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Generalist health professionals (GHPs) or those healthcare professionals working in nonmental health facilities are increasingly being required to provide care to consumers with a mental illness. The review aimed to synthesize the qualitative research evidence on the meanings and interpretations made by GHPs (nonmental health professional) who interact with consumers with mental illness in nonmental health settings. A systematic review of the qualitative literature was undertaken for the years 1994-2016. The following electronic databases were searched: CINAHL, MEDLINE, PsycINFO, and Sociological Abstracts. Using narrative synthesis methods, the following themes were identified: mental health knowledge (the GHPs' knowledge level about mental illness and how this impacts their experiences and perceptions); GHPs perceive mental illness as a safety risk (GHPs concern over harm to the consumer and themselves); organizational support (the system response from the environmental design, and expert support and care); and emotional consequences of care (the feelings expressed by GHPs based on their experiences and perceptions of consumers). The results suggest that GHPs provide care in a setting which consists of multiple understandings of what care means. Efforts beyond educational initiatives such as organizational and system-level changes will need to be implemented if we are to progress care for this consumer group.

AIMS AND OBJECTIVES To investigate the feasibility of a 13-week mentoring programme in providing social support to promote hope for recovery in anorexia nervosa. BACKGROUND With no clear first-line psychological treatment for people with anorexia nervosa, mentoring support programmes, as an adjunct to treatment, may provide the social support necessary to promote hope for recovery. DESIGN A mixed-method study; participatory action research. METHODS Women (n = 11), recovering and who had recovered from anorexia nervosa, participated in the programme and completed self-report questionnaires related to quality of life, distress and the mentoring relationship at different time points. Qualitative feedback from logbooks, workshop evaluation questionnaires, interviews and focus groups was also collected to assess the programme's acceptability. RESULTS General compliance for completing most study outcome questionnaires was 90%; however, the mentoring relationship questionnaires were not completed to the same degree. Five key themes emerged from the focus group/interview data: (i) she understands me and could relate to me; (ii) reconnecting with the world-asking questions and being challenged; (iii) mentors' altruistic motivations and the transformation and discovery of self; (iv) instilling hope-recovery is possible; and (v) effective communication-the key to successful mentoring. CONCLUSIONS Further research is needed; however, the results provide preliminary support for the mentoring programme's feasibility as an adjunct to treatment. We found that having someone who understands, to talk and share with, met a clear need for people with anorexia nervosa. RELEVANCE TO CLINICAL PRACTICE While further research is warranted mentoring support or recovered mentors, may play a potentially valuable role in supporting those in community settings.

In the present study, we investigated a unique set of historical health-care records of women admitted to a psychiatric hospital in Sydney, Australia with a diagnosis of psychosis or mania after childbirth in the post-World War II (WWII) period, from 1945 to 1955. This research is part of a larger project examining how the descriptions of these women documented in the health-care records from 1885 to 1975 affected their treatment and the outcome of their admission. In the present paper, we report on the findings from an intensive examination of the post WWII documents. Eighteen health-care records from a psychiatric facility (Gladesville Hospital) were identified from admission registers housed in the State Records Office of New South Wales in 2014. Although seven records had been destroyed, 11 were transcribed verbatim. The records contain demographic information; descriptions of the women's signs and symptoms on admission; and information about the women before, during, and after their admission found in letters from relatives or medical staff. A content analysis of admission information showed how the women were described by health-care professionals, but a textual analysis of the records revealed that there were other factors that could have contributed to the women's condition, which might not have been taken into consideration when treatment and care were devised. The present study demonstrates the value of investigating historical health-care records to understand how prevailing attitudes and practices might affect diagnosis and treatment.

This study investigated changes in the 'atmosphere' of an acute adult mental health setting following relocation to a new purpose-built facility. The Ward Atmosphere Scale (WAS) was designed and validated for specific use in hospital-based psychiatric facilities, and measures several dimensions of an environment. In this study, the WAS was administered to consumers and staff at periods before and also after their relocation to a new purpose-built acute adult mental health facility. There were significant improvements in the physical atmosphere of the new facility, when compared with the old facility. In terms of ward atmosphere, however, improvements were seen to occur in only a small number of measures and there were minor differences between consumers' and staff perspectives on some indicators. Interestingly, it was found that consumers noted less 'staff control' in the new setting, raising the question of the differences in understanding of control. For staff only, there was a perception of greater levels of consumer 'involvement' in the new facility. Despite the minor differences in perception, the study does confirm that architecture is an important influence on the 'atmosphere' of a health facility, for both staff and consumers.

