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Zonneveld D, Conroy T, Lines L. Clinical supervision experience of nurses in or transitioning to advanced practice: A systematic review. J Adv Nurs 2024; 80:3547-3564. [PMID: 38433321 DOI: 10.1111/jan.16126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
AIMS To systematically explore the clinical supervision (CS) experience for nurses transitioning to advanced practice. DESIGN A qualitative systematic review using Joanna Briggs Institute meta-aggregation following an a priori protocol published on PROSPERO (CRD42023426658). DATA SOURCES Qualitative studies obtained from Medline, CINAHL, PsycINFO, Scopus, Emcare and ERIC databases and ProQuest dissertations and theses for peer-reviewed, published and unpublished studies from inception to July 2023. REVIEW METHODS Two authors conducted data screening and abstraction. Quality was appraised using the Critical Appraisal Skills Programme tool and reporting followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist for systematic reviews. RESULTS Sixteen studies contributed to five synthesized findings: CS that is beneficial requires structure and commitment, trusting relationships are foundational for learning, lifting burdens and preventing burnout, learning through reflection, critical thinking and feedback and barriers to CS. CONCLUSIONS This review provides a meaningful exploration of CS to support nurses transitioning to advanced practice. Well-structured supervision offers a safe space to share work-related concerns and develop an advanced practitioner identity. Sharing experiences helps alleviate work-related burdens and reduce professional isolation and burnout. IMPLICATIONS FOR THE PROFESSION Peer-support networks are vital for successful transition to advanced practice. IMPACT This review highlighted the impact of effective supervisory relationships in forming professional identity and possible links with nursing retention. PUBLIC CONTRIBUTION No direct patient contributions are included as it forms part of a research degree.
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Affiliation(s)
- Debbie Zonneveld
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Lauren Lines
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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Happell B, Jacob A, Furness T, Stimson A, Curtis J, Watkins A, Platania-Phung C, Scholz B, Stanton R. Nurse-led physical health interventions for people with mental illness: an integrative review of international literature. J Ment Health 2024:1-23. [PMID: 39150334 DOI: 10.1080/09638237.2024.2390364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/29/2024] [Accepted: 06/06/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND People experiencing mental illness receive physical healthcare from nurses in a variety of settings including acute inpatient, secure extended care, forensic, and community services. While nurse-led clinical practice addressing sub-optimal consumer physical health is salient, a detailed understanding and description of the contribution by nurses to physical health interventions in people experiencing mental illness is not clearly articulated in the literature. AIMS The aim of this integrative review is to describe the state of knowledge on nurse-led physical health intervention for consumers, focusing on nursing roles, nursing assessment, and intervention settings. METHODS A systematic search of six databases using Medical Subject Headings from 2001 and 2022 inclusive was conducted. The Mixed Methods Appraisal Tool (MMAT) was utilised for quality appraisal. RESULTS Seventy-four studies were identified as "nurse-led". Interventions were most common among community settings (n = 34, 46%). Nurses performed varied roles, often concurrently, including the collection of 341 physical health outcomes, and multiple roles with 225 distinct nursing actions identified across the included studies. A nurse as lead author was common among the included studies (n = 46, 62%). However, nurses were not always recognised for their efforts or contributions in authorship. CONCLUSIONS There is potential gap in role recognition that should be considered when designing and reporting nurse-led physical health interventions.
