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Health Nurses (health + nurse)
Kinds of Health Nurses Terms modified by Health Nurses Selected AbstractsGetting Your Feet Wet: Becoming a Public Health Nurse, Part 1PUBLIC HEALTH NURSING, Issue 1 2004D.N.Sc., Lee SmithBattle R.N. Abstract While the competencies and theory relevant to public health nursing (PHN) practice continue to be described, much less attention has been given to the knowledge derived from practice (clinical know-how) and the development of PHN expertise. A study was designed to address this gap by recruiting nurses with varied levels of experience and from various practice sites. A convenience sample of 28 public health nurses and seven administrators/supervisors were interviewed. A subsample, comprised of less-experienced public health nurses, were followed longitudinally over an 18-month period. Data included more than 130 clinical episodes and approximately 900 pages of transcripts and field notes. A series of interpretive sessions focused on identifying salient aspects of the text and comparing and contrasting what showed up as compelling, puzzling, and meaningful in public health nurses' descriptions. This interpretive analysis revealed changes in understanding of practice and captured the development of clinical know-how. In Part 1, we describe the sample, study design, and two aspects of clinical knowledge development,grappling with the unfamiliar and learning relational skills,that surfaced in nurses' descriptions of early clinical practice. In Part 2, which is to be published in the next issue of Public Health Nursing (SmithBattle, Diekemper, & Leander, 2004), we explore gradual shifts in public health nurses' understanding of practice that led to their engagement in upstream, population-focused activities. Implications of these findings for supporting the clinical learning of public health nurses and the development of expertise are described. [source] IDentify, Educate and Alert (IDEA) trial: an intervention to reduce postnatal depressionBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2003Joan Webster Objective To test the effectiveness of a prenatal intervention in reducing the incidence of postnatal depression. Design A randomized controlled trial. Setting A large metropolitan obstetric hospital. Population or sample Pregnant women with risk factors for postnatal depression. Methods Women attending their first prenatal visit at the Royal Women's Hospital, Brisbane, were screened for risk factors for postnatal depression (IDentify). Positively screened women were randomly allocated to the intervention group or the control group. The intervention consisted of a booklet about postnatal depression, which included contact numbers; prenatal screening using the Edinburgh Postnatal Depression Scale; a discussion with the woman about her risk of developing postnatal depression (Educate); and a letter to the woman's referring general practitioner and local Child Health Nurse, alerting them of the woman's risk for postnatal depression (Alert). Main outcome measure Edinburgh Postnatal Depression Scale Score> 12 at 16 weeks postpartum. Results Of the 509 women who were sent a follow up questionnaire, 371 (72.9%) responded. The proportion of women who reported an Edinburgh Postnatal Depression Scale score of>12 was 26%. There were no significant differences between intervention (46/192, 24%) and control groups (50/177, 28.2%) on this primary outcome measure (OR 0.80; 95% CI 0.50,1.28). Conclusion Over one-quarter of women with risk factors will develop postnatal depression. It is a treatable disorder but under-diagnosis is common. Efforts to reduce postnatal depression by implementing interventions in the prenatal period have been unsuccessful. [source] Public Health Nurses and the delivery of quality nursing care in the communityJOURNAL OF CLINICAL NURSING, Issue 10 2008DipHE, Trish Markham MSc (Hons) Aim., The aim of the study was to explore factors which impact on quality nursing care in the community from the Public Health Nurse's (PHN) perspective. Background., Public Health Nursing has significantly evolved over the past few years with the delivery of quality nursing being a focus point. This study explores factors that impact upon the delivery of quality care in Public Health Nursing in Ireland. The findings provide an opportunity for an additional perspective to be included in the existing international findings and act as a starting point from which further research can be built. Method., A qualitative method using semi-structured interviews were conducted. Interviews were taped and content analysed. Findings., Four main categories emefrged from the data, namely role change, components of quality nursing care, barriers to quality nursing care and the factors that facilitate the delivery of quality nursing care in the community. PHNs strive for evidence-based practice; they acknowledged their inability to achieve this and referred to factors that inhibited them from reaching their goal. Conclusion., Enhanced education for PHNs will equip them in the delivery of a quality service and have a positive impact on patient care. Better communication is required between PHNs, line managers and the multidisciplinary team. The delivery of community services need to be reviewed and