What is the process of a comprehensive mental health nursing assessment? Results from a qualitative study (original) (raw)
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What is a comprehensive mental health nursing assessment? A review of the literature
International Journal of Mental Health Nursing, 2011
Assessment is the foundation on which nursing care is delivered. The aim of this paper is to better understand the content (what information nurses seek about consumers) and the process (how they go about gathering that information) of a comprehensive mental health nursing assessment in practice. Using terms, such as 'nursing', 'mental health', and 'assessment', the CINAHL, Medline, and PsycINFO databases were searched for studies that describe the content and process of a comprehensive mental health nursing assessment. Although studies of aspects of mental health nursing assessment, such as the assessment of risk or carer burden, were found, no single study described both the content and process of a comprehensive mental health nursing assessment in practice. In Australia, a comprehensive assessment is codified as a competency to practice nursing; however, the standards of practice set for mental health nurses are less clear on what constitutes a comprehensive assessment or how this should be undertaken. The peer-reviewed literature describes assessment as both an independent and interdependent activity. It is described as informal, and there is evidence that comprehensive mental health nursing assessments are not well documented. The credibility of training and research into mental health nursing requires that the content and the process of a comprehensive mental health nursing assessment needs to be clearly defined.
Journal of Advanced Nursing, 1999
Patient initiatives during the assessment and planning of psychiatric nursing in a hospital environment¶ The qualitative study reported in this paper aims to describe the planning and assessment of psychiatric nursing in a hospital environment. The theoretical framework consists of the three types of psychiatric nursing outlined in a developmental model of nursing: confirmatory, educational and catalytic. Confirmatory psychiatric nursing is based on a hierarchical and authoritarian model. Educational psychiatric nursing is based on a professionally driven and behavioural model. Catalytic psychiatric nursing is systematic, theoretical, and research-based. Catalytic psychiatric nursing may vary, depending on the patient’s needs, from confirmatory and educational to situationally determined nursing. However, it always enables patient initiatives. The purpose of this paper is to describe patient initiatives during the assessment and planning of patient care by an interdisciplinary mental health team in a psychiatric hospital environment, and the assessment and planning as described by nurses working in a hospital environment. The data, which were collected in two psychiatric hospitals by videotaping interdisciplinary teamwork situations and recording interviews of nurses afterwards, consisted of 384 pages of written text. A total of 640 sentences were identified in the text as reflecting the assessment of care by the interdisciplinary team and by the nurses working in the hospital environment. Deductive content analysis techniques were used to analyse the written data. The results showed that nursing was described by the nurses to be catalytic in 13% of the cases, while the same nurses assessed psychiatric nursing to be most commonly educational (40%) or confirmatory (47%).
Journal of Clinical Nursing, 2010
Objectives. To establish a national picture of the implementation of these recommendations in both trusts and higher education institutions. Background. The Chief Nursing Officer for England Review of Mental Health Nursing made 17 key recommendations to improve mental health nursing. Subsequent publications aimed to help implement these recommendations. Design. An e-survey. Methods. The survey was based on the Chief Nursing Officer review recommendations and guidance. Participants: all relevant trusts who deliver mental health services (n = 68) and higher education institutions who deliver pre-registration mental health nursing education (n = 50) in England. Results. A total of 42 trusts (63AE6%) and 40 higher education institutions (80%) completed the survey. The survey indicates that the Chief Nursing Officer review has stimulated some activity in all organisations who responded. Eleven of the recommendations were ranked similarly by trusts and higher education institutions. There were statistically significant differences between trusts and higher education institution priorities in four areas, inpatient care, evidence-based interventions, multidisciplinary team working and recruitment and retention. Conclusions. The findings of the survey demonstrate that all organisations have made some progress in the implementation of the Chief Nursing Officer recommendations. Trusts and higher education institutions broadly agree on the importance of each of the Chief Nursing Officer recommendations, with the exception of four items. A range of factors was identified by respondents that were perceived as facilitators and barriers to the implementation of the Chief Nursing Officer review. Relevance to clinical practice. This article contains findings that are highly relevant for current and future clinical practice in mental health. Despite some progress, clear differences between higher education institutions and trusts are apparent. It is important that these differing perspectives are acknowledged and resolved to improve healthcare provision. Both trusts and higher education institutions reported difficulty with engaging service users and carers. A range of factors are identified that act as facilitators and barriers to the implementation of healthcare policy.
The practice assessment of student nurses by people who use mental health services
Nurse Education Today, 2010
Service user involvement s u m m a r y This paper reports on a participatory action research project focusing upon service-user involvement in the assessment of student mental health nurses in practice. The principle of student nurses being assessed by service-users was found to be desirable in theory. However, its implementation proved to be fraught with difficulty especially with regard to the concerns about increased workload and feelings of vulnerability amongst students. It is recommended that the model of assessment should be adjusted to that of review and that a program of service-users reviewing student nurses on placement be implemented and evaluated.
The Mental Health Nursing Review: implications for community psychiatric nurses
Psychiatric Bulletin, 1995
The recent review of mental health nursing recommended that nurses refocus their attention on people with serious mental illness. There are some encouraging trends in the training of nurses in problemoriented case management. However, mental health nursing needs to face various problems. These include the need for the large-scale retraining of nurses currently working in traditional psychiatric hospitals and difficulties in the new Project 2000 programmes. In addition, there is a clear lack of leadership in the profession, largely because of the recent emphasis on management rather than clinical and academic attributes. Finally, nursing needs people who care what happens to the seriously mentally ill.