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Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, Adelaide, New South Wales, Australia
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Alycia Jacob
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Trentham Furness
- Faculty of Health, Southern Cross University, Adelaide, New South Wales, Australia
- Forensicare, Fairfield, Victoria, Australia
| | - Alisa Stimson
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, South East Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, South East Sydney Local Health District, Sydney, New South Wales, Australia
| | - Chris Platania-Phung
- Department of Psychology, Australian College of Applied Psychology, Melbourne, Australia
| | - Brett Scholz
- Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, South Australia, Australia
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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Wardrop R, Ranse J, Chaboyer W, Young JT, Kinner SA, Crilly J. Profile and Outcomes of Emergency Department Mental Health Patient Presentations Based on Arrival Mode: A State-Wide Retrospective Cohort Study. J Emerg Nurs 2023; 49:951-961. [PMID: 37610408 DOI: 10.1016/j.jen.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/08/2023] [Accepted: 06/28/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION People arriving to the emergency department with mental health problems experience varying and sometimes inferior outcomes compared with people without mental health problems, yet little is known about whether or how their arrival mode is associated with these outcomes. This study describes and compares demographics, clinical characteristics, and patient and health service outcomes of adult mental health emergency department patient presentations, based on arrival mode: brought in by ambulance, privately arranged transport, and brought in by police. METHODS Using a retrospective observational study design with state-wide administrative data from Queensland, Australia, mental health presentations from January 1, 2012, to December 31, 2017, were analyzed using descriptive and inferential analyses. RESULTS Of the 446,815 presentations, 51.8% were brought in by ambulance, 37.2% arrived via privately arranged transport, and 11.0% were brought in by police. Compared with other arrival modes, presentations brought in by ambulance were more likely to be older and female and have more urgent triage categories and a longer length of stay. Presentations arriving by privately arranged transport were more likely than other arrival modes to present during the day, be assigned a less urgent triage category, be seen within their recommended triage time, have a shorter length of stay in the emergency department, have higher rates of discharge, and have waited longer to be seen by a clinician. Presentations brought in by police were more likely than other arrival modes to be younger and male and experience a shorter time to be seen by a clinician. DISCUSSION Discrepancies between arrival modes indicates a need for further investigation to support inter- and intra-agency mental health care interventions.
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Happell B, Furness T, Jacob A, Stimson A, Curtis J, Watkins A, Platania-Phung C, Scholz B, Stanton R. Nurse-Led Physical Health Interventions for People with Mental Illness: A Scoping Review of International Literature. Issues Ment Health Nurs 2023:1-16. [PMID: 37294933 DOI: 10.1080/01612840.2023.2212772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
People with mental illness have a higher prevalence of co-occurring physical health conditions and poor health behaviors, leading a mortality gap of up to 16 years, compared with the general population. Nurses working in mental health settings play an important role in addressing factors influencing sub-optimal physical health. Therefore, this scoping review aimed to identify nurse-led physical health interventions and align interventions to eight recognized physical healthcare priority areas (i.e. Equally Well in Victoria Framework). A systematic search strategy was used to identify relevant literature. Data extraction included alignment to the Equally Well priority areas, research design, and indication of co-design (meaningful and collaborative involvement of consumers and significant others) and recovery-oriented practice (focusing on needs and goals of a consumer's recovery journey). All included papers (n = 74) were aligned to at least one of eight Equally Well priority areas. Papers were predominately quantitative (n = 64, 86%), with the remainder mixed methods (n = 9, 9%) or qualitative (n = 4, 5%). Most papers were aligned to improving metabolic health and support to quit smoking. One study focused on nurse-led intervention designed to reduce falls. Recovery-oriented practice was evident in six papers. No paper described evidence of co-design. A research gap was identified for nurse-led intervention to reduce falls and improve dental/oral care. Relative to mental healthcare policy, there is a need for future nurse-led physical health research to be co-designed and include recovery-oriented practice. Evaluation and description of future nurse-led physical interventions should seek to report perspectives of key stakeholders as these remain relatively unknown.
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Affiliation(s)
- Brenda Happell
- Mental Health and Psychosocial Well-being Theme, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Alycia Jacob
- School of Nursing and Midwifery, Australian Catholic University, Fitzroy, Australia
| | - Alisa Stimson
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | - Andrew Watkins
- Mindgardens Neuroscience Network, South East Sydney Local Health District, University of New South Wales - Cliffbrook Campus, Coogee, Australia
| | | | - Brett Scholz
- Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Robert Stanton
- Cluster for Resilience and Wellbeing, Appleton Institute, Rockhampton, South Australia, Australia
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Queensland, Australia
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van Dusseldorp L, Groot M, van Vught A, Goossens P, Hulshof H, Peters J. How patients with severe mental illness experience care provided by psychiatric mental health nurse practitioners. J Am Assoc Nurse Pract 2023; 35:281-290. [PMID: 37074260 PMCID: PMC10144266 DOI: 10.1097/jxx.0000000000000867] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/11/2023] [Accepted: 03/14/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Previous studies in somatic health care revealed that patients find nurse practitioners reliable, helpful, and empathic and feel empowered, at peace, and in control when cared for by nurse practitioners (NPs). Only one study so far considered what value people with severe mental illness (SMI) attached to treatment by a psychiatric mental health nurse practitioner (PMHNP). PURPOSE To explore what meaning people with SMI associate with the care provided by a PMHNP. METHODOLOGY A qualitative study from a phenomenological perspective was conducted, in which 32 people with SMI were interviewed. Data were analyzed using Colaizzi's seven-step method and the metaphor identification procedure (MIP). RESULTS Eight fundamental themes emerged: (1) impact of the PMHNP on well-being, (2) feeling connected with, and (3) acknowledged by the PMHNP; (4) the PMHNP's care (not) needed; (5) perception of the PMHNP as a person; (6) shared decision-making; (7) PMHNP's expertise; and (8) flexibility of contact with the PMHNP. MIP analysis revealed six metaphors: PMHNP is a travel aid, means trust, is a combat unit, means hope, is an exhaust valve, and a helpdesk/encyclopedia. CONCLUSIONS The interviewees highly appreciated the treatment and support by the PMHNP for the impact on their well-being. Thanks to the connection with and recognition by the PMHNP, they felt empowered, human, and understood. Challenged by the PMHNP, they focused on possibilities to strengthen self-confidence and self-acceptance. IMPLICATIONS For further positioning of and education for PMHNPs, it is recommended to consider the meaning people with SMI associate with treatment and support by a PMHNP.
