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Optimizing the response to mental health deterioration : Nurses experiences of using a Mental Health Observation Response Chart
Forster, John A. Coventry, Alysia A. Daniel, Catherine
Forster, John A.
Coventry, Alysia A.
Daniel, Catherine
Abstract
Recognizing mental health deterioration remains a challenge for health systems globally, with evidence of suboptimal care for patients with increasing co-morbid psychiatric illness. Mechanisms exist to detect and respond to physical deterioration with the use of Observation Response Charts, monitoring of vital signs and medical emergency teams but registered nurses lack psychiatric nursing skills to care for this patient population. Currently, there are no validated processes in place to recognize and respond to mental health deterioration in general hospital wards. This qualitative descriptive study explores nurses' experiences of using a Mental Health Observation Response Chart that uses signs of distress to track and trigger tiered responses to mental health deterioration on general hospital wards. Thirty-five surgical and rehabilitation nurses participated in focus groups from January to March 2020. All qualitative data were thematically analysed using an inductive approach. Analysis resulted in four themes: clinical relevance, a useful chart, identifying distress, and working with doctors. The clinical relevance of the chart was influenced by the level of nursing experience; patient distress; existing escalation pathways and ward culture. The study findings will inform the establishment of a process for nurses to recognize mental health deterioration that could improve patient outcomes and promote staff safety. Further research is needed to validate specific signs of distress with patients in general hospital wards and to develop findings for the clinical relevance of this approach to detect mental health deterioration and improve patient outcomes.
Keywords
clinical deterioration,, mental health,, patients,, psychiatric nursing, vital signs
Date
2023
Type
Journal article
Journal
International Journal of Mental Health Nursing
Book
Volume
32
Issue
1
Page Range
95-105
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled