scholarly journals Experiences of advanced psychiatric nurses regarding the need for prescriptive authority in KwaZulu-Natal

2021 ◽  
Vol 26 ◽  
Author(s):  
Eve P. Jacobs ◽  
Sipho W. Mkhize
Keyword(s):  
Quality Care ◽  
Mental Healthcare ◽  
Psychiatric Nurses ◽  
Prescribe Medication ◽  
Prescriptive Authority ◽  
Nurse Prescribing ◽  
Nurse Role ◽  
Kwazulu Natal ◽  
Optimal Health ◽  
Colaizzi's Method

Background: Nurse prescribing has become a global and transformational practice to ensure the achieving of optimal health outcomes, including advanced psychiatric nurses. Despite the transformational practice globally, South Africa seems to lag behind because nurses do not have permission to prescribe medication.Aim: To describe the experiences of advanced psychiatric nurses regarding the need to prescribe medication treatment in KwaZulu-Natal.Setting: The study took place in three mental healthcare institutions in KwaZulu-Natal in inpatient units.Method: The qualitative, descriptive design was used to collect the experiences of advanced psychiatric nurses in KwaZulu-Natal regarding the need for prescriptive authority. Six focus group interviews were conducted to gather information. The seven steps of Colaizzi’s method were used to analyze the data.Results: The study found two primary themes and two sub-themes. The findings highlighted the necessity for advanced psychiatric nurse role recognition and prescribing. Insufficient use of skilled psychiatric nurses caused delays in addressing mental health patients in emergencies.Conclusion: The two themes, prescribing role of advanced psychiatric nurses and role recognition, revealed that granting advanced psychiatric nurses’ autonomy to prescribe remained a challenge. Advanced psychiatric nurses are expected to provide high-quality care, but they are limited in their abilities. Because advanced psychiatric nurses are not used to prescribe in KwaZulu-Natal, they rely on psychiatrists to manage psychotic patients.Contribution: The evaluation of policies and procedures that guide advanced psychiatric nurses in prescribing psychotropic medications.

scholarly journals The DELTA® nursing measure: Its development and testing for nursing utility

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Hendrik J. Loubser ◽  
Judith C. Bruce ◽  
Daleen Casteleijn
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Content Analysis ◽  
Health Outcomes ◽  
Mental Healthcare ◽  
Mental Health Outcomes ◽  
Psychiatric Nurses ◽  
Multidisciplinary Teams ◽  
Analysis Techniques ◽  
Care Plans

