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Van de Velde E, Vandewiele H, Van Hecke A, Eeckloo K, Malfait S. Bedside handovers in mental health care: An explorative review. Arch Psychiatr Nurs 2024; 51:10-16. [PMID: 39034063 DOI: 10.1016/j.apnu.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/15/2023] [Accepted: 04/25/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Involving mental healthcare patients in nursing handover practices seems a promising method for increasing patient participation, empowerment, and shared decision-making but is hardly found in practice. METHOD An explorative review on bedside handovers in mental health care was conducted. Searched databases included CINHAHL, Web of Science, PubMed, and Embase. The search strategy yielded 3126 articles. Nine articles met the inclusion criteria and were included in this review. RESULTS Pre- and post-implementation perspectives were described, as well as strategies for implementation. After the implementation of bedside handover, nurses and patients experienced more time spent together and a greater sense of involvement with the care plans could be noticed. DISCUSSION Being involved in bedside handovers facilitates active participation and open dialogue between nurses and patients. This accelerates the opportunities for patients to take part in shared decision-making and feel recognised as experts in their illness experience. More research on possible differences in effectiveness across different patient diagnoses is recommended. CONCLUSION Involving patients in mental health care in handover practices seems a promising method but limited research has been done to explore the meaning it has to mental healthcare nurses and patients.
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Affiliation(s)
| | - Hanne Vandewiele
- Clinical Nurse Specialist Psychiatry, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium.
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
| | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium; Head of Strategic Policy Cell, Ghent University Hospital, Belgium.
| | - Simon Malfait
- Strategic Unit & Nursing Department, Ghent University Hospital, Belgium.
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Cruchinho P, Teixeira G, Lucas P, Gaspar F. Evaluating the Methodological Approaches of Cross-Cultural Adaptation of the Bedside Handover Attitudes and Behaviours Questionnaire into Portuguese. J Healthc Leadersh 2023; 15:193-208. [PMID: 37674524 PMCID: PMC10478977 DOI: 10.2147/jhl.s422122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/26/2023] [Indexed: 09/08/2023] Open
Abstract
Nurse managers need culturally adapted assessment instruments to support the implementation of change to Nursing Bedside Handover (NBH) in healthcare institutions. This study aimed to cross-culturally adapt the Bedside Handover Attitudes and Behaviours (BHAB) questionnaire to the Portuguese context and evaluate the methodological approaches used for this purpose. To guide this study, we followed a guideline for cross-cultural translation and adaptation measurement instruments in healthcare. The results of the content validity testing suggested that the BHAB questionnaire is a valid instrument for use in the Portuguese context. To obtain these results we showed 1) using of a new methodological approach, the dual focus, to resolve the divergences and ambiguities in the translators' committee and the multi-professional committee; 2) the lack of a conceptual definition of the construct of the instrument as a requirement to retain items with I-CVI <0.70 after validity relevance pretesting and 3) the cognitive debriefing and relevance pretesting as methodological approaches which can be used alone or together to reinforce the evaluation of cultural relevance of the items. We concluded there is a need for guidelines to support the decision-making process of healthcare researchers with comprehensive information about the different methodological approaches they can follow.
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Affiliation(s)
- Paulo Cruchinho
- Nursing Research, Innovation and Development Centre (CIDNUR) of Lisbon, Nursing School of Lisbon, Lisboa, 1600-190, Portugal
| | - Gisela Teixeira
- Nursing Research, Innovation and Development Centre (CIDNUR) of Lisbon, Nursing School of Lisbon, Lisboa, 1600-190, Portugal
| | - Pedro Lucas
- Nursing Research, Innovation and Development Centre (CIDNUR) of Lisbon, Nursing School of Lisbon, Lisboa, 1600-190, Portugal
| | - Filomena Gaspar
- Nursing Research, Innovation and Development Centre (CIDNUR) of Lisbon, Nursing School of Lisbon, Lisboa, 1600-190, Portugal
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Influencing Factors of Nurses' Practice during the Bedside Handover: A Qualitative Evidence Synthesis Protocol. J Pers Med 2023; 13:jpm13020267. [PMID: 36836500 PMCID: PMC9965971 DOI: 10.3390/jpm13020267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Nursing Bedside Handover (NBH) is acknowledged as a nursing practice implemented at the patient's bedside to improve communication safety during the shift change, but it is vulnerable due to inconsistent application among nurses. This synthesis of qualitative evidence aims to review and synthesize the perceptions and experiences of nurses regarding the factors that, in their perspective, influence NBH practice. We will follow the thematic synthesis methodology of Thomas and Harden and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) Statement guidelines. A search will be conducted through the databases of MEDLINE, CINAHL, Web of Science, and Scopus, and we will follow the three-step search process to identify primary studies with qualitative or mixed-method research designs and projects of quality improvement. The screening and selection of the studies will be carried out by two independent reviewers. We will use the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to report the screening, search, and selection of studies. To assess its methodological quality, two reviewers will independently use the CASM Tool. The extracted data will be reviewed, categorized, and summarized in tabular and narrative formats. The findings obtained will allow us to inform future research and change management led by nurse managers.
