Biomedical subjects

Michelle Cleary

Publications and source records attributed to Michelle Cleary.

9 recordsLinked to original sources

PubMed2003

Consumer feedback on nursing care and discharge planning.

BACKGROUND: Gaining consumer feedback about nursing care and discharge planning is especially important given the changes that have occurred in acute inpatient mental health facilities. Consumers can best define the quality of the service they receive and surveys are considered to be good sources of information about nursing care and discharge planning. AIM: The aims of this study were to clarify consumer discharge needs, ascertain consumer perceptions of helpful practice, identify areas that require improvement, identify resources consumers deem important, ascertain satisfaction with specific aspects of services, and obtain baseline data to improve future discharge planning. METHOD: Satisfaction-with-services and discharge questionnaires were completed by clients (39 and 45, respectively) prior to discharge from three acute inpatient mental health units over a 2-month period. FINDINGS: Findings indicated that clients were most satisfied with the respect they received from staff, attention staff gave to concerns and worries, quality of service provided by nurses, way treatment met client needs and overall stay in hospital. The majority of respondents (95%) indicated that their discharge arrangements were explained to them and 90% were satisfied with these. Whilst over two-thirds indicated that the information provided in hospital to assist with discharge had been helpful, they highlighted some areas for service improvement. Resources to prepare them better for discharge included increased contact with consumer consultants and more information about mental health problems, medication and relapse prevention. CONCLUSION: This study constitutes another small step towards decreasing the gap between consumer expectations and actual treatment by asking consumers about their perceptions of discharge planning. The findings provide the basis for the development of more appropriate strategies to improve the continuity of services between hospital and community mental health settings.

Adult↗

PubMed2003

The challenges of mental health care reform for contemporary mental health nursing practice: relationships, power and control.

This ethnographic investigation was concerned with the way mental health nurses' construct their practice in an acute inpatient psychiatric unit in light of the current challenges, demands and influences brought about by service reforms of the 1990s. The setting for this study was a 22-bed acute inpatient mental health facility. Over a 5-month period, data were collected through fieldwork observations, focused interviews and discussion groups. In this article, common cultural practices in relation to the imperatives of relationships, power, restrictions and safety are discussed. The findings demonstrate how the client stabilization role of the unit locates these imperatives as central to the delivery of nursing care. The discussion reveals nurses negotiating relationships that are contradictory and challenging in ordinary and everyday ways within the exigencies of daily practice.

Australia↗

PubMed2003

Guidelines for presentations and publications.

The oral and written presentation of work arising from clinical practice, service development, quality improvement projects and research is presently encouraged and supported. Because this work may involve consumers, staff and the organization, it is important that proper consideration is given to how the work is disseminated, including any ethical implications. There is a need to ensure that consumers, staff, facilities, the organization and intellectual property are protected from any potential concerns that may arise. This research note provides protocols and a checklist that may be of interest and may be relevant for clinicians and researchers to review and appraise their work before oral or written presentation.

Guidelines as Topic↗

PubMed2002

Mental health quality improvement: what about ethics?

Nurses are increasingly developing and coordinating quality improvement projects under the auspices of state, area health service and organization policies, however, ethical frameworks are commonly absent. This study aims to define key terms, provide an overview of current policy in relation to ethics and outline some procedures and processes for mental health nurses involved in such projects. The use of appropriate ethical frameworks has the potential to foster participation and safeguard participants by providing a greater assurance of integrity and confidentiality regarding quality improvement data collection, utilization and dissemination.

Attitude of Health Personnel↗

PubMed2002

Quality improvement projects: finding a pathway through policies.

It is increasingly common for mental health nurses to develop and implement quality improvement and/or research projects. The requirement that these activities be conducted in accordance with local, state and national policy; organizational accreditation frameworks; and within ethical frameworks is daunting. This paper aims to define relevant terms, relate some of the competing demands to each other and outline a pathway for developing nurse-based quality-related projects. When a specific exemplar is required, protocols from Central Sydney Area Mental Health Service will be drawn upon as it is likely that policy developed in this health area will not be significantly different to that of other health areas in New South Wales and other Australian States.

Australia↗

PubMed2002

Experience, knowledge and attitudes of mental health staff regarding clients with a borderline personality disorder.

A survey of mental health staff experience, knowledge and attitudes regarding the management of clients with a diagnosis of borderline personality disorder (BPD) aimed to obtain baseline data to provide direction for developing planned education and determining staff willingness to participate in such training. A 23-item questionnaire was developed and posted to mental health staff in a public Area Mental Health Service in New South Wales (n = 516). A total of 229 staff completed the questionnaire. Most staff (85%) reported having contact with clients who have a diagnosis of BPD at least once a month or more frequently, with 32% of respondents reporting daily contact. Eighty per cent of respondents found dealing with clients who have a BPD to be moderate to very difficult; 84% of staff felt that dealing with this client group was more difficult than dealing with other client groups. Most staff (82%) believed that, as mental health professionals, they had a role in the assessment, management and referral of clients with BPD, as well as in educating and providing information. Staff readily identified resources which would be helpful to them when working with such clients. It was encouraging to see that the majority of staff (95%) indicated their willingness to gain further education and training in the management of these clients. Although many staff believed they were knowledgeable about and confident in managing these clients, most staff also indicated difficulties posed by these clients and perceived a need for further education and training in this area.

Adult↗

PubMed2002

Ethical practice guidelines: an evaluation.

Ethical practice guidelines (EPGs) were developed for use in Central Sydney Area Mental Health Service to guide contemporary mental health nursing practice and serve as a resource for clinical mental health nurses in relation to their professional conduct and practice. This survey of mental health nurses aimed to ascertain feedback on the application of the EPGs in the clinical arena. Nurses from the Central Sydney Area Mental Health Service (n = 350) were asked to complete a 15-item survey developed by the authors. A total of 121 nurses completed the survey. Findings from the survey reveal that the information provided in the EPGs is useful (91%) and the EPGs provide sufficient guidance for practice (94%). Most respondents (96%) reported feeling confident dealing with ethical practice situations and 75% indicated interest in further education and training in this domain. Findings from this survey support the need to explore avenues to facilitate education, discussion and reflective practice in relation to ethical mental health nursing practice.

Attitude of Health Personnel↗

PubMed2002

Measuring outcomes in the workplace: the impact of an education program.

There is an increasing pressure for mental health nurses to engage in research and quality improvement activities to demonstrate how nursing care contributes to improved patient outcomes. This paper describes the evaluation of an educational program, particularly its impact on participants' attitudes towards and confidence in the measurement of patient outcomes. Nurses from the Central Sydney Area Mental Health Service (n = 38) participated in one of two 1-day workshops. The participants were asked to complete three surveys. The first prior to the commencement of the workshop, the second on completion of the workshop and the third 3 months later. The findings suggest the workshops were beneficial to participants in many areas relevant to the measurement of outcomes. The recommendations made on the basis of this study are described.

Adult↗

PubMedDate not supplied

Patient concerns about seclusion: developing a leaflet.

Seclusion continues to be used as a last resort in many acute in-patient mental health facilities, hence, mental health nurses must consider a range of strategies to improve seclusion practice. This article reviews selected literature to glean relevant information to provide to patients regarding seclusion protocols, rationales, and aims. Some postseclusion debriefing, nurse education, and organizational monitoring issues are also briefly discussed. The provision of supplementary written patient information about seclusion processes has the potential to decrease patient anxiety and fear. This initiative involves collaboration with consumer consultants to creatively develop effective solutions to some long-standing patient-identified problems associated with the experience of seclusion.

Attitude↗