In the specialised nursing field of acute mental illness nurses expressed a need to measure and evaluate their patients’ mental-health outcomes both empirically and routinely. The aim was to develop and test a measurement tool, named the DELTA nursing measure, which could be embedded routinely into the nursing process and care plans, enabling the psychiatric nurses to score and evaluate their patients’ acute mental-health outcomes. A qualitative, exploratory study design was used to address two sequential objectives. Firstly, qualitative data that described observable behaviours in patients with acute mental illness were collected from psychiatric nurses (n = 5) who were experienced in acute mental healthcare. The data were analysed using inductive content analysis techniques to design and construct the DELTA nursing measure. In the second objective, the nursing utility of the DELTA nursing measure was studied. This was done by training and testing a new team of psychiatric nurses (n = 25) working in a 116-bed acute psychiatric hospital, in the application of the DELTA nursing measure. After 30 months a focus group (n = 6) representing this team was held to explore their perceptions and experiences of the nursing utility of the newly-developed measure. The descriptive data were analysed using deductive content analysis techniques. The outcome of the DELTA nursing measure as a routine nursing measure of acute mental illness provided good results. The nursing-utility characteristics have confirmed positive responses with regard to its acceptance, usefulness and confidence as a worthwhile tool to be used in expediting nursing services in acute mental healthcare. The positive responses to the DELTA nursing measure are noteworthy. It has the potential to add substantial value to the mental health care field in nursing by adding a measurable dimension to patient outcomes, a much needed requirement by patients, multidisciplinary teams and healthcare funders.In die gespesialiseerde verplegingsveld van akute psigiatrie het verpleegkundiges ’n behoefte uitgespreek om roetineweg pasiënte se geestesgesondheidsuitkomste empiries te meet en te evalueer. Die doel van die studie was om ’n meetinstrument, genoemd die ‘DELTA nursing measure’, te ontwikkel en toets wat ingebed kan word in die verplegingsproses en versorgingsplan en wat psigiatriese verpleegkundiges in staat kan stel om roetine-weg die pasiënte se akute geestesgesondheidsuitkomste te meet en te evalueer. ’n Kwalitatiewe, eksploratiewe studie ontwerp is gebruik om twee opeenvolgende doelwitte aan te spreek. Eerstens is kwalitatiewe data wat observeerbare gedrag in pasiënte met akute geestessiektes beskryf ingesamel van psigiatriese verpleegkundiges (n = 5) wat ervaring het in akute geestesgesondheidsorg. Die data is geanaliseer met induktiewe inhouds analiese tegnieke om die ontwerp en konstruksie van die ‘DELTA nursing measure’ te bewerkstellig. In die tweede doelwit was die ‘DELTA nursing measure’ se bruikbaarheid vir verpleging bestudeer. Om dit te doen was ’n nuwe span psigiatriese verpleegkundiges (n = 25) wat werksaam was in ’n 116-bed akute psigiatriese hospitaal opgelei en getoets in die gebruik van die ‘DELTA nursing measure’. Na 30 maande is ’n fokusgroep (n = 6) gehou wat verteenwoordigend was van die span om hulle persepsies en ervarings van die nuut-ontwikkelde meetskaal se bruikbaarheid te eksploreer. Beskrywende data is met behulp van deduktiewe inhouds tegnieke geanaliseer. Die uitkoms van die ‘DELTA nursing measure’ as ’n routine verplegingmeetskaal vir die bepaling van akuutheid in psigiatrie het baie goeie resultate opgelewer. Die bruikbaarheidseienskappe het positiewe response bevestig dat aanvaarding, betroubaarheid en vertroue bereik is en dat dit ’n nuttige instrument is om die verplegingsdiens te bevorder. Die positiewe response op die ‘DELTA nursing measure’ is merkwaardig. Dit het die potensiaal om ’n betekenisvolle bydrae te lewer tot die psigiatriese verplegingsveld omdat dit ’n meetbare dimensie toevoeg tot pasient uitkomste, ’n hoogs-benodigde vereiste van pasiënte, multidissiplinêre spanne en gesondheidsorgbefondsers.

scholarly journals Family Members’ Existential and Moral Dilemmas With Coercion in Mental Healthcare

2018 ◽  
Vol 28 (6) ◽  
pp. 900-915 ◽  
Author(s):  
Reidun Norvoll ◽  
Marit Helene Hem ◽  
Hilde Lindemann
Keyword(s):  
Moral Distress ◽  
Mental Health Problems ◽  
Family Relations ◽  
Quality Care ◽  
Family Members ◽  
Mental Healthcare ◽  
Moral Dilemmas ◽  
Narrative Study ◽  
Lack Of Information ◽  
Using Data

Coercion in mental healthcare does not only affect the patient, but also the patient’s families. Using data from interviews with 36 family members of adult and adolescent people with mental health problems and coercion experiences, the present narrative study explores family members’ existential and moral dilemmas regarding coercion and the factors influencing these dilemmas. Four major themes are identified: the ambiguity of coercion; struggling to stay connected and establishing collaboration; worries and distress regarding compulsory care; and dilemmas regarding initiating coercion. Subsequently, coercion can reduce, but also add burden for the family by creating strains on family relations, dilemmas, (moral) distress, and retrospective regrets; this is reinforced by the lack of information or involvement and low-quality care. Subsequently, it is a moral obligation to develop more responsive health services and professionals who provide more guidance and balanced information to increase the possibilities for voluntary alternatives and informed decision making.

