Identifying mental health nursing research priorities: A Delphi study.

Abstract Engaging in research and using evidence based practice are essential for mental health nurses to provide quality nursing care to consumers and families. This paper reports on a Delphi study that identified the top 10 mental health nursing research priorities at one area health service in Australia servicing a population of 840,000 people. Initially 390 research questions were identified by nurses and these were then reduced to 56 broader questions. Finally, the top 10 questions were ranked in order of importance. The priority questions were clinically and professionally focussed and included research into the delivery and organisation of mental health services and the need to design and evaluate new practice paradigms for nurses in the primary care setting. The mental health knowledge and skill set of graduates from Australian comprehensive nursing programmes along with improved recruitment and retention of graduates in mental health were also identified priority areas for research.

Prevalence and nature of antipsychotic polypharmacy among inpatients with schizophrenia spectrum disorders at an Australian mental health service.

OBJECTIVE: Though antipsychotic polypharmacy (APP) is widely utilised in many clinical settings for the treatment of people with schizophrenia, the extent of this practice varies considerably between different regions, countries and clinical settings. Studies from Australasia exploring the prevalence and factors associated with APP are sparse and have yielded inconsistent results. METHODS: We conducted a systematic retrospective audit of the medical records of all admissions in 2010 in the adult wards of a metropolitan public mental health service in Western Australia, having a diagnosis of schizophrenia or schizoaffective disorder. We analysed the rates of APP use, and its association with selected demographic and clinical variables. RESULTS: The prevalence of APP among our sample of 229 patients was high, at 43.2%. APP was associated with a longer hospital stay (p=0.033) and voluntary admission (p=0.027); but APP was not significantly related to: age, gender, diagnosis and treatment by different psychiatrists. CONCLUSIONS: Substantial difference exists between everyday clinical practice and recommendations of practice guidelines of schizophrenia, regarding the use of APP. Prospective studies from different settings exploring the relevant clinical, patient, prescriber and system-related issues are warranted, to comprehend the rationale behind high utilisation of APP in clinical practice.

Identifying mental health nursing research priorities: A Delphi study.

Abstract Engaging in research and using evidence based practice are essential for mental health nurses to provide quality nursing care to consumers and families. This paper reports on a Delphi study that identified the top ten mental health nursing research priorities at one area health service in Australia servicing a population of 840,000 people. Initially 390 research questions were identified by nurses and these were then reduced to 56 broader questions. Finally, the top ten questions were ranked in order of importance. The priority questions were clinically and professionally focused and included research into the delivery and organisation of mental health services and the need to design and evaluate new practice paradigms for nurses in the primary care setting. The mental health knowledge and skill set of graduates from Australian comprehensive nursing programs along with improved recruitment and retention of graduates in mental health were also identified priority areas for research.

Assessing falls risk in older adult mental health patients: a Western Australian review.

Falls are a common and costly complication of hospitalization, particularly in older adult populations. This paper presents the results of a review of 139 falls at two older adult mental health services in Western Australia, Australia, over a 12-month period. Data were collected from the hospital incident report management system and from case file reviews of patients who sustained a fall during hospitalization. The results demonstrated that the use of different risk assessment and falls management tools led to variations in practice, policies, and management strategies. The review identified mental health-specific falls risk factors that place older people with a mental illness at risk when admitted to the acute mental health setting. With the expansion of community mental health care, many older people with a mental illness are now cared for in a variety of health-care settings. In assessing falls risk and implementing falls-prevention strategies, it is important for clinicians to recognize this group as an ambulant population with a fluctuating course of illness. They have related risks that require specialized falls assessment and management.