National survey of psychiatric mental health advanced practice nursing: the adequacy of educational preparation: voices of our graduates

Mental health nurses' attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings

Background

There has been a recent growth in research addressing mental health nurses’ routine physical healthcare knowledge and attitudes. We aimed to systematically review the empirical evidence about i) mental health nurses’ knowledge, attitudes, and experiences of physical healthcare for mental health patients, and ii) the effectiveness of any interventions to improve these aspects of their work.

Methods

Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases were searched using comprehensive terms. Inclusion criteria: English language papers recounting empirical studies about: i) mental health nurses’ routine physical healthcare-related knowledge, skills, experience, attitudes, or training needs; and ii) the effectiveness of interventions to improve any outcome related to mental health nurses’ delivery of routine physical health care for mental health patients. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative, narrative synthesis of study findings was conducted.

Results

Fifty-one papers covering studies from 41 unique samples including 7549 mental health nurses in 14 countries met inclusion criteria. Forty-two (82.4%) papers were published since 2010. Eleven were intervention studies; 40 were cross-sectional. Observational and qualitative studies were generally of good quality and establish a baseline picture of the issue. Intervention studies were prone to bias due to lack of randomisation and control groups but produced some large effect sizes for targeted education innovations. Comparisons of international data from studies using the Physical Health Attitudes Scale for Mental Health Nursing revealed differences across the world which may have implications for different models of student nurse preparation.

Conclusions

Mental health nurses’ ability and increasing enthusiasm for routine physical healthcare has been highlighted in recent years. Contemporary literature provides a base for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes. At the same time, developments are needed which are congruent with the needs and wants of patients.

Electronic supplementary material

The online version of this article (10.1186/s12912-019-0339-x) contains supplementary material, which is available to authorized users.

Achieving Full Scope of Practice Readiness Using Evidence for Psychotherapy Teaching in Web and Hybrid Approaches in Psychiatric Mental Health Advanced Practice Nursing Education

Radical changes in role, education, and practice have affected how education of advance practice nurses and practice deliverables occur.

PURPOSE

This article examines the effects of distance education upon the teaching/learning of psychotherapy in integrating Web-based technology and platforms.

DESIGN AND METHODS

With the advent and proliferation of online programs of study, the question begs: How do distance-linked programs successfully introduce, practice, and supervise one-to-one and group psychotherapy training?

FINDINGS

By employing evidence-based education strategies, technology, and strong interpersonal skills and evidence-based therapies, a charter Psychiatric Mental Health Nurse Practitioner Doctor of Nursing Practice program paved an innovative and successful path.

PRACTICE IMPLICATIONS

In that program, they prepared their students for full scope of practice, upon graduation, inclusive of psychotherapy as well as the other highly demanding and compressed requirements of the 3-year program. This article explores that journey and its recommendations for application derived from this 2010 cohort.

Majors in mental health nursing: issues of sustainability and commitment

PURPOSE

Major streams in mental health nursing in undergraduate nursing programs were introduced in Australia as a strategy to address current and projected workforce shortages. Of the 14 programs originally planned or implemented, only five are continuing.

DESIGN AND METHODS

A qualitative exploratory study was conducted involving in-depth interviews with representatives of universities that had ceased the major streams or abandoned plans to introduce them.

FINDINGS

Significant themes from interview material on abandoned programs were efficient use of resources, expertise, and problems with registration. On the programs now terminated significant themes were viability and commitment to mental health nursing.

PRACTICE IMPLICATIONS

These findings suggest demonstrable and sustainable commitment to mental health nursing is a precursor to success of major streams and advancement of the mental health nursing specialty.

Learning essentials: what graduates of mental health nursing programmes need to know from an industry perspective

AIMS AND OBJECTIVES

To explore the perspectives of nursing directors in mental health in Queensland, Australia, regarding the skills and attributes of graduates of comprehensive nursing programme to provide an industry perspective and thus augment knowledge from theoretical and professional dimensions.

BACKGROUND

There is a worldwide shortage of appropriately qualified nurses with the knowledge, skills and attitudes to work effectively in mental health services. Within Australia, this has been well documented since the introduction of comprehensive nursing education. The underrepresentation of mental health content in undergraduate curricula has been identified as the primary reason for nursing graduates not being adequately prepared for practice in this field. To date, this issue has primarily been addressed from the perspective of university academics, with the voice of industry relatively silent in the published literature.

DESIGN

Qualitative exploratory.

METHOD

In-depth telephone interviews with Director of Nursing (Mental Health) in Queensland, Australia.

RESULTS

The concerns of participants were expressed in six main themes: (1) foundational knowledge of mental health and disorders, (2) recovery-oriented skills, (3) physical as well as mental health skills, (4) therapeutic strategies, (5) resilience and self-development and (6) advanced knowledge and skills.

CONCLUSIONS

The education of comprehensive nursing education needs to be reviewed as a matter of priority to ensure graduates with the attributes required to provide high-quality care for consumers of mental health services.

RELEVANCE TO CLINICAL PRACTICE

A skilled and knowledgeable workforce is an essential component of high-quality mental health services. Research highlighting the current deficits and issues is therefore of the highest priority.

Expanding the scope of psychiatric nursing practice: devaluing the essence of psychiatric nursing?

Psychiatric Nurse Practitioners are quickly becoming sought after employees, especially in public mental health systems where a shrinking number of psychiatrists necessitate alternate access to prescribers. In addition, new guidelines necessitate greater attention to the follow up and monitoring of the medical problems of psychiatric patients. These events are occurring in the midst of declining reimbursement and rising litigation concerns in psychiatry. At the same time there is an increased focus on a recovery orientation to psychiatry alongside the primacy of psychotropic medicine as the most cost effective treatment, which can become competing aims for practitioners. It is important for psychiatric nurses and psychiatric nurse practitioners to consider how these opportunities might also have a negative impact on the core foundation of psychiatric nursing.

The 1998 Curriculum Guidelines and Regulatory Criteria for family nurse practitioners seeking prescriptive authority: what should we be teaching nurse prescribers today?

PURPOSE

The Provus Discrepancy Model is applied to suggest revisions to consensus curriculum and regulatory guidelines for nurse practitioners (NPs) seeking prescriptive authority.

DATA SOURCE

Literature review related to prescribing policy, regulation, NP role competencies, and pharmacologic trends.

CONCLUSION

The document "Curriculum Guidelines and Regulatory Criteria for Family Nurse Practitioners Seeking Prescriptive Authority to Manage Pharmacotherapeutics in Primary Care" should be examined for relevance to current prescribing practice, scope, and influences that emerged since publication.

IMPLICATIONS FOR PRACTICE

In order to prepare NPs of the future it is important to acknowledge the implications of increased autonomy, scope, and depth of practice that explicitly includes broad prescriptive authority.