Role of nurses in the initiation and the monitoring of Lithium. (1st June 2022)

• Record Type: Journal Article
• Authors: Moalla, M.; Larnaout, A.; Skhiri, D.; Lansari, R.; Staali, N.; Melki, W.
• Is Part Of: European psychiatry. Volume 65:Supplement 1(2022)
• Page Start: S177
• Page End: S178
• Publication Date: 2022-06-01
• Subjects: monitoring -- Nurses -- initiation -- Lithium; Psychiatry -- Periodicals; Mental illness -- Periodicals; Electronic journals; 616.89
• DOI: 10.1192/j.eurpsy.2022.470
• Languages: English
• ISSNs: 0924-9338

Abstract

Abstract : Introduction: Lithium is the oldest known treatment of bipolar disorders and remains the gold standard. Nevertheless, it remains difficult to handle, largely due to its narrow therapeutic index and its long-term side effects. Thus, it requires special initiation and monitoring measures. Objectives: This study aims to assess nurses' knowledge and attitudes regarding lithium. A protocol on Lithium initiation and monitoring will be established. Methods: This is a descriptive study including 20 nurses in a psychiatry department conducted from January to May 2021 based on an self-assessment questionnaire that was established to assess nurses' knowledge about Lithium, its side effects, initiation and monitoring. Results: None of the recruited nurses had any training regarding the use of lithium. The vast majority of subject (85%) said that lithium's dosage must be individualized and adaptable to each patient throughout a specific blood test. 90% recognized renal failure as the most common contraindication of lithium. Complete Blood Count (CBC), and renal check-up were the only tests recognized as necessary by all the sample subjects. 90% answered that lithium is toxic and 65% answered that it is fatal. In case of toxicity by lithium all subjects (100%) agreed to call the responsible doctor of the patient, 25% of them chose it as a unique measure and 75% thought it was necessary to stop the lithium immediately as well. Conclusions: Lithium is considered as a double-edged sword largely due to its narrow therapeutic index. Nevertheless, nurses are undertrained when it comes to its use and manipulation. Disclosure: No significant relationships.