Abstract: In 1995 we conducted a retrospective audit on a prospectively collated database to find out which intensive care patients missed out on psychiatric care after self poisoning. Our results showed that 57 patients in 1995 may not have received psychiatric follow-up assessment. Department of Critical Care Medicine (DCCM) follow-up was also less successful for this particular group. It was recommended that on admission to intensive care, all self poisoning patients would be referred to the Liaison Psychiatry Service (LPS).In 1996 we reviewed the databases of DCCM and LPS to determine if the quality of psychiatric follow-up had improved after the initial 1995 audit. In 1996 124 patients had 149 admissions (85F, age range 14.6-85.3, median 35, median GCS 9, 99 ventilated, 3 deaths). Thirteen patients had 25 admissions within 6 months of their index admission , 7/13 had a major psychiatric disorder. Mixed poisoning remained common. Forty-five admissions took cyclic antidepressants, 21 sedatives, 52 other medications, 25 ethanol (median 43 mmol/l ), 30 carbon monoxide and 5 took various non-prescription poisons.Thirteen went home, 32 to other hospitals, 4 to psychiatric hospitals and 97 were transferred to wards within Auckland Hospital. Psychiatric follow-up assessment was successful in 96/97 patients prior to discharge from Auckland Hospital. Those discharged to other hospitals or home were referred and followed up by LPS teams or other Mental Health Services.DCCM follow-up 4-6 weeks post discharge was more successful for 1996 with 120/146 contacted of which 33/120 were receiving ongoing psychiatric care.

Abstract: The ICN International classification for nursing practice project.Terms used by Community-based Mental Health Nurses to describe their practice.In December 1995 a team of advisors from throughout the Asia and pacific region gathered in Taipei, Republic of China, for the International Council of Nurses (ICN) International Classification of Nursing Practice (ICNP) project. During the week long workshop the early draft Classification architecture was presented and exercises were undertaken to test the relevance and accuracy of selected Terms and associated characteristics from the classification. The team of Consultants, who have been working on the Classification since 1990, identified that the most underdeveloped aspects of the hierarchy were community health and mental health nursing. They encouraged the team of Advisors to conduct research with nurses to add to these areas of the Classification in particular.The purpose of the ICP is to make nursing visible through an internationally accepted language which represents nursing diagnoses, interventions and outcomes. The classification is sponsored by ICN and follows a format similar to the WHO International Classification of Diseases (ICD) which is used extensively throughout the world to statistically record work completed by medical practitioners.The research undertaken at Lakeland Health with five Community-based Mental Health Nurses used the retrospective method of nursing diagnosis validation tool and field exercise method provided by the ICNP Consultant team. These were underpinned by participatory action research methodology. Over four sessions the participants identified six Terms and then field tested each to assess the relevance of that Term in practice. At the weekly sessions the participants shared their reflections on the validity of each Term and discussed other outcomes resulting from their involvement in the research process.The research report outlines the ICNP project and associated literature, explains the research methodology, identifies the resulting Terms and characteristics ready for submission to the ICNP Consultant team and examines outcomes from involvement in the participatory process