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Affiliation(s)
- Loes van Dusseldorp
- Expertise Center for Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- Master Advanced Nursing Practice, HAN University of Applied Science, Nijmegen, The Netherlands
| | - Marieke Groot
- HR University of Applied Science, Rotterdam, The Netherlands
| | | | - Peter Goossens
- Dimence Group Mental Health Care, Deventer, The Netherlands
- University of Gent, Ghent, Belgium
| | - Hugo Hulshof
- HAN University of Applied Science, Nijmegen, The Netherlands
| | - Jeroen Peters
- HAN University of Applied Science, Nijmegen, The Netherlands
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O'Sullivan M. Effecting change and improving practice in a regional Emergency Department: A Mental Health Nurse Practitioner's perspective. Int J Ment Health Nurs 2022; 31:1534-1541. [PMID: 35986578 DOI: 10.1111/inm.13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Providing appropriate, timely intervention and care to people who present with mental health issues to an Emergency Department presents unique ongoing challenges, often affecting patient experiences and outcomes. To address such concerns, a Mental Health Liaison Nurse role, led by a Mental Health Nurse Practitioner, was introduced to a regional Emergency Department. This role provided integrated emergency-based mental health clinical practice, with positive findings reported in a recently published multi-site translational research project. With sound quantitative and qualitative evidence detailing the benefits of this role, the experiential perspective from a clinician working in this frontline space further confirms the importance of having access to such a position in leading cultural and systemic change. This discussion article identifies key processes that align current research with the clinical perspective. Such processes recognize the challenges of implementing a new role and moving forward from these to embed consistent clinical practices. The need to build sound internal and external stakeholder partnerships, effect change implementation, and assign recommendations to ensure sustainability of improved practice and processes are highlighted in this paper. This article is, therefore, designed to assist other advanced practice nurses, who may be embarking on a similar journey and want to influence organizational policy and practice.
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Affiliation(s)
- Margaret O'Sullivan
- Hunter New England Local Health District, Metford, New South Wales, Australia
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Tabvuma TS, Stanton R, Browne G, Happell B. Mental health consumers' perspectives of physical health interventions: An integrative review. Int J Ment Health Nurs 2022; 31:1046-1089. [PMID: 35388954 PMCID: PMC9542531 DOI: 10.1111/inm.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022]
Abstract
Consumers of mental health services experience poor physical health compared to the general population, leading to long-term physical illness and premature death. Current research and policy activity prioritizes the physical health of consumers yet few of these recommendations have translated to practice. This implementation gap may be influenced by the paucity of literature exploring consumer perceptions and experiences with physical healthcare and treatment. As a result, little is understood about the views and attitudes of consumers towards interventions designed to improve their physical health. This integrative review aims to explore the literature regarding consumer perspectives of physical healthcare and, interventions to improve their physical health. A systematic search was undertaken using (i) CINAHL, (ii) MEDLINE, (iii) PsycINFO, (iv) Scopus, and (v) Google Scholar between September and December 2021. Sixty-one papers comprising 3828 consumer participants met the inclusion criteria. This review found that consumers provide invaluable insights into the barriers and enablers of physical healthcare and interventions. When consumers are authentically involved in physical healthcare evaluation, constructive and relevant recommendations to improve physical healthcare services, policy, and future research directions are produced. Consumer evaluation is the cornerstone required to successfully implement tailored physical health services.
