Biomedical subjects

Michelle Cleary

Publications and source records attributed to Michelle Cleary.

At least 19 recordsLinked to original sources

PubMed2006

Patient and carer perceptions of need and associations with care-giving burden in an integrated adult mental health service.

OBJECTIVE: To identify patients' and carers' perceptions of need in inpatient and community settings and investigate the relationship between need and caregiver burden. METHOD: The study was conducted across a metropolitan mental health service in Sydney, Australia. Patients (n = 407) and carers (n = 50) completed the Camberwell Assessment of Need Short Appraisal Schedule. Carers also completed a shortened version of the Involvement Evaluation Questionnaire to assess caregiver burden. RESULTS: When completing the assessment tools, patients and carers in hospital settings were asked to consider the 4 weeks preceding hospitalisation; in the community, patients and carers were asked to consider the previous 4 weeks. These data show a high percentage of patients in hospital and community settings have unmet needs for company, daytime activities and intimate relationships. Inpatients had more unmet needs than community based patients. Agreement between patients' and carers ratings' of need ranged from 'poor' to 'moderate'. There was a strong relationship between unmet need and burden from the carer's perspective. Patients with and without carers had similar numbers of needs. Carers of patients recently admitted to hospital reported a significantly higher burden. CONCLUSIONS: Carers of inpatients experienced significantly more burden than carers of outpatients. Opportunities to access support, information and education should be readily available and not contingent upon demonstrating a close familial relationship to the patient. We found that unmet need was significantly related to burden, suggesting that meeting patient needs could reduce carer burden.

Adult↗

PubMed2006

Fostering a culture of support in mental health settings: alternatives to traditional models of clinical supervision.

Clinical supervision [CS] for mental health nurses in inpatient settings in Sydney, Australia, is virtually nonexistent despite over a decade of discussion regarding its benefits to staff, patients, and organisations. Whilst there is general agreement about the merit of CS, its ad-hoc implementation and the use of models that do not correspond to the realities of the environment have led to its adoption being somewhat half-hearted. It is unsurprising then that there is an absence of achievable policy regarding CS making its integration into modern inpatient units even harder to attain. In this paper, we outline some pragmatic issues concerning CS and advocate for facility-specific professional development and support processes that incorporate succession planning opportunities. This we believe has the potential to promote professional behaviour, continuous learning and development, cohesive teamwork, and ultimately a change in culture regarding CS.

Culture↗

PubMed2006

The quest to fund research: playing research lotto.

OBJECTIVE: To provide some direction for those interested in obtaining funding with the purpose of highlighting opportunities for beginner researchers in the health-care field. METHOD: Features of a good grant application are described and an audit of seven mental health professional journals was undertaken, the latter to determine, inter alia, whether the paper reported research findings and whether the authors received formal research funding. RESULT: The audit revealed that many types of papers that are published do not receive formal research funding and describe, for example, services, training issues, clinical practice and education programmes. CONCLUSION: Innovative and enterprising efforts are required to secure clinical research funding. Submissions must be detailed, comprehensive and relevant, but the onus is also on the researcher to ensure a feasible study, where funding obligations can be fulfilled and findings readily disseminated. Many research studies are conducted without achieving competitive funding, and getting published--and getting started in writing--does not hinge on conducting formal research or receiving research funding.

Australia↗

PubMed2006

'Consumer consultant': expanding the role of consumers in modern mental health services.

We aim to increase understanding about issues affecting 'consumer consultants' at an Area Mental Health Service level in the hope that consumers and mental health staff are informed of the challenges and changes associated with that role. Anecdotal feedback indicates that consumer consultants are working harder than ever and that their role is more diverse and challenging than before. Increased organizational demands and responsibilities are testing traditional roles and approaches. There is opportunity for greater sharing of expertise and skills among health professional staff and consumer consultants to enhance current work practices, increase workplace satisfaction, and achieve positive patient outcomes.

Community Participation↗

PubMed2006

Carer participation in mental health service delivery.

There is increasing emphasis on enhancing consumer and carer participation in the planning and provision of mental health services. However, health professionals, consumers, and carers have different perceptions about what constitutes optimal care; identifying, negotiating, and meeting their respective needs can be challenging. The aim of the paper is to highlight the challenges of facilitating carer participation in daily practice and emphasize the broader issues that would benefit from more extensive discussion among health professionals. By examining the strategies used to enhance consumer participation, there is the potential to avoid many of the mistakes of the past and create a flexible and responsive framework to increase carer involvement. The authors anticipate that this discussion will resonate with many clinical staff as well as carers themselves. Identifying barriers to carer participation opens the way to promoting collaboration and enhancing care.

Attitude to Health↗

PubMed2005

The development, implementation, and evaluation of a clinical leadership program for mental health nurses.