Journal of Advanced Nursing, 2011
Aims. This article is a report of a study that aimed to establish a national picture of the implementation of Review recommendations over time in both Mental Health Trusts and Higher Education Institutions (Universities) in England. Background. The 2006 Review of Mental Health Nursing in England by the Chief Nursing Officer made 17 key recommendations for Mental Health Trusts and Universities to improve mental health nursing. This article outlines key findings from a national survey of National Health Service Trusts and Universities in England with regard to prioritization and progress on implementation of these recommendations. Methods. An e-survey was carried out in 2008-2009 based on the Chief Nursing Officer review recommendations and guidance. Participants included all Trusts which delivered mental health services (n = 68) and Universities which delivered pre-registration mental health nursing education (n = 50) in England. Results. There appears to be some evidence that the Chief Nursing Officer review of Mental Health Nursing in England continues to be implemented in both Mental Health Trusts and Universities. There is variety in levels of implementation, but Mental Health Trusts and Universities broadly agree on priority areas. Conclusions. The Chief Nursing Officer review has been influential in focusing the care and education of mental health nurses and services in England. There appears to be a range of barriers and facilitators which aid the implementation of healthcare policy. More attention is required from researchers to enhance and evaluate the impact of policy implementation on the quality of care provided.
Evaluation of the Chief Nursing Officer’s Reviewof Mental Health Nursing in England
2012
• The Chief Nursing Officer's Review of mental health nursing was published in 2006. This paper reports an evaluation of the implementation of the Review in mental health trusts. • There was widespread acceptance of the Review, but actions to implement the Review varied. • The lack of an evidence-based implementation plan and a lack of strategic nursing leadership in many mental health trusts hampered the implementation. • The Review recommendations may become widespread by a systematic policy implementation plan from the centre, supported by local leadership in practice.
Journal of Advanced Nursing, 2010
macneela p., clinton g., place c., scott a., treacy p., hyde a. & dowd h. (2010) Psychosocial care in mental health nursing: a think aloud study. Journal of Advanced Nursing 66(6), 1297–1307.macneela p., clinton g., place c., scott a., treacy p., hyde a. & dowd h. (2010) Psychosocial care in mental health nursing: a think aloud study. Journal of Advanced Nursing 66(6), 1297–1307.AbstractTitle. Psychosocial care in mental health nursing: a think aloud study.Aim. This paper is a report of a study identifying psychosocial interventions relevant to routine care and exploring their content critically and analysing patterns in the use of these interventions.Background. People experiencing enduring and serious mental disorders value psychosocial engagement as a means of achieving recovery and rehabilitation. However, mental health nurses’ use of person-centred and directive psychosocial engagement in routine care is unclear, with the potential arising for benevolence and paternalism.Method. A think aloud study was carried out with 37 mental health nurses responding to a simulated case depicting a person with an enduring mental health problem. Participants were recruited from community and acute hospital facilities across Ireland and responded to two tasks: identifying the nature of the person’s problems and recommending what to do next. Transcripts were coded using judgement and intervention themes designed for the purpose. Patterns in the use of psychosocial intervention themes were described and further analysed by level of experience (highly experienced or not) and practice setting (acute/community setting).Findings. A task-oriented psychosocial intervention labelled structured engagement was used extensively, followed by reassurance and encouragement based on pragmatic communication. A minority of nurses used dialogue, representing person-centred care. Highly experienced community mental health nurses were the most likely to talk in terms of intensive psychosocial engagement.Conclusion. Relying on pragmatic problem-solving is problematic in terms of decision-making transparency and service user involvement. The use of informal knowledge in practice should be negotiated through more open discussion by nurses, including adoption of a consensus on the components of psychosocial care.Title. Psychosocial care in mental health nursing: a think aloud study.Aim. This paper is a report of a study identifying psychosocial interventions relevant to routine care and exploring their content critically and analysing patterns in the use of these interventions.Background. People experiencing enduring and serious mental disorders value psychosocial engagement as a means of achieving recovery and rehabilitation. However, mental health nurses’ use of person-centred and directive psychosocial engagement in routine care is unclear, with the potential arising for benevolence and paternalism.Method. A think aloud study was carried out with 37 mental health nurses responding to a simulated case depicting a person with an enduring mental health problem. Participants were recruited from community and acute hospital facilities across Ireland and responded to two tasks: identifying the nature of the person’s problems and recommending what to do next. Transcripts were coded using judgement and intervention themes designed for the purpose. Patterns in the use of psychosocial intervention themes were described and further analysed by level of experience (highly experienced or not) and practice setting (acute/community setting).Findings. A task-oriented psychosocial intervention labelled structured engagement was used extensively, followed by reassurance and encouragement based on pragmatic communication. A minority of nurses used dialogue, representing person-centred care. Highly experienced community mental health nurses were the most likely to talk in terms of intensive psychosocial engagement.Conclusion. Relying on pragmatic problem-solving is problematic in terms of decision-making transparency and service user involvement. The use of informal knowledge in practice should be negotiated through more open discussion by nurses, including adoption of a consensus on the components of psychosocial care.
Journal of psychiatric and mental health nursing, 2015
The majority of mental health problems in England are dealt with in primary care but most of the healthcare workers in primary care have little knowledge of mental health. We wanted to develop an accessible education programme which was appropriate to the learning needs of this workforce. Mental health nurses can deliver training in mental health and well-being (which has been developed by an expert) to practice nurses. This increases the knowledge of both parties and promotes working together. Utilizing mental health nurses as trainers improves both their clinical practice and that of the practice nurses they have taught. As the time mental health nurses need to spend away from practice to carry out education is minimal, it has little impact on their usual workload. Other health organizations both nationally and internationally could adapt the education programme to suit their particular needs. Research is required to find out whether training practice nurses in this way has an imp...