developed further in accordance with the health strategy policy. Relevance to clinical practice., This study has identified the evolution in clinical practice associated with the changing role and scope of Public Health Nursing. Clinical practice has evolved over time to incorporate societal change, technological advances and the delivery of an evidence-based service responsive to identified need. This study identified the presence of an increase in the specialist clinical work being undertaken as a result of new technological advances entering the community working environment. [source] Te Ao Maramatanga: The New Zealand College of Mental Health NursesINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2004Anthony J O'Brien No abstract is available for this article. [source] Scoping the prospects of Australian mental health nursingINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2000Michael Clinton ABSTRACT: In March 2000 the Australian & New Zealand College of Mental Health Nurses submitted the final report on the National Scoping Study of Mental Health Nursing in Australia to the Mental Health Branch of the Department of Health and Aged Care. In this final article, in a series of four, the authors present an overview of the future prospects of mental health nursing in Australia. [source] Scoping practice issues in the Australian mental health nursing workforceINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2000Michael Clinton ABSTRACT This is the third of four articles on the scoping study of the Australian mental health nursing workforce conducted on behalf of the Australian and New Zealand College of Mental Health Nurses (ANZCMHN) for the Australian Health Ministers Advisory Council (AHMAC) National Working Group on Mental Health (NWGMH). Its purpose is to focus on factors that significantly affect mental health nursing practice. The issues of advanced practice, regulation of nursing, accreditation, credentialling and demarcation with other disciplines are addressed. [source] Scoping mental health nursing educationINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2000Michael Clinton ABSTRACT: In late 1999 the National Mental Health Working Group of the Australian Health Ministers Advisory Council commissioned the Australian and New Zealand College of Mental Health Nurses to undertake a scoping study of mental health nursing. A final report will be submitted to the National Mental Health Working Group in February 2000. The purpose of this article is to draw attention to some of the systemic problems that confront the education of mental health nurses in Australia. Shortcomings in the preparation of undergraduate students of nursing for commencing practice in mental health nursing are described and comments are given on issues affecting the quality of postgraduate mental health nursing education. KEY WORDS: mental health, nursing education. [source] Development and validation of clinical indicators for mental health nursing practiceINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2000Georgina Skews ABSTRACT: A national study was undertaken in Australia to develop and validate a set of clinical indicators for mental health nursing. Using survey and action research procedures, the indicators were developed in two stages. During stage one, focus group interviews involving 39 nurses were conducted at national conferences in Australia and New Zealand in order to provide a pool of indicator statements. A Delphi survey of an Australian sample of mental health nurses (n = 33) was then conducted to refine the indicators. In stage two, the refined indicators were tested and validated in selected clinical settings. A total of 1751 mental health nurses employed at 14 sites were involved in the second stage of the study. The resulting data were used to establish the set of national indicators that the Australian and New Zealand College of Mental Health Nurses will use in practice accreditation and benchmarking. [source] Public Health Nurses and the delivery of quality nursing care in the communityJOURNAL OF CLINICAL NURSING, Issue 10 2008DipHE, Trish Markham MSc (Hons) Aim., The aim of the study was to explore factors which impact on quality nursing care in the community from the Public Health Nurse's (PHN) perspective. Background., Public Health Nursing has significantly evolved over the past few years with the delivery of quality nursing being a focus point. This study explores factors that impact upon the delivery of quality care in Public Health Nursing in Ireland. The findings provide an opportunity for an additional perspective to be included in the existing international findings and act as a starting point from which further research can be built. Method., A qualitative method using semi-structured interviews were conducted. Interviews were taped and content analysed. Findings., Four main categories emefrged from the data, namely role change, components of quality nursing care, barriers to quality nursing care and the factors that facilitate the delivery of quality nursing care in the community. PHNs strive for evidence-based practice; they acknowledged their inability to achieve this and referred to factors that inhibited them from reaching their goal. Conclusion., Enhanced education for PHNs will equip them in the delivery of a