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Affiliation(s)
- Tracy Samkele Tabvuma
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Graeme Browne
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Brenda Happell
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Sonethavy M, Morvillers JM. Promotion de la santé en psychiatrie et santé mentale : l’exemple du syndrome métabolique et des pratiques infirmières. Rech Soins Infirm 2022; 147:55-66. [DOI: 10.3917/rsi.147.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Suggett J, Foster K, Lakra V, Steele M, Furness T. Natural cause mortality of mental health consumers: A 10-year retrospective cohort study. Int J Ment Health Nurs 2021; 30:390-400. [PMID: 33035405 DOI: 10.1111/inm.12797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/02/2020] [Accepted: 09/14/2020] [Indexed: 01/09/2023]
Abstract
People with mental illness have substantially lower life expectancy than the general population, with mortality from natural causes most commonly attributed to cardiovascular diseases. The study aim was to identify characteristics of consumers who died of natural causes between 2009 and 2018 at one of Australia's largest publicly funded mental health services. Data were collected with a retrospective medical record review of 102 consumers. Mean mortality age was 52.4 years (SD = 10.7) (with females 51.9 years [SD = 12.0], and males 52.7 years [SD = 9.9]), which was more than 30 years lower than the Australian population. Cardiovascular diseases were the most frequent mortality cause (39%), followed by respiratory conditions (23%), cancers (20%), and all other causes (19%). Sixty (61%) consumers had at least three co-occurring physical health conditions. Seventy-five (74%) smoked tobacco. Consumers who died from cardiovascular diseases were less likely to attend specialist medical follow-up for their condition (P = 0.004), and more likely to die at home (P = 0.001). Consumers whose mortality age was above 55 years were more likely to have three co-occurring physical health conditions (P = 0.034). Consumers whose mortality age was below 55 years were more likely to have sub-optimal nutritional intake (P = 0.014) and higher body mass index (P = 0.008). There is a critical need to close the life expectancy gap for consumers. This requires dedicated focus on reducing mortality risk due to modifiable clinical characteristics which lead to consumer mortality. Mental health nurses play a key role in helping reduce consumers' mortality and morbidity risk through prevention and early intervention strategies.
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Affiliation(s)
- Joanne Suggett
- North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kim Foster
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Vinay Lakra
- North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Michael Steele
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Trentham Furness
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, Victoria, Australia
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Howard R, Kuhn L, Millar F, Street M. Physical health assessment and cardiometabolic monitoring practices across three adult mental health inpatient units - a retrospective cohort study. Int J Ment Health Nurs 2020; 29:1144-1156. [PMID: 32743951 DOI: 10.1111/inm.12755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/07/2020] [Accepted: 05/25/2020] [Indexed: 02/06/2023]
Abstract
Australians with lived experience of mental illness die on average 10 or more years earlier than the general population. Cardiometabolic disorders, including cardiovascular disease and diabetes mellitus, are common causes of premature death in this cohort. Little is known about cardiometabolic monitoring practices in mental health inpatient units. The aim of this study was to examine the characteristics of cardiometabolic monitoring and physical health assessments of adult mental health consumers within the first 72 hours of admission to an inpatient unit. We implemented a retrospective descriptive exploratory design by medical record audit. Data were collected using a pre-validated audit tool, adapted with recent literature and policy, from a randomly selected sample of consumers admitted to three acute mental health adult inpatient units of a large Australian metropolitan health service in 2016. Of 228 consumers, the mean age was 37.5 (range 18-64) years and 51.3% were women. Cardiometabolic risks were common, yet most consumers received incomplete cardiometabolic monitoring. While few consumers (15%) were diagnosed with cardiometabolic comorbidities, 67.5% were prescribed psychotropic medications with high cardiometabolic risk. Compliance with recommended cardiometabolic monitoring varied considerably between risk factors: for example, blood pressure was measured in 56.1% of consumers, whereas waist circumference was never recorded. There were no statistically significant associations between cardiometabolic monitoring completion and sex or cardiometabolic risk. These findings demonstrate the need for increased education and awareness of cardiometabolic risk and identify a critical gap between physical health assessment practices and recommendations for this cohort.
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Affiliation(s)
- Rebekah Howard
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,Eastern Health, Adult Mental Health Services, Melbourne, Victoria, Australia
| | - Lisa Kuhn
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | | | - Maryann Street
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research - Eastern Health Partnership, Melbourne, Victoria, Australia
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