A structured clinical leadership program was developed to assist nurses working in a metropolitan mental health service to develop and consolidate clinical leadership skills. The Nurses' Self-Concept Questionnaire (NSCO) was used to elicit responses from participants prior to commencement of the leadership program and again at completion. Findings indicate that the program was considered useful and its benefits were carried over into the workplace via the sharing of information. The self-directed nature of this program was found to be an effective way for clinical nurses to undertake continued professional development within the exigencies of clinical practice.

Adult↗

PubMed2005

The cultural realities of clinical supervision in an acute inpatient mental health setting.

In this paper, the cultural realities of clinical supervision (CS) in acute inpatient mental health settings are explored using an ethnographic approach. Findings suggest that there is a verbal acceptance of CS by mental health nurses but a cultural belief that it has limited experiential value and, thus, a cautious attitude towards its adoption is in practice. This may, in part, be attributable to many nurses believing that they are already undertaking CS, although the informal supervision described does not fit with established definitions of formal supervision. The language used by nurses demonstrates an understanding and appreciation of the benefits of clinical supervision. However, the belief that existing structures inherent to nursing practice already convey these benefits may contribute to the culture of passive resistance to clinical supervision revealed by the findings. This study contributes to current discussions regarding the purpose of CS, the realities of its implementation, and its role relative to existing professional support opportunities.

Acute Disease↗

PubMed2005

What patients and carers want to know: an exploration of information and resource needs in adult mental health services.

OBJECTIVE: The objectives of this study were to: (i) obtain baseline data on the extent of carer involvement across a representative sample of hospital and community patients within an integrated area health service; and (ii) examine perspectives on discharge planning and community care among patients and their carers to identify information and resources they consider important. METHOD: Over a 4-month period, inpatients before discharge and patients accessing community mental health services participated in face-to-face interviews. Information was collected about carer involvement and, with the patient's consent, the identified carer was sent a similar survey to determine demographics and information needs. This resulted in a representative sample of patients and carers accessing inpatient and community settings across a metropolitan mental health service. Support needs and carer burden were also assessed but are not reported here. RESULTS: A total of 407 interviews were completed, 207 in inpatient settings and 200 in the community. An inpatient response rate of 70% and a community response rate of 75% was achieved. Across both settings, 67% of patients identified a carer and a carer response rate of 28% was then obtained. We found carers and patients have different priorities regarding the information they want and information is often not provided to carers. Furthermore, patients were more confident in their ability to manage their mental health in the community than carers. CONCLUSIONS: This study yielded important baseline data about the number of patients who have a carer. We were also able to determine that routine clinical information provided to patients and carers is inadequate from their perspective. It is anticipated that this initiative will assist ongoing service planning and improve partnerships with patients and their carers.

Adult↗

PubMed2005

Towards a healthier lifestyle for staff of a psychiatric hospital: description of a pilot programme.

Various lifestyle factors contribute to morbidity and mortality. Health promotion programs have the potential to increase awareness about, and possibly modify, some of these factors. In the workplace, these programs can be accessed by large groups of people. A healthy lifestyles programme was piloted for non-clinical staff in Central Sydney Area Mental Health Service, Australia. The aim of the programme was to provide non-clinical staff working in a mental health setting with education and information on a range of health conditions and topics. A needs analysis survey, along with formal and informal liaison and discussion, informed the programme's development and implementation. A total of 28 sessions were held; attendance ranged from 1 to 51 with a mean of 13.57 and a median of 12.5. Feedback regarding the programme has generally been positive. This pilot demonstrates that nurses, with their colleagues from other disciplines, are well positioned to deliver health promotion and education initiatives that may contribute to increasing awareness, and possibly modification, of lifestyle factors.

Health Promotion↗

PubMed2005

Email etiquette: guidelines for mental health nurses.

This note is about the use of email and its role in mental health settings. We anticipate that it may be of assistance to mental health nurses unfamiliar with the benefits and pitfalls of email and wanting to learn more about how to use it professionally and effectively. In mental health nursing, we pride ourselves on our interpersonal skills and being able to communicate. However, transferring these skills to an electronic medium is not always easy. Because many of us are self-taught, there is potential for email to be a hindrance rather than a help in the quest for good collegial relationships. In this note, we discuss some of the common situations that can arise when email use goes awry and provide some helpful tips for getting the most out of email. It is hoped that the information and checklist provided in this paper will strike a chord with many, encouraging discussion and promoting appropriate use of this form of communication.

Electronic Mail↗

PubMed2005

The experience and views of mental health nurses regarding nursing care delivery in an integrated, inpatient setting.