quality service and have a positive impact on patient care. Better communication is required between PHNs, line managers and the multidisciplinary team. The delivery of community services need to be reviewed and developed further in accordance with the health strategy policy. Relevance to clinical practice., This study has identified the evolution in clinical practice associated with the changing role and scope of Public Health Nursing. Clinical practice has evolved over time to incorporate societal change, technological advances and the delivery of an evidence-based service responsive to identified need. This study identified the presence of an increase in the specialist clinical work being undertaken as a result of new technological advances entering the community working environment. [source] Genetic Testing, Genetic Information, and the Role of Maternal-Child Health Nurses in IsraelJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2006Sivia Barnoy Purpose: To examine the rate of genetic testing, the characteristics of those who had these tests, and to examine the public's openness to the possibility of expanding nurses' roles in maternal-child health (MCH) clinics to include providing genetic information. Design: The study was conducted in nine MCH clinics in the central district of Israel. All women attending the clinics during 1 week were requested to complete the questionnaire. The sample consisted of 361 participants. Findings: A high rate of genetic testing (80.4%) was shown. Higher education, being secular, and native-born Israeli predicted testing performance. Half of the tested participants reported that they did not understand the test results and were interested in receiving explanations regarding these results. Forty-four percent of respondents were interested in receiving genetic information from an MCH nurse. Conclusions: A high rate of genetic testing performance was reported. The public reported lack of information regarding genetic tests and their results. An appropriate setting for providing this information is the maternal-child health clinics. [source] Medicine use in older people's inpatient mental health servicesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010J. A. BAKER phd mphil msc bnurs (hons) rmn Accessible summary ,,Aging increases the risks associated with medicines. ,,Complex regimes of medicines are used with older people in mental health services. ,,Mental Health Nurses need to consider their skills and knowledge in dealing with these complex regimes. Abstract The aims of this audit were to establish the range and volumes of medicines used in older people's mental health settings and to explore the safety of the prescribing habits through the application of the revised Beers criteria. An audit of all patients on all selected wards (both functional and organic) for current prescriptions of all drugs routinely prescribed on the census day was undertaken on 11 wards in three Mental Health NHS Trusts in the North West of England. Data were collected on 154 patients in 11 different inpatient settings in three Mental Health Trusts. A total of 153 patients had 882 prescriptions of 196 drugs (mean 5.8 drugs). Most frequently prescribed drugs were aspirin (n= 57, 6.5%), paracetamol (n= 36, 4.1%) and quetiapine (n= 35, 4.0%). Nine of the 48 potentially inappropriate medicines in the revised Beers criteria had been prescribed, although at within appropriate limits. The audit highlights the complexity of poly-pharmacotherapy in older adults admitted to mental health services. Further works needs to establish whether nurses have the clinical knowledge and skills to ensure safe practice. There appears to be continued variation in prescribing practice. [source] Views on nurse prescribing: a survey of community mental health nurses in the Republic of IrelandJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2009J. WELLS phd rpn A nurse prescribing scheme has recently been implemented within the Republic of Ireland. This paper reports on the views of community mental health nurses on nurse prescribing just prior to the implementation of the scheme. Data were gathered through a 13-item questionnaire administered to 103 members of the Association of Community Mental Health Nurses in Ireland. Results indicated a distinct difference of view between male and female community mental health nurses, with female nurses having greater reservations towards the desirability of nurse prescribing in relation to educational preparation and impact on professional relationships. Overall, only 17% of respondents favoured being supervised in their prescribing practice by their consultant psychiatrist. The paper concludes that there is ambivalence towards prescribing in this important group of nurses which may need to be taken into account if nurse prescribing is to be successfully implemented within the Irish mental health service context. [source] Matching a Graduate Curriculum in Public/Community Health Nursing to Practice Competencies: The Rush University ExperiencePUBLIC HEALTH NURSING, Issue 2 2006R.N.C., Susan Swider Ph.D. ABSTRACT An evidence-based approach to Public/Community Health Nursing (P/CHN) requires that P/CHN educators prepare practitioners with the relevant skills, attitudes, and knowledge. Such education should be competency-based