Clinical Nurse Specialist Regulation

2015 ◽  
Vol 26 (1) ◽  
pp. 58-76
Author(s):  
Paul Thurman
Keyword(s):  
Quality Care ◽  
Clinical Nurse Specialist ◽  
Nurse Specialist ◽  
Health Care Environment ◽  
Care Environment ◽  
Clinical Nurse ◽  
State Recognition ◽  
Prescriptive Authority ◽  
The Core ◽  
Effective Cost

High-quality care will continue to be a driver in the evolution of today’s health care environment. Ensuring effective, cost-conscious, quality care is the core of clinical nurse specialist (CNS) practice. The CNS practice varies by state, depending on each state’s Nurse Practice Act. Some states have separate scopes of practice for CNSs, including prescriptive authority, whereas some states do not recognize CNS practice as different from the practice of the registered nurse. The journey to state recognition and title protection for the CNS role in the state of Maryland is described.

scholarly journals Impacto del gasto público en la calidad del sistema de salud de México

2020 ◽  
pp. 1-10
Author(s):  
María Guadalupe ZÁRATE-MARTÍNEZ ◽  
Paulina AGUILERA-ARREDONDO ◽  
Artemio JIMÉNEZ-RICO
Keyword(s):  
Health System ◽  
Public Expenditure ◽  
Quality Care ◽  
Public Spending ◽  
Health Sector ◽  
Health Needs ◽  
Human Right ◽  
The Public ◽  
Optimal Health

Health is considered a Human Right that every person should receive for free and in quality, it is important in the fact that it is a basic service for the development of a country. In Mexico, public spending on health is equivalent to 2.5% of GDP, however, the OECD indicates that it is necessary to allocate at least 6% to have an optimal Health System. In the same tenor, Mexico has 2.9 nurses per thousand inhabitants, while Norway has 17.8 nurses per thousand. The objective of this research is to analyze public spending for the health sector to determine its impact on the main indicators that measure the quality of service provided by the Mexican Health System. Some results indicate that Mexico faces complex and challenging health needs and that there are huge discrepancies compared to other countries. This research contributes to providing a broader perspective on the public expenditure allocated to the Health System of Mexico in order to design public policies that allow offering high-quality care focused on people.

scholarly journals Should nurses be given the rights to autonomously initiate medications for adult patients’ experiencing acute pain at triage prior to a physicians’ consult in Singapore’s Emergency Departments? A Systematic Review

2021 ◽  
Author(s):  
Gerard Charles
Keyword(s):  
Length Of Stay ◽  
Thematic Analysis ◽  
Acute Pain ◽  
Pain Control ◽  
Positive Impact ◽  
Safety Issues ◽  
Prescriptive Authority ◽  
Independent Prescribing ◽  
Special Events ◽  
Nurse Prescribing

Abstract Background: Globally, in most countries, nurses are restricted from independent prescribing however, seven countries have achieved legislation to implement prescriptive authority to nurses with more countries in bid to follow suit. Since the inception of nurse-initiated medications in the 1990s, the increase in prescribing authority has shown a positive impact on the measured metrics with evidence improving patient care with timeliness to analgesia and greater pain control. Objectives: The objectives of this review is to rationalise the use of nurse-initiated medications at triage for patients’ presenting with acute pain in the emergency department, to critically analyse the risks and benefits of NIM and to generate ideas and make recommendations about practice implications regarding NIM at triage.Methods: A literature review using a systematic approach was undertaken. Multiple keyword combinations were incorporated, and an inclusion and exclusion criteria were set. All studies chosen were critically appraised using four different toolkits based on research design for rigour & quality. Ten studies were selected for this review. Thematic analysis was conducted, stitching the similarities identified within the studies and a discussion of the results with a conclusion was written. Results: Nurses who were given prescriptive authority significantly decreased time to analgesia in nine studies with the initiation of NIM at triage. There were no complaints or mentions of medication errors, special events or adverse reactions reported in the selected research papers. Thematic analysis identified pain assessment as a key indicator for nurses to initiate medications for patients upon triage. The introduction of NIM has attained clinically significant pain reduction scores and increased patient satisfaction. There was, however, little effect between NIM and ED length of stay. Safety concerns, anxiety, and overwhelming workload were identified as barriers for nurse prescribing with measures set in place to combat these issues.Conclusion: This review has found that nurse-initiated medications are beneficial as it does increase timeliness to analgesia and improve pain control for patients. It also highlights compelling evidence with an increase in timeliness to analgesia and that authority should be given to nurses in Singapore for the rights to autonomously prescribe analgesia for patients’ experiencing acute pain at triage prior to a physicians’ consultation. Prescriptive authority for nurses will be a step forward in contemporary emergency medicine. Further exploration and research should be undertaken about the concept and impact of NIM on safety issues, ED length of stay with randomised studies to solidify this initiation.

