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Author Farrow, T.
Title Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments Type Journal Article
Year 2002 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 11 Issue 4 Pages 214-219
Keywords Interprofessional relations; Psychiatric Nursing; Community health nursing; Qualiltative research; Suicide
Abstract 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
Call Number NRSNZNO @ research @ Serial 785
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Author Fourie, W.; McDonald, S.; Connor, J.; Bartlett, S.
Title The role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality Type Journal Article
Year 2005 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal Available online from Coda: An institutional repository for the ITP sector
Volume 14 Issue 2 Pages 134-141
Keywords Psychiatric Nursing; Nurse-patient relations; Organisational change
Abstract This study compared the perceptions that registered psychiatric nurses have of their roles with their actual practice. Following the closure of large scale psychiatric institutions in New Zealand, there was was an increased demand for limited beds in acute inpatient facilities for acutely mentally ill patients. This change in location and downsizing of acute inpatient beds challenged traditional roles of mental health nursing, resulting in confusion over what roles mental health nurses should now perform in the new context of care. This qualitative descriptive exploratory study observed nursing practice on three selected wards and used focus group interviews to establish from registered nurses what they perceived their roles to be. A key finding of this study was that many of the nursing roles related to delivering care from a crisis management perspective, which covers aspects such as assessment, stabilisation of symptoms and discharge planning. Participants also believed that the therapeutic relationship was a fundamental role in inpatient care. Nurses used any opportunity to make it a reality such as kitchen organisation, medications, or dealing with a challenging patient. This study highlighted the complexity of the roles that nurses performed and went some way to give voice to what at times seems an invisible practice.
Call Number NRSNZNO @ research @ Serial 875
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Author Rydon, S.E.
Title The attitudes, knowledge and skills needed in mental health nurses: The perspective of users of mental health services Type Journal Article
Year 2005 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 14 Issue 2 Pages 78-87
Keywords Patient satisfaction; Psychiatric Nursing; Attitude of health personnel
Abstract In this study a qualitative descriptive methodology with focus group interviews was used to explore with users of mental health services, the attitudes, knowledge and skills that they need in mental health nurses. Users of mental health services valued the therapeutic work of mental health nurses, and identified positive attitudes towards users of mental health services as essential in mental health nurses. However, they did not consistently experience a therapeutic approach in their interactions with mental health nurses. In a sociopolitical climate where the views of users of mental health services are increasingly incorporated into education and the planning and delivery of services, there is a need for more research that reflects the perspective of users.
Call Number NRSNZNO @ research @ 961 Serial 945
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Author McKenna, B.; O'Brien, A.J.; Dal Din, T.; Thom, K.
Title Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992 Type Journal Article
Year 2006 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 15 Issue 2 Pages 128-134
Keywords Advanced nursing practice; Psychiatric Nursing; Law and legislation
Abstract The objectives of this research were to determine how many registered nurses are working as 'responsible clinicians', under what phases of the legislation they are functioning, and to describe the enabling processes and barriers to nurses undertaking this statutory role. An anonymous descriptive survey was distributed to the 11 nurses who were currently responsible clinicians as well as five senior nurses selected from each of the 21 district health boards and the Auckland Regional Forensic Psychiatry Services (n=121). The response rate was 88.4% (n=107). The survey questioned respondents on statutory roles currently undertaken. Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain it. They were also asked which competencies of the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. Of the approximately 395 responsible clinicians nationally, 11 (2.8%) are nurses. Most nurses viewed the role as legitimate. However, many were unaware of competencies for the role and credentialing processes, and were somewhat ambivalent about achieving the role due to current workload, role conflict and lack of remuneration. Competency deficits were highlighted. The authors conclude that there are grounds to encourage nurses as responsible clinicians given the intent of the legislation. This will require the promulgation of appropriate mental health policy, and a concerted effort by major stakeholders in mental health service delivery.
Call Number NRSNZNO @ research @ Serial 1044
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Author Crowe, M.; Ward, N.; Dunnachie, B.; Roberts, M.H.
Title Characteristics of adolescent depression Type Journal Article
Year 2006 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 15 Issue 1 Pages 10-18
Keywords Psychiatric Nursing; Mental health; Adolescents
Abstract This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.
Call Number NRSNZNO @ research @ 1065 Serial 1050
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Author O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J.
Title Clinical indicators as measures of mental health nursing standards of practice in New Zealand Type Journal Article
Year 2004 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 13 Issue 2 Pages 778-788
Keywords Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth
Abstract This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
Call Number NRSNZNO @ research @ Serial 1059
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Author Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J.
Title The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand Type Journal Article
Year 2003 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 4 Pages 259-270
Keywords Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research
Abstract This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.
