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Biomedical subjects

Heather Jarman

Publications and source records attributed to Heather Jarman.

6 recordsLinked to original sources

Emergency department mental health triage scales improve outcomes.

The assessment and management of clients with mental illness is an important facet of providing emergency care. In Australian emergency departments, it is usually the generalist registered nurses* without adequate preparation in the assessment and care for clients with mental illness who conduct the initial assessment at triage. A search of the literature revealed a limited number of publications addressing the provision of triage and management guidelines to assist nurses to make objective clinical decisions to ensure appropriate care for clients with mental illness. This paper examines the need for such guidelines and reviews a number of mental health triage scales that have been evaluated for use in emergency departments. Findings show that these triage scales have led to improvements in staff confidence and attitudes when dealing with clients with mental health problems, resulting in improved outcomes for clients. Strengths and limitations of the evaluations have also been explored. Highlighted is the need for consideration of the inclusion of clients' reactions to the impact of this change to service delivery in future evaluations.

Australia↗

The clinical application of three screening tools for recognizing post-partum depression.

Postnatal depression is a major health issue for childbearing women world-wide, as it is not always identified early. This study aimed to evaluate the clinical application of three screening instruments for the early recognition of post-partum depression, the Postpartum Depression Prediction Inventory, the Postpartum Depression Screening Scale and the Edinburgh Postnatal Depression Scale, and to examine nurse interventions following use of the instruments. Data were collected at two points, at 28 weeks prenatal (107 women) and eight weeks postnatal (84 women). Results showed that 17% of the women scored significant symptoms of post-partum depression and 10-15% had a positive screen for major postnatal depression. There was a statistically significant correlation between the total score on the Postpartum Depression Screening Scale and the Edinburgh Postnatal Depression Scale. Of those eight women identified as being at risk, seven had received anticipatory guidance and five had received counselling by the nurses. The Postpartum Depression Prediction Inventory enabled nurses to identify women at risk of post-partum depression and offer interventions.

Adult↗

Allowing the patients to sleep: flexible medication times in an acute hospital.

In 1999, under the leadership and direction of the Director of Clinical Services (Nursing), Roger Napthine, Project Consultant, was commissioned to undertake a review of medication policies and practices for a regional acute-care hospital. This initiative was taken with the view of improving nursing practice and patient care. Recommendations from Napthine's review included the trial in a medical and a surgical unit of a change in the administration of routine morning and evening medication times. A descriptive study that included a convenience sample of 52 patients and 25 registered nurses was conducted in the two units. The findings demonstrated that patients were able to sleep longer. Further, although they tended to wake earlier, their 'in hospital' and 'at home' sleeping patterns were more closely aligned. There was agreement among the nurse participants that the change to flexible medication times allowed patients to sleep longer. However, concerns were raised about the impact of the change on other nursing duties, particularly those performed in the mornings.

Acute Disease↗

Medication study supports registered nurses' competence for single checking.

In 1999, a review of medication policies and practices for The Geelong Hospital, a Victorian regional acute care hospital, was conducted under the leadership and direction of the Executive Nursing Director. The findings of the review suggested that a study be conducted to examine the safety of single-person (registered nurse division 1) checking of a designated group of medications that had previously been double-checked. The present study was conducted as a descriptive study in adult inpatient units and speciality and midwifery services of The Geelong Hospital, and included the monitoring of medication errors for the designated group of medications under a single-person checking protocol for a 7-month period. A similar number of medication errors were reported when compared with a similar time-frame in which double-person checking was standard practice. At the completion of the study, a convenience sample of 129 nurses from the participating units and services completed questionnaires. The majority of the nurses appreciated the increased autonomy the change to single-person checking of medications provided. They also identified benefits for patients, including that they were able to be more responsive to patient needs.

Attitude of Health Personnel↗

Private practice--an advanced practice option.

Currently there is considerable debate on the role and function of nurses in Australia and internationally. This debate stems from developments within the nursing profession itself from political and economic issues in health platforms, due to restructuring of the health care system, consumer expectations of health care and nurses' expectations of a career. This paper provides the opportunity to reflect on the development of the role of the private practice (independent nurse) and where that role is situated in the nursing profession. This forms the basis for discussion of the development of specialty practice at an advanced level in Australia and to demonstrate its relationship with the nurse practitioner movement in Australia.

Attitude of Health Personnel↗

The early detection of postpartum depression: midwives and nurses trial a checklist.

OBJECTIVE: To evaluate the use of a standard pen-and-paper test versus the use of a checklist for the early identification of women at risk of postpartum depression and to investigate the experiences of nurses in using the checklist. DESIGN: A prospective cohort design using repeated measures. SETTING: The booking-in prenatal clinic at a regional hospital in Victoria, Australia, and the community-based postpartum maternal and child health service. PARTICIPANTS: 107 pregnant women over 20 years of age. MAIN MEASURES: Postpartum Depression Prediction Inventory (PDPI), Postpartum Depression Screening Scale (PDSS), Edinburgh Postnatal Depression Scale (EPDS), demographic questionnaire, and data on the outcome from the midwives and nurses. RESULTS: The PDPI identified 45% of the women at risk of depression during pregnancy and 30% postpartum. The PDSS and EPDS both identified the same 8 women (10%), who scored highly for depression at the 8-week postpartum health visit. Nurses provided 80% of the women with anticipatory guidance on postpartum depression in the prenatal period and 46% of women at the 8-week postpartum health visit. Nurse counseling or anticipatory guidance was provided for 60% of the women in the prenatal period. CONCLUSION: The PDPI was found to be a valuable checklist by many nurses involved in this research, particularly as a way of initiating open discussion with women about postpartum depression. It correlated strongly with both the PDSS and the EPDS, suggesting that it is useful as an inventory to identify women at risk of postpartum depression.

Adult↗