and have measurable outcomes to demonstrate student preparation. In 2003, the Quad Council competencies were developed to be applied at two levels of public health nursing practice: the staff nurse/generalist role and the manager/specialist/consultant role. This paper describes a process for evaluation and revision of a graduate curriculum to prepare Advanced Practice Clinical Nurse Specialists (CNS) in P/CHN, to ensure that the educational program addresses and develops knowledge and proficiency in all relevant competencies. This paper documents the process of integrating the competencies throughout the P/CHN graduate curriculum at varying levels, guiding students to achieve proficiency in each competency by the end of the program. Measurement of achievement in these competencies will be discussed, and examples provided. Advanced Practice Public Health Nurses educated via this competency-based approach will be prepared to sit for national certification as a CNS in Public/Community Health, and to assume leadership roles in public health nursing. [source] The Child Welfare System: Through the Eyes of Public Health NursesPUBLIC HEALTH NURSING, Issue 4 2005Janet U. Schneiderman Abstract,Objective: This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organization's effect on their case management practice. Design: Semistructured interviews were conducted utilizing the Bolman,Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. Sample: A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Results: Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Conclusions: Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in "host settings." Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis. [source] The Public Health Nursing Practice Manual: A Tool for Public Health NursesPUBLIC HEALTH NURSING, Issue 2 2004M.S.N./ M.P.H., Sharon D. Sakamoto R.N. Abstract Public health nursing is recognized as an important and critical component of the public health workforce, and today, it makes up the largest single category of public health professionals, according to the U.S. Department of Health and Human Services. Preparation of generalist public health nurses with the knowledge base, skills, and training to effectively respond to public health challenges is essential. The County of Los Angeles Department of Health Services, Public Health Nursing Section, in response to this need, implemented the Public Health Nursing Practice Manual to provide public health nurses with interventions and guidelines to articulate their role and practice as outlined by the framework of the Public Health Nursing Practice Model developed by Los Angeles County. Identification and development of new methods to support the practice of nursing is imperative in facilitating a more sophisticated and expanded level of practice, as well as providing a means of improving, protecting, and enhancing the quality of health for all people. The Public Health Nursing Practice Manual is an effective tool to monitor performance improvement and provide standardization of the generalist public health nurse practicing in Los Angeles County. [source] Promotion of the Good Life by Public Health NursesPUBLIC HEALTH NURSING, Issue 6 2001Leena M. Uosukainen Lic. The question of what is the good life has been discussed by philosophers since antiquity. The good of an individual and of a community is complicated. Communities influence an individual's experiences and world views, which are always individual. Public health nurses promoting the good life need multidisciplinary knowledge, as well as other skills such as personal competence and qualifications. The focus of the theoretical framework of promotion of the good life is based on models of health promotion and sustainable development. Working with different clients requires nursing theories, other theories, and multidisciplinary models in practice. Continual quality improvement is needed in order to increase customer satisfaction. This article discusses a doctoral thesis that consists of three empirical studies. The theoretical framework for promotion of the good life as the work of public health nurses is outlined, and the outcomes of the first study, the qualifications concerning health, and the environment are described. In the other parts of the study, curriculum building using future methodology and evaluation with concept maps is reported. [source] Finding Ways to Create Connections Among Communities: Partial Results of an Ethnography of Urban Public Health NursesPUBLIC HEALTH NURSING, Issue 1 2000Judeen Schulte Ph.D. The purpose of this ethnographic study was to describe the culture of public health nurses (PHNs) in a large, Midwestern urban health department. Data collection methods, data management, and analyses followed ethnographic procedures and resulted in the development of categories, domains, and cultural themes. The general study participants were PHNs, clients, supervisors, and administrators. The primary cultural theme that emerged was that public health nursing is finding ways to create connections among communities. Three interacting communities were identified: the local communities, communities created by individuals and families, and communities of resources. This article describes one of the three subthemes that emerged, processes