 patients with a total of 348 readmissions over the span of 90 days at one inner-city hospital in the Chicagoland area. Study findings suggest that higher rates of readmission are linked to cocaine abuse in both male and female populations. Diagnosis of bipolar in females and schizoaffective disorder in male populations were the among the highest for readmission. Key social factors such as homelessness and low socioeconomic status were identified to contribute to a large proportion of psychiatric readmission burden. However, an overwhelming amount of information was missing due to unobtained labs and lack of current patient social history. By using this data as well as data from electronic medical records (EMRs) to further investigate and identify other features of at-risk patients, hospitals can potentially address these markers to lower readmission rates. Ultimately, a higher understanding of the patients’ needs can be understood and can help develop standardized plans of care for prevalent psychiatric illnesses in these populations.