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Pérez-Toribio A, Moreno-Poyato AR, Roldán-Merino JF, Nash M. Spanish mental health nurses' experiences of mechanical restraint: A qualitative descriptive study. J Psychiatr Ment Health Nurs 2022; 29:688-697. [PMID: 35856924 DOI: 10.1111/jpm.12860] [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] [Received: 11/16/2021] [Revised: 06/02/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Mechanical restraint is a common practice in mental healthcare settings in Spain, despite controversy. Mechanical restraint is perceived as a negative experience for nurses and service users. Mechanical restraint damages the nurse-patient therapeutic relationship, which is essential in providing quality care and promoting recovery. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The negative experiences of service users and mental health nurses arising from use of mechanical restraint affects both parties involved and results in trauma. Using mechanical restraint can provoke a moral injury in mental health nurses which can negatively impact on the establishment of trust within the therapeutic nurse-patient relationship. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses must be aware of the negative effects that mechanical restraint use has on both their practice and their day-to-day lives. Post-mechanical restraint debriefing is required to repair the damage to the trust aspect of the nurse-patient relationship. Involving service users in co-producing a debriefing framework may be a way to rebuild trust through constructive dialogue. ABSTRACT INTRODUCTION: Mechanical restraint is an intervention that causes harm to service users and nurses, yet continues to be used in many countries, including Spain. However, there is a lack of research exploring Spanish mental health nurses' experiences of using mechanical restraint. AIM To describe the experiences of mental health nurses who have used mechanical restraint in practice. METHODS A qualitative descriptive methodology was used and a purposive sample of 10 Spanish mental health nurses were interviewed about their experiences of using mechanical restraint. Thematic analysis was then employed to analyse interview data. RESULTS Participants' experiences of using mechanical restraint were mostly negative. Three main themes arose from the analysis of interview transcripts, (i) symmetrical trauma, (ii) moral injury and (iii) broken trust. DISCUSSION The use of restrictive practices, which can be perceived as counter-therapeutic, exposes nurses to risks such as moral injury and service users to broken trust in the therapeutic nurse patient relationship. Avoiding empathy in order to use mechanical restraint is counterproductive, in the understanding that empathy is key to reducing this intervention. IMPLICATIONS FOR PRACTICE Reducing or eliminating use of mechanical restraints should be a policy and practice priority due to the symmetrical harms it causes both nurses and service users. The trust aspect of the therapeutic nurse-patient relationship is a significant casualty when mechanical restraint is used, therefore involving service users in co-production of post-mechanical restraint debriefing can be an avenue for restoring this trust through dialogue.
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Affiliation(s)
- Alonso Pérez-Toribio
- Unitat de Salut Mental de l'Hospitalet, Servei d'Atenció Primària Delta de Llobregat/Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, Spain
| | - Antonio R Moreno-Poyato
- Departament of Public Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, Barcelona, Spain
| | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Michael Nash
- School of Nursing & Midwifery, Trinity College Dublin, Dublin 2, Ireland
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Mullen A, Browne G, Hamilton B, Skinner S, Happell B. Safewards: An integrative review of the literature within inpatient and forensic mental health units. Int J Ment Health Nurs 2022; 31:1090-1108. [PMID: 35365947 PMCID: PMC9544259 DOI: 10.1111/inm.13001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/27/2022]
Abstract
Mental health inpatient units are complex and challenging environments for care and treatment. Two imperatives in these settings are to minimize restrictive practices such as seclusion and restraint and to provide recovery-oriented care. Safewards is a model and a set of ten interventions aiming to improve safety by understanding the relationship between conflict and containment as a means of reducing restrictive practices. To date, the research into Safewards has largely focused on its impact on measures of restrictive practices with limited exploration of consumer perspectives. There is a need to review the current knowledge and understanding around Safewards and its impact on consumer safety. This paper describes a mixed-methods integrative literature review of Safewards within inpatient and forensic mental health units. The aim of this review was to synthesize the current knowledge and understanding about Safewards in terms of its implementation, acceptability, effectiveness and how it meets the needs of consumers. A systematic database search using Medline, CINAHL, Embase and PsychInfo databases was followed by screening and data extraction of findings from 19 articles. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of empirical articles, and the Johanna Brigg's Institute (JBI's) Narrative, Opinion, Text-Assessment and Review Instrument (NOTARI) was used to undertake a critical appraisal of discussion articles. A constant comparative approach was taken to analysing the data and six key categories were identified: training, implementation strategy, staff acceptability, fidelity, effectiveness and consumer perspectives. The success of implementing Safewards was variously determined by a measured reduction of restrictive practices and conflict events, high fidelity and staff acceptability. The results highlighted that Safewards can be effective in reducing containment and conflict within inpatient mental health and forensic mental health units, although this outcome varied across the literature. This review also revealed the limitations of fidelity measures and the importance of involving staff in the implementation. A major gap in the literature to date is the lack of consumer perspectives on the Safewards model, with only two papers to date focusing on the consumers point of view. This is an important area that requires more research to align the Safewards model with the consumer experience and improved recovery orientation.