scholarly journals Values-Based Foundation for a U.S. Single Payer Health System Model

2021 ◽  
Vol 6 ◽  
Author(s):  
Walter Markowitz ◽  
Renee McLeod-Sordjan
Keyword(s):  
Health System ◽  
Affordable Care Act ◽  
Quality Care ◽  
System Model ◽  
Health Access ◽  
Health Insurance System ◽  
Social Good ◽  
Single Payer ◽  
Optimal Health ◽  
Unequal Access

A universal, single payer model for the American health system aligns with and should emanate from commonly held values contained within the country’s foundational religious teachings, morals, ethics and democratic heritage. The Affordable Care Act in its attempt to create expanded health access has met with significant challenges. The conservative Supreme Court decreases the likelihood of a federal mandated single payer model. As uncertainty of the structure of the healthcare system increases, this paper supports its transformation to a single payer model. Healthcare should be considered a duty within the framework of a Kantian approach to ethics and a social good. Evidently ignoring this duty, the American health system perpetuates a healthcare underclass, with underserved portions of the population, with unequal access to quality care and persistent health status and outcome disparities. The COVID-19 pandemic demonstrated the effect of social determinants on optimal health outcome. A health insurance system based on the nation’s commonly held values has the potential to eliminate these disparities.

scholarly journals Attitudes towards mental illness in Uganda: a survey in 18 districts

2007 ◽  
Vol 4 (1) ◽  
pp. 19-21 ◽  
Author(s):  
Vuokko Wallace ◽  
Jed Boardman ◽  
James Walsh
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Workers ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
Capital City ◽  
Sub Saharan Africa ◽  
Psychiatric Nurses ◽  
Poor Access ◽  
Sub Saharan

Uganda, in common with many countries in sub-Saharan Africa, has many population risk factors predictive of high levels of mental disorder but poor coverage of mental healthcare (Kigozi, 2005). Recent population studies conducted in Uganda have shown rates of disorder in excess of 20% (Kasoro et al, 2002; Bolton et al, 2004; Ovuga et al, 2005) and the survey by Kasoro et al (2002) showed a high prevalence of patients with severe mental illness and poor access to services. There are 19 psychiatrists for 24.8 million people in Uganda, all but one of whom is based in the capital city, Kampala (Kigozi, 2005). The provision of mental health services relies on the use of psychiatric clinical officers (a cadre of trained mental health workers, similar to community psychiatric nurses, who currently cover 18 of the 56 districts in Uganda), primary care personnel, non-governmental organisations and members of the community. Liaison with traditional healers is encouraged (Ovuga et al, 1999).

scholarly journals Community mental healthcare for people with severe personality disorder: narrative review

2010 ◽  
Vol 34 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Bauke Koekkoek ◽  
Berno van Meijel ◽  
Giel Hutschemaekers
Keyword(s):  
Personality Disorder ◽  
Meta Analysis ◽  
Mental Healthcare ◽  
Occupational Therapists ◽  
Formal Structure ◽  
Psychiatric Nurses ◽  
Community Based ◽  
Community Psychiatric ◽  
Severe Personality Disorder

