Physical deterioration in an acute mental health unit : A quantitative retrospective analysis of medical emergencies
- Authors: Porter, Joanne , Cant, Robyn , Missen, Karen , Raymond, Anita , Churchill, Anne
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 27, no. 5 (2018), p. 1364-1370
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- Description: Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011–2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals’ quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the ‘Worried’ category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the ‘Worried’ category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am–12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration.
An evaluation of the effect of a mental health clinical placement on the mental health attitudes of student nurses
- Authors: Chadwick, Louise , Porter, Joanne
- Date: 2014
- Type: Text , Journal article
- Relation: Nursing and Health Vol. 2, no. 3 (2014), p. 57-64
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- Description: The aim of this study is to evaluate the effect of a mental health clinical placement on student nurses attitudes towards mental illness and mental health nursing. Health holds different definitions for different people. The term health can mean wellness or a state of being. Mental health in our society still is wrought with stigma. It is the use of negative labels to identify someone living with a mental illness. Stigma can be a barrier and may discourage families and individuals from seeking help. In the health care system, these barriers need to be broken, from the first contact with the health profession, these being the nurses. Nurse’s attitudes can develop for many different reasons, these being, and lack of knowledge, stigma, and prior experience with mental illness. As a health care profession, we need to start at the beginning, with assessing and encouraging more understanding and tolerance of mental illness with our student nurses. This study used a longitudinal descriptive pre-post survey design to determine the degree to which a clinical placement with a psychiatric/mental health agency changed student nurses’ attitudes towards mental illness and mental health/psychiatric nursing. Bachelor of nursing students are required to complete a mental health unit of study within the Bachelor of Nursing Degree. This unit of study required student nurses to complete a 4 week clinical placement in a mental health facility. Students were invited to complete a survey before the clinical placement and at the completion of the clinical placement. Of the (n=184) nurses invited to participate in this study, 65 completed the pre and post clinical placement surveys, giving a response rate of 35%.The results show that there is a statistical significance of .001 in the mean attitude scores towards mental illness for pre and post placement. The attitudes towards psychiatric nursing show a statistical significance of .01.Results from this study support recent literature towards a positive change in student nurses attitudes towards mental illness and mental health nursing on the completion of a clinical placement in a mental health facility.
An exploration into suicide prevention initiatives for mental health nurses : a systematic literature review
- Authors: Dabkowski, Elissa , Porter, Joanne
- Date: 2021
- Type: Text , Journal article , Review
- Relation: International Journal of Mental Health Nursing Vol. 30, no. 3 (2021), p. 610-623
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- Description: Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer-reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long-term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives. © 2021 John Wiley & Sons Australia, Ltd
Exploring mental health clinicians' perceptions of the zero suicide prevention Initiative
- Authors: Porter, Joanne , Dabkowski, Elissa , Connolly, Owen , Prokopiv, Valerie
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 31, no. 3 (2022), p. 536-543
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- Description: Suicide continues to impact rural and regional families and communities across Australia and has become a key focus of healthcare, research, and government policy in recent years. The challenge for healthcare organizations is to translate policy visions and research for clinicians to effectively embed in day to day practice when supporting people who experience suicidal crisis. This study explored the introduction of an evidence-based Zero Suicide framework that includes a suicide prevention pathway and training package to a rural and regional community mental health team in Victoria, Australia. A qualitative semi-structured interview technique was used to explore the perceptions of mental health clinicians of the Zero Suicide approach, the training package and the barriers to inform its implementation across a specialist mental health service. Clinicians were complimentary of the intent of Zero Suicide and the training package and felt they had increased confidence in delivering suicide safe care. Four major themes were identified through thematic analysis: (i) Minimizing risk with realistic expectations; (ii) A good approach to making a difference; (iii) Lessons learnt; and (iv) Barriers to implementation needing to change culture. Overall participants identified the importance of continued regular suicide prevention training for all staff but also in tailoring it to different consumer and clinician needs. In addition, organizational structure and adequate staff resourcing were important to participants as was working within a safety culture. © 2021 John Wiley & Sons Australia, Ltd.