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Affiliation(s)
- Antony Mullen
- University of Newcastle, Callaghan, New South Wales, Australia.,Hunter New England Mental Health, Newcastle, New South Wales, Australia
| | - Graeme Browne
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, Department of Nursing, School of Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Stephanie Skinner
- Hunter New England Mental Health, C/- Centre for Psychotherapy, James Fletcher Hospital, Newcastle, New South Wales, Australia
| | - Brenda Happell
- University of Newcastle, Callaghan, New South Wales, Australia
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Van de Velde E, Van Hecke A, Van Cleemput N, Eeckloo K, Malfait S. Nursing handover involving consumers on inpatient mental healthcare units: A qualitative exploration of the consumers' perspective. Int J Ment Health Nurs 2021; 30:1713-1725. [PMID: 34495574 DOI: 10.1111/inm.12930] [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] [Received: 06/08/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 11/30/2022]
Abstract
Handovers between nurses are a significant cause of communication problems and possible consumer safety issues. A potential solution for both problems is the nursing handover involving consumers, in which the consumer is present at the time of handover. This practice invites consumers to be more involved in their care process and supports a recovery-oriented practice. Research into nursing handovers involving consumers on inpatient mental health units is however very limited. A qualitative, phenomenological study was conducted. Semi-structured interviews with 13 consumers staying on an inpatient mental health unit of a general hospital were used. The interviews were transcribed verbatim and thematically analysed. Data saturation was reached after 11 interviews when no new themes or codes emerged from the data. Three themes were generated from the interviews: (i) the first moments on the inpatient mental health unit; (ii) the nurse as an ally; and (iii) informing each other. The COREQ-checklist was used. According to consumers, nursing handover involving consumers initiated a change in the relationship between consumers and nurses. Consumers and nurses got to know each other better during handover and built a relationship of trust. The introduction of nursing handover involving consumers created an accessible opportunity for consumers to exchange information with nurses and ask questions concerning their admission. Consumers felt jointly responsible for the continuity of the information about their healthcare process. Due to the use of nursing handover involving consumers, consumers experienced the opportunity to take more control in their health process and ensured that information is correct and complete.
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Affiliation(s)
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Nursing Department, Ghent University Hospital, Ghent, Belgium
| | | | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Ghent, Belgium
| | - Simon Malfait
- Strategic Unit & Nursing Department, Ghent University Hospital, Gent, Belgium
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Paul D, Glover S, Roche MA, Klarnett K, Chen X, Wall J, Joyce M. Enhancing person-centred care in inpatient mental health settings through supported person-side handover: a multi method study. Contemp Nurse 2021; 57:290-301. [PMID: 34709985 DOI: 10.1080/10376178.2021.1999837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND : Many nursing contexts have introduced bedside handover, where the person in care participates in the transfer of clinical information, with benefits for person, carers, and clinicians. This type of handover has been implemented across a number of mental health settings, but there is limited evidence regarding implementation approaches or of practice change. This study reports the development and evaluation of a co-produced education and support package. AIM : To evaluate changes in nurses' practice regarding bedside (person-side) handover following implementation of a structured education and support package. DESIGN : Multi-method design incorporating nurse surveys and chart audit. METHODS : The survey and audit were conducted in 2019-2020 on two inpatient mental health units in a metropolitan health service immediately prior to, and 6 months after, implementation, with 70 survey responses and 52 files audited. Non-parametric tests assessed change, and text comments were reported. RESULTS : Significant improvements were observed in nurses' reports of confidence, the ability to maintain privacy, identified benefits for the person and in information transfer. In contrast, the chart audit identified no change in documentation of this practice. CONCLUSIONS : The implementation of a co-produced education and support package demonstrated positive practice change in engaging people receiving care in handover. This approach to handover provides increased opportunity for nurses to work in partnership with people receiving mental healthcare, facilitating collaborative person-centred care and shared decision making.