Aims and methodTo assess the contents and the theoretical and empirical base of community mental healthcare (CMHC) for people with severe personality disorder. Medline and PsycINFO databases and handbooks were searched from 1980, as well as a recent meta-analysis and systematic review of trials in which CMHC served as the control condition.ResultsCommunity mental healthcare is a long-term community-based treatment within a supportive atmosphere, aimed at stability rather than change. Mostly offered by community psychiatric nurses, occupational therapists and social workers, it lacks a formal structure, as well as theoretical underpinnings that guide interventions.Clinical implicationsCommunity mental healthcare might profit from a more systematic application of effective ingredients from other treatments.

scholarly journals Participation of psychiatric nurses in public and private mental healthcare in Kenya

2015 ◽  
Vol 12 (01) ◽  
pp. 19-21 ◽  
Author(s):  
Victoria Pattison de Menil ◽  
Martin Knapp
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Mental Healthcare ◽  
Psychiatric Nursing ◽  
Psychiatric Nurses ◽  
Low Income Countries ◽  
Public And Private ◽  
Mental Health Patients ◽  
Salaried Employment ◽  
The Brain

We studied the rate of participation of psychiatric nurses in mental healthcare in Kenya. A simple questionnaire was delivered to 50 nurses attending a mental health meeting of the National Nursing Alliance of Kenya in April 2012. Of the 40 nurses with psychiatric nursing qualifications, 19 worked specifically as psychiatric nurses; among those employed as general nurses, half their case-loads were mental health patients. Ten per cent of psychiatric nurses had run a private clinic (75% of them general clinics) and 15% were doing private locum work alongside salaried employment. Kenya would need to increase the number of psychiatric nurses 20-fold in order to achieve an internationally recommended ratio (for low-income countries) of 12 psychiatric nurses per 100 000. It appears psychiatric nurses are migrating internally to nursing positions in other areas of healthcare, aggravating the ‘brain drain’ in mental health.

scholarly journals Awareness and Knowledge about Occupational Therapy in Jordan

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Wesam Barakat Darawsheh
Keyword(s):  
Occupational Therapy ◽  
Quality Care ◽  
Occupational Therapists ◽  
Interdisciplinary Teams ◽  
Healthcare Personnel ◽  
Prescribe Medication ◽  
Learning Needs ◽  
The Public ◽  
Physical Conditions ◽  
Lay Persons

Knowledge and awareness about occupational therapy (OT) are essential for the delivery of quality care to all clients and for occupational therapists’ (OTRs) job satisfaction. OT has been a poorly understood profession in Jordan. The current study reports on the assessment of Jordanians’ awareness and knowledge of occupational therapy. Convenience sampling was used. There were 829 participants (474 males, 355 females), with mean age of 32 ± 11.6 yrs. They were recruited from the three main geographical areas of Jordan (northern, central, and southern) and from all educational levels. The sample included 222 (26.8%) healthcare personnel, 146 (17.6%) clients, and 461 (55.6%) lay persons. Participants completed questionnaires, and the results revealed that 48% of the sample had poor or no knowledge about OT, while 28.3% were unaware of it. Also, OT was commonly (50%) perceived to be exclusively targeting people with disabilities (PWDs) and neurological and physical conditions (58% and 53%, resp.) in addition to exclusively providing services for the rehabilitation of the upper extremity (48%). Common misconceptions associated with OT were that OTRs prescribe medication (43%) and OTRs are physiotherapists (44%). These preliminary findings suggest that efforts need to be directed by OTRs, the Jordanian Society of Occupational Therapy (JSOT), and the Ministry of Health to preserve the OT identity and value and promote knowledge about OT in the public and among members of interdisciplinary teams. More interprofessional learning needs to be incorporated within the curricula and placements of all healthcare personnels.

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