used to help clients create connections, and describes how caring is shown uniquely in public health nursing. As a result of the study, implications for nursing practice, education, and research were developed. The results of the study supported a position that public health nursing is a unique nursing specialty. It reinforced also the applicability of an ethnographic design and methodology to nursing research. [source] Whose life is it anyway?INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2008An exploration of five contemporary ethical issues that pertain to the psychiatric nursing care of the person who is suicidal: Part one ABSTRACT:, It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries is that the individual owns his/her own body. Yet given that contemporary mental healthcare policy and associated practice positions do not reflect view, this can easily lead to the scenario where a Mental Health nurse is faced with a major ethical dilemma, and the corresponding probability of moral distress. The authors also find that it is inaccurate to posit a simple positive correlation between the potential seriousness and/or extent of bodily harm and the degree of paternalistic removal of an individual's rights to personal body ownership. Lastly, the authors find that the relevant theoretical and ethical literature in this area suggests, at least for some and under certain conditions, suicide can be the right thing to do. [source] Guided self-help supported by paraprofessional mental health workers: an uncontrolled before,after cohort studyHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2009Paul Farrand Senior Lecturer in Health Psychology Abstract There has been considerable development of guided self-help clinics within primary care. This uncontrolled before,after cohort study examines efficiency and effectiveness of these clinics when supported by paraprofessional mental health workers having little mental health training and experience. Data were collected by seven Graduate Mental Health Workers (GMHW) located in South-west England. Alongside an analysis of clinic attendance and dropout, efficiency was measured with respect to the number and length of sessions to support patients with the effectiveness of the interventions examined with respect to problem severity. Over a 15-month period, 1162 patients were referred to the GMHW clinics with 658 adopting guided self-help. Patients using guided self-help received an average input per patient, excluding assessment, of four sessions of 40 minutes. Dropout rate was comparable to other primary-care-based mental health clinics supported by experienced mental health professionals with 458 patients completing all support sessions. However, only 233 patients went on to attend the 3 months of follow-up session. Effectiveness of guided self-help clinics supported by paraprofessional mental health workers was comparable to that supported by an experienced mental health nurse. Improvements in problem severity were statistically significant, with 55% and 58% (final support session) and 63% and 62% (3 months of follow-up) of patients experiencing clinically significant and reliable change for anxiety and depression, respectively. However, concerns exist over the efficiency of the GMHW clinic especially with respect to the use of longer support sessions and high dropout rate at the 3 months of follow-up session. The paper concludes by highlighting the effectiveness of guided self-help when supported by paraprofessional mental health workers, but questions the utility of the two-plus-one model of service delivery proposing a collaborative care approach as an alternative. [source] A qualitative study of mental health nurse identities: Many roles, one professionINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 6 2009John Hurley ABSTRACT The aim of the study was to clarify and build upon current understandings of mental health nurse (MHN) identity. The study adopted a framework of social constructionism and qualitative methodology. Semistructured interviews were conducted, which were thematically analyzed using Nvivo software. Twenty-five MHN were recruited across three geographical sites in the UK. Participants constructed a cluster of seven MHN identity characteristics that constituted a unique contribution to talk-based therapies. These themes of characteristics are: (i) the MHN as generic specialist; (ii) the MHN as adopting a service-user focus; (iii) the MHN as positioning and utilizing the personal self; (iv) the MHN as spending time with the service user; (v) the MHN as delivering talk-based therapies in versatile ways; (vi) the MHN as having an everyday attitude; and (vii) the MHN as having transferable skills. The distinctiveness, and thus, professional identity of mental health nursing, must be understood as a cluster of capabilities rather than a search for a singular point of difference. The breadth of capabilities employed by MHN highlights the value and worth of their contribution to service-user care. [source] Would the real mental health nurse please stand up?INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2006The relationship between identification, professional identity No abstract is available for this article. [source] Expectations of the child health nurse in Sweden: two