Nursing care for patients with acute mania : exploring experiential knowledge and developing a standard of good care : results of the Delphi study

Background: When patients diagnosed with bipolar disorder are suffering from acute mania (involuntary), hospitalization is often necessary. Patients are often quite disruptive, which makes it difficult to regulate their behavior and manage them in their current condition. The nursing team must also ensure the safety of the other patients on the ward. Nursing practice in this domain appears to draw primarily on tradition and experience. Objective: To achieve consensus on a standard for nursing practice for patients suffering from mania who are admitted to a closed psychiatric ward. Study Design: Previously, professionals, patients, and informal caregivers in the Netherlands were interviewed about the nursing care and their lived experiences. Based on these findings and on the results of a literature review, 89 statements were formulated. A three-round Delphi study among professionals, patients, and informal caregivers was carried out. The accepted statements were summarized. Results: In the first round, 71 statements were accepted, none were rejected, and for 18 statements, no consensus could be reached. These were reformulated and presented in a second round. Thirteen of these statements were accepted, none were rejected, and five statements needed to be reformulated and were presented in the third and final round of this Delphi study. In this final round, all statements were accepted. Conclusion: Consensus was reached among professionals, patients, and informal caregivers in the Netherlands about essential and valuable components of nursing care for patients suffering from acute mania who are admitted to a closed psychiatric ward