Call Number NRSNZNO @ research @ Serial 1064
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Author Bishop, D.; Ford-Bruins, I.
Title Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study Type Journal Article
Year 2003 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 3 Pages 203-212
Keywords Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models
Abstract This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
Call Number NRSNZNO @ research @ 1082 Serial 1067
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Author Palmer, S.G.
Title Application of the cognitive therapy model to initial crisis assessment Type Journal Article
Year 2003 Publication (up) International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 1 Pages 30-38
Keywords Mental health; Clinical assessment; Psychiatric Nursing
Abstract This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
Call Number NRSNZNO @ research @ 1085 Serial 1070
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Author O'Brien, A.P.; O'Brien, A.J.; Hardy, D.J.; Morrison-Ngatai, E.; Gaskin, C.J.; Boddy, J.M.; McNulty, N.; Ryan, T.; Skews, G.
Title The New Zealand development and trial of mental health nursing clinical indicators: A bicultural study Type Journal Article
Year 2003 Publication (up) International Journal of Nursing Studies Abbreviated Journal
Volume 40 Issue 8 Pages 853-861
Keywords Biculturalism; Psychiatric Nursing; Professional competence; Evaluation
Abstract This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.
Call Number NRSNZNO @ research @ Serial 956
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Author Crowe, M.
Title Psychiatric diagnosis: Some implications for mental health nursing care Type Journal Article
Year 2006 Publication (up) Journal of Advanced Nursing Abbreviated Journal
Volume 53 Issue 1 Pages 125-131
Keywords Psychiatric Nursing; Diagnosis; Culture; Gender; Socioeconomic factors; Nursing models
Abstract This article explores some of the functions of psychiatric diagnosis and the implications this has for mental health nursing care. It critiques the psychiatric diagnosis as a categorisation process that maintains oppressive power relations within society, by establishing and enforcing normality through gender, culture and class biases. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is used to illustrate some of the inherent biases in the diagnostic process. The author argues that mental health nursing practice needs to demonstrate an awareness of the power relations inherent in any diagnostic process and make attempts to redress these at both the individual and sociopolitical levels. To create a true patient-centred partnership in mental health nursing, the nursing focus should be on the patient's experience rather than the psychiatric diagnosis with which the experience is attributed. NB this is a reprint of article first published in Journal of Advanced Nursing, 2000 Mar; 31(3), 583-9.
Call Number NRSNZNO @ research @ Serial 837
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Author Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N.
Title Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand Type Journal Article
Year 2004 Publication (up) Journal of Advanced Nursing Abbreviated Journal
Volume 46 Issue 1 Pages 95-109
Keywords Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori
Abstract The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
Call Number NRSNZNO @ research @ Serial 1060
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Author Crowe, M.; Carlyle, D.
Title Deconstructing risk assessment and management in mental health nursing Type Journal Article
Year 2003 Publication (up) Journal of Advanced Nursing Abbreviated Journal
Volume 43 Issue 1 Pages 19-27
Keywords Psychiatric Nursing; Risk management; Policy; Culture
Abstract The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
Call Number NRSNZNO @ research @ Serial 1069
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Author Crowe, M.; O'Malley, J.; Gordon, S.
Title Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand Type Journal Article
Year 2001 Publication (up) Journal of Advanced Nursing Abbreviated Journal
Volume 35 Issue 1 Pages 88-96
Keywords Community health nursing; Psychiatric Nursing; Patient satisfaction; Mental health
Abstract The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.
Call Number NRSNZNO @ research @ Serial 1087
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Author Cook, N.; Phillips, B.N.; Sadler, D.
Title The Tidal Model as experienced by patients and nurses in a regional forensic unit Type Journal Article
Year 2005 Publication (up) Journal of Psychiatric & Mental Health Nursing Abbreviated Journal
Volume 15 Issue 5 Pages 536-540
Keywords Psychiatric Nursing; Nursing models; Evaluation; Nurse-patient relations
Abstract This study looks at the effect of implementing the Tidal Model at Rangipapa, a regional secure mental health forensic unit. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four registered nurses and four “special patients”. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism. Levelling was experienced as an effect emerging from individual and group processes whereby a shift in power enhanced a sense of self and connectedness in their relationships. These interpersonal transactions were noted by the special patients as being positive for their recovery. This enabled effective nurse-patient collaboration expressed simply as working together. The participants reported a feeling of humanity, so that there was a human face to a potentially objectifying forensic setting. Implications arising from this study are that the use of the model enables a synergistic interpersonal process wherein nurses are professionally satisfied and patients are validated in their experience supporting their recovery.
Call Number NRSNZNO @ research @ Serial 941
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