Journal of Psychosocial Nursing and Mental Health Services
Vol. 47 No. 3 March 2009
Handover in Psychiatric Settings: Is Change Needed?
Michelle Cleary, PhD, RN; Garry Walter, PhD, MB BS, BMedSc, FRANZCP; and Jan Horsfall, PhD
ABSTRACT
Handover is a tradition in mental health settings and can occupy a significant amount of time each day, yet the topic has commanded limited attention in the psychiatric literature. Increasing staff changes and growing reliance on casual staff has heightened the need for the effective and efficient transfer of essential information, as staff will often find themselves in settings with unfamiliar patients. In this context, effective and timely handovers are crucial. The aim of this article is to examine handover and consider how it may be used optimally to enhance service delivery. To reduce information loss and increase accuracy, verbal handover could be supplemented with computer-generated patient data. This combination will ensure face-to-face interaction remains and perhaps decrease time spent unproductively. Further research is necessary to evaluate such a handover system.
AUTHORS
Dr. Cleary is Clinical Nurse Consultant, Research Unit, Sydney South West Area Mental Health Service, Dr. Walter is Professor of Child and Adolescent Psychiatry, Discipline of Psychological Medicine, University of Sydney, and Area Clinical Director, Child and Adolescent Mental Health Services, Northern Sydney Central Coast Health, and Dr. Horsfall is Research Officer, Research Unit, Sydney South West Area Mental Health Service, Sydney, New South Wales, Australia.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
The authors thank Sandra Matheson for her contribution to an earlier draft of the manuscript.
Address correspondence to Michelle Cleary, PhD, RN, Research Unit, Level 1 Executive Unit and Administration Support, Concord Centre for Mental Health, Concord Hospital, Hospital Road, Concord, New South Wales, 2139, Australia; e-mail: michelle.cleary@email.cs.nsw.gov.au.
The Role of Nurse Practitioners in Meeting the Need for Child and Adolescent Psychiatric Services: A Statewide Survey
Lara Kaye, PhD, MSW; Lynn Alice Warner, PhD, MSW, MPP; Cathleen A. Lewandowski, PhD; Rose Greene, MA; Janet K. Acker, LCSW-R; and Nancy Chiarella, MSW
ABSTRACT
The high prevalence of child and adolescent mental health disorders coupled with shortages in age-appropriate mental health services pose a significant problem likely to be exacerbated over time. A survey was designed to identify the current status of and need for child and adolescent psychiatrists (CAPs) and mental health services, as well as strategies and recommendations to address identified needs in the state of New York. Key informants from each county and New York City were surveyed by telephone (N = 58). Most respondents identified a shortage of child and adolescent psychiatry services and reported that when CAPs are unavailable, nurse practitioners (NPs) are currently among the top four professional groups who prescribe and/or monitor psychotropic medication. Almost half of the respondents (48%) identified employing NPs with advanced certification in child and adolescent psychiatry as a promising strategy to improve access to care. Addressing the shortage of CAPs can provide an opportunity for the nursing profession to advance its role in the provision of mental health services to youth.
AUTHORS
Dr. Kaye is Research Scientist, Dr. Lewandowski is Director, Ms. Greene is Associate Director, and Ms. Chiarella is Research Support Specialist, Center for Human Services Research, University at Albany; Dr. Kaye is also Assistant Research Professor, Dr. Warner and Dr. Lewandowski are Associate Professors, and Ms. Acker is Research Assistant, School of Social Welfare, University at Albany, The State University of New York, Albany, New York.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity.
This study was supported by the New York State Conference of Local Mental Hygiene Directors as part of their Solution to End Psychiatric Shortages (STEPS) Initiative.
Address correspondence to Lara Kaye, PhD, MSW, Research Scientist, Center for Human Services Research, and Assistant Research Professor, School of Social Welfare, Richardson 184, University at Albany, 135 Western Avenue, Albany, NY 12222; e-mail: lkaye@uamail.albany.edu.
Physical Restraint in Acute Care Psychiatry: A Humanistic and Realistic Nursing Approach
Lois Biggin Moylan, PhD, RN
ABSTRACT
Despite the many advances in psychiatry, violence in acute care settings continues and may be increasing. This is particularly problematic, considering the desire of mental health professionals to attain the goal of a restraint-free environment. Respecting the inherent worth, dignity, and autonomy of the patient is necessary if a therapeutic outcome is to be achieved; however, protecting the safety of the patient, other patients, and the caregivers is of no less importance, yet this responsibility also carries with it legal and ethical implications. Balancing these two responsibilities can be realized even in a situation where supportive therapeutic interventions have been ineffective in de-escalation of an aggressive patient. When used with a compassionate, humanistic approach, restraint can achieve a therapeutic outcome for the patient while protecting the safety of others.
AUTHOR
Dr. Moylan is Professor of Nursing, Molloy College, Rockville Centre, New York.
The author discloses that she has no significant financial interests in any product or class of products discussed directly or indirectly in this activity, including research support.
Address correspondence to Lois Biggin Moylan, PhD, RN, Professor of Nursing, Molloy College, 1000 Hempstead Avenue, Rockville Centre, NY 11571-5002; e-mail: lmoylan@molloy.edu.