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Affiliation(s)
- Diane Paul
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, Wicks Road, North Ryde, NSW 2113, Australia
| | - Suzanne Glover
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, Wicks Road, North Ryde, NSW 2113, Australia
| | - Michael Anthony Roche
- Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW 2007, Australia.,Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia
| | - Karen Klarnett
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, Wicks Road, North Ryde, NSW 2113, Australia
| | - Xiaomeng Chen
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, Wicks Road, North Ryde, NSW 2113, Australia
| | - James Wall
- Hornsby and Kuringai Hospital, Mental Health Intensive Care Unit, Northern Sydney Local Health District, Palmerston Road, Hornsby, NSW 2077, Australia
| | - Mark Joyce
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, Wicks Road, North Ryde, NSW 2113, Australia
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Olasoji M, Plummer V, Cross W. Strategies for Implementing Consumer Involvement in Nursing Handover on Acute Mental Health In-Patient Units. Issues Ment Health Nurs 2021; 42:951-959. [PMID: 33325756 DOI: 10.1080/01612840.2020.1852460] [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: 10/22/2022]
Abstract
Consumer participation in the process of care delivery is crucial to recovery-oriented care. Nursing handover is an important process during the delivery of care on acute in-patient units. Despite the importance of involving consumers in this process, it remains a relatively new concept within mental health. This is due to the complexities involved in the provision of care within the mental health setting. There is a paucity of research on how to successfully implement consumer involvement in nursing handover within mental health settings even though this practice has been occurring within generalist settings for some time now. This paper reports on the findings on the implementation of consumer involvement on an acute in-patient unit. The views of consumers and mental health nurses about the process have already being reported. This current paper describes how a new handover system was implemented using a modified version of the model for successful change to bedside handover by McMurray et al. which was based on Lewin's force-field model of unfreezing, moving and refreezing and Kotter's model of change. The key elements of successful implementation are discussed. There is a need to carefully design and implement consumer involvement in nursing handover within acute in-patient units. There are lessons to be learnt in the process adopted and described in this paper.
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Affiliation(s)
- Michael Olasoji
- Faculty of Health, Arts and Design, Swinburne University of Technology, Wantirna, Australia.,School of Health, Federation University Australia, Berwick, Australia
| | - Virginia Plummer
- School of Health, Federation University Australia, Berwick, Australia
| | - Wendy Cross
- School of Health, Federation University Australia, Berwick, Australia
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Mullen A, Isobel S, Flanagan K, Harman K. Involving Mental Health Consumers in Nursing Handover: A Qualitative Study of Consumer Perspectives. Issues Ment Health Nurs 2021; 42:730-735. [PMID: 33315485 DOI: 10.1080/01612840.2020.1853288] [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: 10/22/2022]
Abstract
A number of benefits have been identified for including consumers in nursing handover, such as improved safety and information exchange. In mental health settings these benefits may translate to improved nurse-consumer engagement and working towards the provision of recovery orientated practice. The process of including the consumer, whilst considered best practice, is not well established in mental health settings. Therefore further understanding, in regards to the consumer perspectives about this practice, is needed to inform its adoption and implementation.This qualitative descriptive study explores consumers' perspectives of their possible involvement in the nursing handover process within a mental health inpatient setting. The study took place in two mental health inpatient units in regional New South Wales, Australia. Thirteen semi-structured individual interviews were conducted with consumers, and a conventional content analysis method was used to analyse the data. Findings are presented under two categories: understanding the purpose and process of nursing handover and considering consumer involvement in handover.Findings provide insight into the views of consumers about being involved in nursing handover and further strengthen the rationale for establishing the process as part of routine practice within acute inpatient mental health units. The study also highlights the need to ensure that all processes within these settings accommodate consumer perspectives and involvement.
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Affiliation(s)
- Antony Mullen
- Hunter New England Mental Health, University of Newcastle, Waratah, Australia
| | | | - Karen Flanagan
- Gold Coast Hospital and Health Service, Southport, Australia
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