Positive and effective consumer outcomes hinge on having in place optimal models of nursing care delivery. The aim of this study was to ascertain the experience and views of mental health nurses, working in hospitals in an area mental health service, regarding nursing care delivery in those settings. Surveys (n = 250) were sent to all mental health nurses working in inpatient settings and 118 (47%) were returned. Results showed that the quality of nursing care achieved high ratings (by 87%), and that two-thirds of respondents were proud to be a mental health nurse and would choose to be a mental health nurse again. Similarly, the majority (71%) would recommend mental health nursing to others. Concern was, however, expressed about the continuity and consistency of nursing work and information technology resources. Nurses with community experiences rated the importance of the following items, or their confidence, higher than those without previous community placements: the importance of interdisciplinary teamwork; the importance of participating in case review; the importance of collaborating with community staff; confidence in performing mental state examinations; and confidence in collaborating with community staff, suggesting that this placement had positive effects on acute care nursing.

Adaptation, Psychological↗

PubMed2005

Promoting a sustainable mental health nursing workforce: an evaluation of a transition mental health nursing programme.

The recruitment and retention of the mental health nursing workforce has been identified as a major issue both nationally and internationally. Transition to practice programmes has been identified as an important strategy in addressing these issues. There is, however, a paucity of literature addressing the potential or effectiveness of transition programmes in achieving these aims. This paper reports the findings of a survey administered to registered nurses at the commencement and completion of the Transition Programme into Mental Health Nursing, in Sydney, Australia. The findings suggest a high level of satisfaction with the programme. The results are directing the ongoing development of clinical placements, clinical supports, education programmes and recruitment and retention initiatives for nurses within the Central Sydney Area Mental Health Service.

Adult↗

PubMed2005

Facilitating research within clinical settings: the development of a beginner's guide.

Increased consumer participation, clinical governance, accreditation, and occupational health and safety requirements have contributed to considerable changes in the demands placed upon mental health staff, and many are now expected to undertake or participate in research. However, many staff have not received formal training in research design and methodology, and the multitude of policies, procedures, and committees, designed to protect research participants, can seem like insurmountable barriers to clinicians new to the field. In response to this, a guide was developed based on self-directed learning principles, to compliment other resource material and promote effective research work. It was considered important to clarify some of the issues surrounding research development, ethics, and scholarly integrity, and to educate staff as to the appropriate approval processes, which must be followed before embarking on research work. This paper seeks to describe the process of developing a guide for novice researchers, its key characteristics, and its implications for practice. The guide 'Undertaking research: a guide for the beginner' described in this paper, provides a helpful resource that can be readily adapted and developed for a variety of workplaces and professional backgrounds. It is a strategy intended to encourage research and ongoing education and narrow the research-practice gap while placing minimum demand upon existing organizational infrastructure.

Clinical Nursing Research↗

PubMed2005

Self-directed learning and portfolio development for nurses: developing workbooks as a facilitative tool.

Workbooks are often used for discipline-specific learning in academic institutions but there is growing recognition of their potential usefulness in the clinical setting to promote learning and professional development. The purpose of this paper is to share some tips/guidelines for those clinical staff interested in developing self-directed learning programs using a workbook approach. Combined with skilled facilitation, custom designed workbooks based on adult learning theories can enhance skills and encourage portfolio development in the clinical setting. This cost and time effective approach utilises existing resources to cater to diverse needs and topics, building sustainable collaborations. This paper will argue that the proposed program has the potential to contribute to healthcare improvement by promoting skill development amongst staff and contributing to evidence-based practice.

Clinical Competence↗

PubMed2005

Making evidence based practice a reality for mental health nursing.

In recent years, efforts have been directed towards making mental health nursing more evidence-based. Making evidence based practice (EBP) a reality in modern health services requires due attention to service planning and management. It is acknowledged that there are many challenges and barriers to implementing EBP as outlined in this article. However, by using an example from our mental health service and drawing upon the literature, we show that a variety of techniques can be used to incorporate EBP into everyday practice. A combination of approaches is recommended, including education and training, leadership programs, research units, dissemination of research findings and structural changes to draw upon the expertise of key clinical, education, management and research staff.

Australia↗

PubMed2004

Apportioning our time and energy: oral presentation, poster, journal article or other?

There is a general expectation for health service employees to present their work in oral or written format to showcase clinical ideas, innovations, service developments, and quality and research initiatives. This research note outlines the types of forums where work can be presented and highlights their relative merits. It is anticipated that this discussion will be of interest to clinicians, managers and researchers when considering where best to present their work.

Clinical Nursing Research↗

PubMed2004

The realities of mental health nursing in acute inpatient environments.

The purpose of this ethnographic study was to understand how nurses construct their practice in an acute inpatient psychiatric unit in light of the current challenges, demands and influences brought about by service reform. During a 5-month period, fieldwork observations, interviews and discussion groups occurred in a 22-bed acute inpatient mental health facility in New South Wales, Australia. The findings demonstrate how the current role of acute care has resulted in nurses working in increasingly complex environments characterized by competing priorities and new demands. Nurses struggled to fit the changed service philosophy with traditional models of practice within this fluid and changing environment. The findings are relevant within the context of current debates and can be used to enhance the understanding of contemporary acute mental health nursing practice and inform the continued development of mental health nursing in these settings.

Acute Disease↗

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↗