The challenges of implementing ADHD clinical guidelines and research best evidence in routine clinical care settings: Delphi survey and mixed-methods study.

Background: The landmark US Multimodal Treatment of ADHD (MTA) study established the benefits of individualised medication titration and optimisation strategies to improve short- to medium-term outcomes in attention-deficit hyperactivity disorder (ADHD). This individualised medication management approach was subsequently incorporated into the National Institute for Health and Care Excellence (NICE) ADHD Clinical Guidelines (NICE CG78). However, little is known about clinicians' attitudes towards implementing these medication management strategies for ADHD in routine care.

The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle.

Background: Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research).

Methods: With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013.

Multidisciplinary post-registered education in child and adolescent mental health services.

This article describes a study conducted in England as part of the preparation work for the Children's Taskforce, looking at the training needs of specialist Child and Adolescent Mental Health Service (CAMHS) staff, and of primary care staff who work with children and young people. A survey of existing service provision and of training opportunities was conducted, and as a result a series of recommendations for future training needs within CAMHS are made. It includes the needs of the developing role of Primary Mental Health Workers (PMHWs) within this area in their crucial link position between primary and secondary services.

The nursing role in out-patient child and adolescent mental health services.

Whilst nurses in the UK have been working in out-patient settings in the speciality of child, adolescent and family psychiatry for nearly 20 years, they are frequently unclear about what is their nursing contribution to the multidisciplinary team. This paper reports a qualitative study of perceptions of the nursing role in child and adolescent mental health teams of 11 clinicians from six different clinics. Whilst other disciplines were each able to define what was unique about their role, there was found to be no consensus as to what nurses brought by virtue of their nursing background.

Keep taking the tablets? Evidence-based approaches to AD(H)D. Part 2: Audit and changing practice.

The audit cycle was used to look at our practice in the light of new developments in the literature and the new evidence available to us. Using this new information we were able to refine our practice, set new standards and measure our practice against these new standards. This new information allowed us to further develop new ways of making our assessment and to implement this into our practice.