perspectivesINTERNATIONAL NURSING REVIEW, Issue 2 2003A. Fägerskiöld MScN Abstract Background: the child health service exists to support and stimulate parents in order to reduce stress and to encourage an advantageous development of the preschool child. Aim: To explore and describe similarities and differences in expectations of the child health nurse, from the perspective of the recently delivered first-time mother, as compared to an expression of what the child health nurse believed mothers of infants expected of them. The data consisted of 15 interviews with child health nurses and 20 interviews with first-time mothers. Thematic content analysis resulted in seven categories of expectations. The child health nurse was expected to be someone to approach, who could assess the child's development and give immunizations and to be a supporter, counsellor, safety provider and a parent group organizer with knowledge. Similarities between the mothers' and the nurses' statements occurred more frequently than differences, which is suggested to depend on the Swedish tradition among new mothers of visiting the child health clinic. The mothers expected participation in parent groups to a higher degree than the nurses thought they did. Child health nurses who fulfil the mothers' expectations appear to require a good relationship with the mother in order to find out what she desires, which the allocation of sufficient time for regular meetings, will facilitate. Moreover, the nurse requires knowledge about children's requirements and the transition to motherhood as well as the father's important role. [source] A theory of maternal engagement with public health nurses and family visitorsJOURNAL OF ADVANCED NURSING, Issue 2 2005Susan M. Jack PhD RN Background., Home visiting by public health nurses and family visitors is promoted as an important intervention for enhancing parent and child development. Mothers of children at-risk for developmental delays tend to be the most difficult to access and engage, and commonly drop out of home visiting programmes prematurely. Purpose., This paper reports a study developing a theory that describes the process by which mothers of children at-risk engage with public health nurses and family visitors in a blended home visiting programme. Methods., Grounded theory was used to guide the collection, recording, organization and analysis of the data. A purposeful sample of 20 mothers receiving public health nurse and family visitor home visits were recruited from a public health unit in Canada. Data were collected through client record reviews and 29 in-depth interviews that explored participants' experiences, beliefs and expectations about engagement. Data collection and analysis continued until all categories were saturated. Findings., Mothers felt vulnerable and frequently powerless when they allowed the service providers into their home. Mothers with children at-risk engage with public health nurses and family visitors through a basic social process of limiting family vulnerability, which has three phases: (1) overcoming fear; (2) building trust; and (3) seeking mutuality. The personal characteristics, values, experiences and actions of the public health nurse, family visitor and mother influence the speed at which each phase is successfully negotiated and the ability to develop a connected relationship. Conclusion., Public health nurses working with families at risk need to identify client fears and perceptions related to home visiting, and to explain the role of public health nurses and family visitors to all family members. Given the importance that mothers place on the development of an interpersonal relationship, it is important for home visitors continually to assess the quality of their relationships with clients. [source] Models of mental health nurse,general practitioner liaison: promoting continuity of careJOURNAL OF ADVANCED NURSING, Issue 5 2003Terence V. McCann BA MA PhD RMN RGN RNT mccann t.v. & baker h. (2003)Journal of Advanced Nursing 41(5), 471,479 Models of mental health nurse,general practitioner liaison: promoting continuity of care Aim and rationale.,Community mental health nurses and general practitioners share a pivotal role in the provision of mental health care in the community. The focus of this study was to identify models of general practitioner collaboration used by these nurses, and analyse the implications of these models for promoting continuity of care. The study was derived from a larger study of how community mental health nurses promote wellness with clients who are experiencing an early episode of psychotic illness. Methods.,This qualitative study used interviews and observation to collect data. The study took place in 1999 in regional and rural New South Wales, Australia and involved community mental health nurses. Findings.,The findings show that two models of nurse and general practitioner (GP) collaboration emerged from the data: Shared Care and Specialist Liaison. In the Shared Care model, nurses maintain close contact with GPs throughout the episode of acute care. In the Specialist Liaison model, the community mental health team assumes overall responsibility for care and treatment throughout the acute episode of illness. Contact with GPs throughout the episode of care by the community mental health