A realist evaluation protocol: assessing the effectiveness of a rapid response team model for mental state deterioration in acute hospitals.

Background: Mental state deterioration poses significant challenges in healthcare, impacting patients and providers. Symptoms like confusion and agitation can lead to prolonged hospital stays, increased costs, and the use of restrictive interventions. Despite its prevalence, there's a lack of consensus on effective practices for managing mental state deterioration in acute hospital settings.

Views of Mental Health Nurses on Responding to Clinical Aggression on General Wards.

The overall aim of this study was to explore the views of mental health nurses (MHNs) about their experience of responding to workplace violence (WPV) and aggression (code greys and blacks) within acute general wards. WPV continues to pose a significant source of challenge within healthcare settings despite several initiatives that have been trialled over the years. It has the potential to impact patient care and overall staff health and well-being.

Realist synthesis of a rapid response system in managing mental state deterioration in acute hospital settings.

Mental state deterioration in patients poses significant challenges in healthcare, potentially resulting in adverse outcomes for patients and continued reliance on restrictive interventions. Implementing evidence-based approaches such as a rapid response system that prioritises early identification and intervention can effectively manage adverse outcomes. However, little is known regarding the effectiveness of these interventions.

Realist synthesis protocol on the effectiveness of a rapid response system in managing mental state deterioration in acute hospital settings.

Introduction: Patient mental state deterioration impacts patient outcomes, staff and increases costs for healthcare organisations. Mental state is broadly defined to include not only mental health but a broad range of cognitive, emotional and psychological well-being factors. Mental state deterioration is inconsistently identified and managed within acute and tertiary medical settings.

Establishing a COVID-positive mental health ward: an Australian-first case study.

Objective: Managing mental health patients during the COVID-19 pandemic has been a global challenge. Current workforce arrangements tend to separate those skilled in caring for highly infectious medical patients from those whose specialism is in managing co-morbid mental health, substance misuse and/or behaviours of concern, including potential non-compliance with community or health care directives. This paper reports an innovative service development through the emergency establishment of a temporary COVID-positive mental health ward in response to a local outbreak in Melbourne.

How Do Mental Health Nurses Define Success? A Comparative Study of Bed-Based and Community-Based Services.

Nursing is the single largest professional group within both hospital and community mental health care services, however the role of mental health nurses in under-defined. The nursing workforce is also coming under increasing pressure from internal and external requirements, and nurses themselves are on the frontline of providing patient care in what can be a risky and unpredictable workplace environment. This project explored via interview the ways in which mental health nurses experience and reflect on their personal and professional feelings of nursing success.

Predictors for clinical deterioration of mental state in patients assessed by telephone-based mental health triage.

Patient safety research focussing on recognizing and responding to clinical deterioration is gaining momentum in generalist health, but has received little attention in mental health settings. The focus on early identification and prompt intervention for clinical deterioration enshrined in patient safety research is equally relevant to mental health, especially in triage and crisis care contexts, yet the knowledge gap in this area is substantial. The present study was a controlled cohort study (n = 817) that aimed to identify patient and service characteristics associated with clinical deterioration of mental state indicated by unplanned admission to an inpatient psychiatric unit following assessment by telephone-based mental health triage.

Crisis averted: How consumers experienced a police and clinical early response (PACER) unit responding to a mental health crisis.

When mental health crisis situations in the community are poorly handled, it can result in physical and emotional injuries. The purpose of this study was to ascertain the experiences and opinions of consumers about the way police and mental health services worked together, specifically via the Alfred Police and Clinical Early Response (A-PACER) model, to assist people experiencing a mental health crisis. Semi-structured in-depth interviews were conducted with 12 mental health consumers who had direct contact with the A-PACER team between June 2013 and March 2015.

Perceptions of crisis care in populations who self-referred to a telephone-based mental health triage service.

Although psychiatric crises are very common in people with mental illness, little is known about consumer perceptions of mental health crisis care. Given the current emphasis on recovery-oriented approaches, shared decision-making, and partnering with consumers in planning and delivering care, this knowledge gap is significant. Since the late 1990s, access to Australian mental health services has been facilitated by 24/7 telephone-based mental health triage systems, which provide initial psychiatric assessment, referral, support, and advice.

Outcomes achieved by and police and clinician perspectives on a joint police officer and mental health clinician mobile response unit.

Despite their limited mental health expertise, police are often first to respond to people experiencing a mental health crisis. Often the person in crisis is then transported to hospital for care, instead of receiving more immediate assessment and treatment in the community. The current study conducted an evaluation of an Australian joint police-mental health mobile response unit that aimed to improve the delivery of a community-based crisis response.

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage.

Inpatient views and experiences before and after implementing a totally smoke-free policy in the acute psychiatry hospital setting.

In the present study, we examined the views and experiences of patients admitted to an acute psychiatry unit before and after the implementation of a totally smoke-free policy. Forty-six inpatients completed a questionnaire assessing their views before the smoking ban. Another 52 inpatients completed a questionnaire assessing their views and experiences after the smoking ban.

Handover of patient information from the crisis assessment and treatment team to the inpatient psychiatric unit.

Handover, or the communication of patient information between clinicians, is a fundamental component of health care. Psychiatric settings are dynamic environments relying on timely and accurate communication to plan care and manage risk. Crisis assessment and treatment teams are the primary interface between community and mental health services in many Australian and international health services, facilitating access to assessment, treatment, and admission to hospital.

Establishing female-only areas in psychiatry wards to improve safety and quality of care for women.

Objective: Our aim was to assess the impact of creating a female-only area within a mixed-gender inpatient psychiatry service, on female patient safety and experience of care.

Method: The Alfred hospital reconfigured one of its two psychiatry wards to include a female-only area. Documented incidents compromising the safety of women on each ward in the 6 months following the refurbishment were compared.

Demonstrating the impact and model of care of a Statewide psychiatric intensive care service.

Objective: To characterise patients and their outcomes following referral to a Statewide psychiatric intensive care service.

Method: This study conducted a medical audit for patients referred to the Statewide service during the first four years of operation (2007-2011). Demographics and the presence of alcohol and other drug and forensic comorbidities were documented along with the treatment received prior to and during admission.

Mental health telephone triage: managing psychiatric crisis and emergency.

Purpose: The study aims to identify and articulate how mental health telephone triage (MHTT) clinicians manage psychiatric crisis and emergency via the telephone.

Design And Methods: An observational design was employed in the study. Wireless headsets were used to observe 197 occasions of MHTT.

Identifying the core competencies of mental health telephone triage.

Aims And Objectives: The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage.

Background: Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment.