The Kennedy NOSIE (K NOSIE) (NURSES' OBSERVATION SCALE FOR INPATIENT EVALUATION) is a powerful tool for tracking changes in patients with severe, chronic mental illness, such as SCHIZOPHRENIA. With increasingly complicated medication regimes, the K NOSIE can play an important role in helping determine MEDICATION EFFECTIVENESS. It can also be very helpful with tracking behaviors associated with AGGRESSION AND VIOLENCE. (See "NOSIE LINKS" to your left.)
The K NOSIE is based on the NOSIE-30 which was developed in the 1960s to track behavioral response to medication. An initial 100 OBSERVABLE BEHAVIORS were narrowed down to 26, including "Refuses to do the ordinary things expected of her," "Starts up a conversation with others," "Keeps her clothes neat," "Gets angry or annoyed easily," and "Is slow moving and sluggish." These direct observations by the nursing staff can be rich in clinical information. The K NOSIE offers a formal method for easily capturing these observations and incorporating them into the clinical process.
MENTAL HEALTH WORKERS (MHWs), under the supervision of the nurses, can often provide the most accurate ratings of the K NOSIE because they are usually doing the most direct observations of the patients. It has been our experience that the further you are from providing direct hands-on care, the less accurate are your ratings of the K NOSIE. For example, nurse supervisors often provided less accurate ratings than the direct care nurses and the direct care nurses provided less accurate ratings than the MHWs. Therefore, in addition to the nurses, you should look to the MHWs as a reliable source for rating the Kennedy NOSIE. Because MHWs' skills can vary widely, there can be marked differences between the ability of individual MHWs to do the ratings. This is one of the reasons why supervision by the nurses is so important.
COST EFFECTIVE. A "reasonable" ROYALTY (approximately $0.25 to $0.50 per rating) will be charged for use of the K NOSIE after 6/30/05. The royalty can be waved during a six month trial period and/or after Dr. Kennedy's approval for its use in any pilot/research project.
Click "Requests/Questions" to have a free copy of the K NOSIE emailed to you.
Requests/Questions
To obtain high interrater reliability (up to 0.90), training using the "Guide to the Kennedy NOSIE" is critical; therefore, we strongly suggest that you use the "Guide to the Kennedy NOSIE" when training and when actually rating the K NOSIE.
Click "Requests/Questions" to have a free copy of the "Guide to the Kennedy NOSIE" emailed to you.
Requests/Questions
NURSING LINKS
THE FOLLOWING ARE LINKS TO NURSING WEBSITES WHICH PROVIDE IMPORTANT INFORMATION THAT CAN SUPPLEMENT THE KENNEDY APPROACH TO PSYCHIATRIC TREATMENT PLANNING AND OUTCOME MEASURE:
1) AllofNursing.com "Welcome to one of the biggest nursing sites on the Internet - with thousands of pages of information on nursing, and much more!" This link will take you to the "Nursing Care Plans" section of the website.
Click Here
2) Nurses.Info provides "Information and resources for nurses worldwide." This link will take you to the "Mental Health" section of the website.
Click Here
3) PsychNursing.com is a "Center for psychopharmacology for advanced practice psychiatric nurses." This link will take you to the home page of the website.
Click Here
4) TopNursing.com is "Your complete source for nursing resources and information." This link will take you to the "Nursing Care Plans" section of the website.
Click Here
THE FOLLOWING ARE LINKS TO ARTICLES WHICH WE FEEL SUPPORT OUR CLAIM THAT THE K NOSIE CAN BE USEFUL FOR TRACKING BEHAVIORS ASSOCIATED WITH PREDICTING AGGRESSION AND VIOLENCE, AS WELL AS TRACKING EFFECTS OF MEDICATION CHANGES:
1) Violence on Inpatient Psychiatric Units: State of the Science
Journal of the American Psychiatric Nurses Association, Vol. 10, No. 3, 113-121 (2004)
© 2004 American Psychiatric Nurses Association
By: Mary E. Johnson
Click Here
2) Use of the NOSIE to predict assaults among acute psychiatric patients
Psychiatric Services 1997; 48:1177-1180
Copyright © 1997 by American Psychiatric Association
By: C Swett and T Mills
Click Here
3) The Prediction of Violence in Acute Psychiatric Units
International Journal of Forensic Mental Health
2003, Vol. 2, No. 2 pages 173-180
By: David Watts, Morven Leese, Stuart Thomas, Zerrin Atakan, and Til Wykes
Click Here
4) The Value of Community to Stress Prevention in Chronically Ill Psychiatric Clients
This presentation was part of "Chronic Mental Illness" seminar. This paper was presented on 7/22/04
By: Karen Ward, PhD, RN and Linda McBride, MSN, RN, C
Click Here
5) Nurses' Observation Scale for Inpatient Evaluation: Reliability Update
Journal of Advanced Nursing
Volume 46 Issue 4 Page 390 - May 2004
By: Dawn Lyall BSc, Chris Hawley MB BS MRCPsych and Kusam Scott RMN
Click Here
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