team is, at best, intermittent. Conclusion.,The findings suggest that the Shared Care model is more consistent with supporting personal and organizational continuity of care, whereas the Specialist Liaison model is limited to encouraging personal continuity of care but further study is needed. [source] Effects of a Home Visiting Program for Older People with Poor Health Status: A Randomized, Clinical Trial in the NetherlandsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2008(See editorial comments by Drs. Andreas Stuck, Robert Kane, pp 56 OBJECTIVES: To evaluate the effectiveness of a home visiting program on health-related measures in a population of older people with poor health status. DESIGN: Randomized, clinical trial. SETTING: Community-dwelling citizens in the Netherlands. PARTICIPANTS: Three hundred thirty people aged 70 to 84 randomly assigned to an intervention group (n=160) or a control group (n=170). INTERVENTION: Eight home visits, lasting 1 hour or more, with telephone follow-up, over an 18-month period, conducted by experienced home nurses under supervision of a public health nurse; key elements of the (systematic) visits were assessment of health problems and risks, advice, and referral to professional and community services. MEASUREMENTS: Self-rated health, functional status, quality of life, and changes in self-reported problems. RESULTS: No differences were found between the intervention and control group in these and other outcome measures at the end of the intervention period (18 months). CONCLUSION: The home visiting program did not appear to have any effect on the health status of older people with poor health and are probably not beneficial for such persons. [source] Vulnerable Older People in the Community: Relationship Between the Vulnerable Elders Survey and Health Service UseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2008Hannah M. McGee PhD OBJECTIVES: The Vulnerable Elders Survey (VES), a recently developed screening tool for at-risk older people in the community, has been validated in the United States. This study evaluated its profile in older Irish people. It assessed whether those categorized as vulnerable according to the VES were likely to use health services more frequently than others. DESIGN: Nationally representative cross-sectional interviews. SETTING: Private homes in the community. PARTICIPANTS: Randomly selected older people (aged ,65) (N=2,033; 68% response). MEASUREMENTS: Interviews included the 13-item VES and questions on health service use. RESULTS: The proportion scoring as vulnerable was identical to the U.S. sample (32.1% vs 32.3%). At the community healthcare level, participants categorized as vulnerable visited their primary care physician more frequently (mean visits 6.7 vs 4.0, P<.001), had more home-based public health nurse visits (29% vs 5%, P<.001), and were more likely to have had preventive influenza vaccinations (81% vs 72%, P<.001) in the previous year. More-vulnerable older adults did not differ on assessment of blood pressure (97% vs 96%), cholesterol (82% vs 85%), or receipt of smoking advice (66% vs 52%). Vulnerable participants were more likely to have used emergency department (17% vs 8%, P<.05), inpatient (21% vs 12%, P<.05), and outpatient (28% vs 21%, P<.05) hospital services. Fourteen percent of those categorized as vulnerable had zero or one visit to their family physician in the previous year. CONCLUSION: This study provides further evidence, from a different healthcare system, of the potential of the VES to differentiate more-vulnerable older people. Prospective studies are needed to assess use of the VES as a clinical decision aid for community professionals such as family physicians and public health nurses. [source] Community mental health nursing and early intervention in dementia: developing practice through a single case historyJOURNAL OF CLINICAL NURSING, Issue 2004John Keady PhD This paper reports on a single case history taken from the ,Dementia Action Research and Education' project, a 15-month primary care intervention study that was undertaken in North Wales in the early part of 2000. The study sought to address the meaning, context and diversity of early intervention in dementia care and employed a community mental health nurse and a psychiatric social worker to undertake early and psychosocial interventions with older people with dementia (aged 75 years and over) and their families. The workers tape-recorded, documented and analysed their interventions with 27 older people with dementia and their families over the 15-month duration of the study. Clinical supervision was also undertaken during the intervention phase. One case history is presented in this paper to illustrate the work of the community mental health nurse and to identify areas of practice development. Greater role transparency, collaborative working and improvement in educational preparation for practice are called for. [source] Parents, infants and health care: Utilization of health services in the first 12 months of lifeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2003SR Goldfeld Objective: To describe patterns of health-service use in the first 12 months of life. Methods: In this prospective cohort study, 173 first-born infants and their families living in two middle socio-economic