Nursing and midwifery students’ mental health status and intention to leave during Covid-19 pandemic
- Authors: Haririan, Hamidreza , Samadi, Parisa , Lalezari, Elnaz , Habibzadeh, Sajad , Porter, Joanne
- Date: 2022
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 8, no. (2022), p.
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- Description: Introduction: COVID-19 has not only affected the physical health of people but it has also had a major impact on their mental health. Objective: To investigate the nursing, midwifery, and operating room students’ mental health and intention to leave during COVID-19 pandemic. Methods: This cross-sectional study was conducted at the nursing and midwifery school of Tabriz, Iran. Over a period of three months (February–May 2021) and through random sampling, 284 students were selected. The research tool consisted of three parts including demographic information, Depression Anxiety Stress scales, and a questionnaire on intention to leave. Results: More than 20% of the students experienced some degrees of depression, anxiety, and stress. Nearly one-third of participants mentioned a high level of intention to leave. Nursing students had a higher level of a turnover tendency than other students (p =.004). Male students and who experienced moderate to high level of depression displayed greater intention to leave (p =.005). Conclusion: Students suffered from some degrees of stress, anxiety, and depression during the COVID-19, and it strengthened the participants’ intention to leave. Relevant authorities are recommended to improve mental health of the students by providing psychological counseling sessions, reducing their direct contact with patients, and providing personal protective equipment. © The Author(s) 2022.
Burnout, stress and resilience of an Australian regional hospital during COVID-19: a longitudinal study
- Authors: Armstrong, Samantha , Porter, Joanne , Larkins, Jo-Ann , Mesagno, Christopher
- Date: 2022
- Type: Text , Journal article
- Relation: BMC health services research Vol. 22, no. 1 (2022), p. 1-1115
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- Description: Abstract Coronavirus disease 2019 (COVID-19) has placed huge strain on hospital staff around the world. The aim of the current longitudinal study was to investigate the resilience, stress and burnout of hospital staff located at a large, regional hospital in Victoria, Australia during the COVID-19 pandemic over time via cross-sectional surveys. The surveys were disseminated six times from August 2020 to March 2021, with the first three data collection points distributed during a state-wide lockdown. A total of 558 responses from various professional roles within the hospital over the survey period were included in the sample. Analysis of variance indicated significant main effects for the psychological variables across time, age, and workload. Hospital staff reported an increase in burnout levels throughout the eight-months. Significant negative relationships were observed between resilience and burnout, and between resilience and stress. A backward regression highlighted the contribution of resilience, stress, age, and nursing roles on burnout. Hierarchical regression analysis indicated that resilience contributed to the stress-burnout relationship. This study strengthens the evidence between resilience and burnout among healthcare workers and hospital staff and highlights the need for psychological wellbeing programs to be implemented for hospital staff impacted by a prolonged worldwide pandemic.
Compliance with the zero suicide initiative by mental health clinicians at a regional mental health service : development and testing of a clinical audit tool
- Authors: Porter, Joanne , Dabkowski, Elissa , Connolly, Owen , Prokopiv, Valerie
- Date: 2023
- Type: Text , Journal article
- Relation: Nursing Reports Vol. 13, no. 1 (2023), p. 29-42
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- Description: Aim: The aim of this study is to investigate the compliance of mental health clinicians in applying the Zero Suicide (ZS) approach to their clinical practice in a rural and regional health community setting. Methods: A retrospective clinical audit of six mental health teams was undertaken at a single site. A clinical audit tool was developed and validated using a six-step approach. The data was extracted and analysed via descriptive and inferential statistics and compared to a specialised mental health team, experienced with the ZS approach. Results: A total of 334 clinical records were extracted for January, April, August, November 2019 and June 2020. The clinical audit and analysis confirmed that the mental health teams are not consistently using the assessments from their training and are therefore not implementing all of these elements into their practice. This could have implications for the risk formulation and treatment for people at risk of suicide. Conclusions: The use of a validated clinical audit tool can be beneficial to establish compliance with the mental health clinicians and to determine any areas requiring further improvement. Further education and reinforcement may be required to ensure consistency with incorporating the elements of ZS into everyday clinical practice. © 2022 by the authors.