urban areas of Melbourne were enrolled consecutively when presenting for their initial maternal and child health nurse (MCHN) visit (at approximately 4 weeks of age). Families kept a daily ,health diary' for the entire 12-month period, recording use of all health services for their infant, and reasons for the contact. Results: There was an 87% completion rate of diaries. The mean number of visits to any health service, including medical, hospitals, MCHN services, pharmacists, allied health services and naturopaths, was 35.7 (95% CI 34.7,36.6) during the 12 months. Of these, 31% (mean 10.9 visits) were visits to a general practitioner (GP) and 41.5% (mean 14.3 visits) were visits to the MCHN. Infants' visits to the MCHN were far more frequent in the first 6 months of life compared with the second 6 months (10.3 vs 3.6, P < 0.001). Rates of GP use were constant over the same periods (5.3 vs 5.7, P = 0.8). Conclusions: In a universal health-care system, this high rate of health-service use equates to approximately one visit to a health service every 2 weeks in the first year of life. The majority of these visits appeared unrelated to illness. This previously undocumented data has implications for future integrated service delivery, health-professional training and policy development for this age group. [source] Nurse prescribing in mental health: national surveyJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2010D. DOBEL-OBER phd Accessible summary ,,Nurse prescribing has grown relatively slowly in mental health care since it was introduced in early 2000s. ,,This paper reports findings from a survey of directors of nursing in England. ,,It provides information about the current level of development of nurse prescribing and about intentions with regards to future implementation and development. Abstract Mental health nurses can now train to become independent prescribers as well as supplementary prescribers. Independent nurse prescribing can potentially help to reorganize mental health services, increase access to medicines and improve service user information, satisfaction and concordance. However, mental health nursing has been slow to undertake prescribing roles, and there has been little work conducted to look at where nurse prescribing is proving successful, and those areas where it is less so. This survey was designed to collect information from directors of nursing in mental health trusts about the numbers of mental health prescribers in England, gather views about prescribing in practice, and elicit intentions with regards to the development of nurse prescribing. In some Trusts, the number of mental health nurse prescribers has increased to the point where wider impacts on workforce, the configuration of teams and services are inevitable. Currently, the way that prescribing is used within different organizations, services and teams varies and it is unclear which setting is most appropriate for the different modes of prescribing. Future work should focus on the impact of mental health nurse prescribing on service delivery, as well as on service users, colleagues and nurses themselves. [source] Section 5(4) (The nurse's holding power): patterns of use in one mental health trust (1983,2006)JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010R. ASHMORE bsc(hons) rmn ma pgce dip coun Accessible summary ,,Section 5(4) (Nurses' holding power) allows a mental health nurse to detain a patient admitted informally to hospital for treatment of a mental health problem for up to 6 h or until they are assessed by a doctor. ,,The use of the holding power has risen significantly since its introduction in 1983 to an average of 1442 per annum (range 789,1953 per annum). ,,The study identifies a number of factors in relation to the use of Section 5(4) including: gender, clinical setting, temporal patterns and medical response time. ,,Although the majority of patients are assessed by a doctor within 4 h of the holding power being applied, 8.3% are detained for 6 h or longer. There is a need to explore this and other issues further. Abstract The majority of studies exploring the use of Section 5(4) (Nurses' holding power) of the Mental Health Act 1983 are now dated, report on small numbers and have been undertaken over relatively short periods of time. A retrospective study was undertaken which sought to identify the factors associated with the use of the section in one mental health trust over a 24-year period (1983,2006). Section 5(4) was applied on 803 occasions, an average of 33.4 times per annum. The majority of sections were applied to female patients (58.4%) by male nurses (54.9%) within adult acute inpatient settings (93.4%). Significant differences were noted in the use of the section over the 24-h period but not for month of the year or day of the week. A total of 349 (43.5%) sections were implemented during doctors' ,office hours' (Monday,Friday, 9:00 h to 17:00 h). The mean length of time spent on the section was 140 min; 80.6% of patients were assessed by a doctor within 4 h; and 8.3% remained on the section for 6 h or more. The holding power was converted to another section of the Act on 642 (80%) occasions. A similar, multi-sited prospective study could be undertaken to validate the findings of this study. [source] | ||||||||||||||||||||||||||||