Clinical handover is the primary source of patient information for nurses; however, inadequate information transfer compromises patient safety. We investigated the content and organization of information conveyed at 81 handovers. A structure that captures and presents the information transferred at handover emerged: identification of the patient and clinical risks, clinical history/presentation, clinical status, care plan and outcomes/goals of care (ICCCO). This approach covers essential information while allowing for prioritization of information when required. Further research into the impact of ICCCO on patient safety is in progress.

Aims and objectives. To report the findings of a service review – specifically the strategy to provide early childhood services ‘on site’ at opioid treatment clinics to address access difficulties. Background. Child and family health nurses are skilled in the assessment and support of families during early childhood. However, women with a history of substance abuse are often cautious when engaging with universal and other health services, with the result that the infant may miss recommended developmental screening and early referral to improve health outcomes. Design. In 2006, an internal review was undertaken of the integration of early childhood and parenting services at opioid treatment clinics in a large Area Health Service of New South Wales, Australia. Methods. A qualitative study design, using semi-structured interview questions was used. Data were collected via six focus groups (4–15 participants in each group) and individual interview of child and family health nurses, nurse unit managers and clinical staff (n = 58). Results. Three key components of a model for providing early childhood support in collaboration with opioid treatment services were identified. First, the importance of building a trusting relationship between the woman and the child and family health nurses, second, maintaining continuity of care and a multidisciplinary/multiagency approach, and finally the importance of staff education, support and professional development. Conclusion. The provision of early childhood and parenting services on site, as part of a multidisciplinary ‘one stop shop’ approach to service delivery was a clear recommendation of the review. Relevance to clinical practice. Reduction of access difficulties to specialised early childhood support is of benefit to clients, community health services attempting to provide a service to this difficult to reach population and to drug and alcohol services seeking to provide a high level of holistic care for clients.

JEFFERIES D., JOHNSON M., NICHOLLS D., LANGDON R. & LAD S. Evaluating an intensive ward-based writing coach programme to improve nursing documentation: lessons learned. International Nursing Review59, 394–401 Aim: This study aimed to develop a ward-based writing coach programme to improve the quality of patient information in nursing documentation. Background: Omissions in the patient information make nursing notes an unreliable source for care planning. Strategies to improve the quality of nursing documentation have been unsuccessful. An education programme, with one-to-one coaching in the clinical environment, was tested. Method: A concurrent mixed methods approach including a pre–post test intervention and control design for the quantitative component combined with a qualitative approach using a focus group (eight nurses) was used. Healthcare records for 87 patients (intervention) (46 pre and 41 post) and 88 patients (control) (51 pre and 37 post) were reviewed using the Nursing and Midwifery Content Audit Tool for quality nursing documentation. Sixteen nurses from two intervention wards participated in an introductory workshop with 2 weeks of coaching. No intervention was given to the control ward. Results: No significant differences were found between the wards across the 14 criteria representing quality documentation; most criteria were present in 75% or more of the records. Improvements were demonstrated in both the intervention and comparison units. Themes identified from the focus groups included the impact these changes had on nurses and patients, perceived difficulties with nursing documentation, medicolegal aspects and the attributes of an effective writing coach. Conclusion: Writing coaching is a supportive approach to improving nursing documentation. Also, regular auditing prompts nurses to improve nursing documentation. Further research using larger sample sizes can further confirm or refute these findings.

Aims and objectives. This study presents a minimum data set designed for an electronic system to complement verbal nursing handover. Background. Poor communication of patient information at handover has been implicated in adverse events with changes to clinical handover being proposed as a solution. This study developed a minimum data set for an electronic patient summary tool. Design. Using an observational design the scope of information being presented by nurses at handover was identified in relation to a generic Nursing Handover Minimum Data Set. Method. Patient handovers (n = 195) were observed and digitally recorded across diverse specialties. Results. Content analysis confirmed the frequent use of the Nursing Handover Minimum Data Set items across all specialties. The use of the items was affected by the patient context and the clinical setting. Aged care patients often had several clinical alerts reported (pressure areas, falls risk). Rapid changes in patient condition in emergency emphasised the need for a focus on observations and presenting problems. Mental health and maternity required further refinement of the items. Conclusion. The generic Nursing Handover Minimum Data Set can direct nurses to give a comprehensive account of their patient’s condition and care. The data set needs to be flexible and adaptable to the patient context and setting and complements structured content verbal handover. This minimum data set provides an excellent framework for system development by clinicians, managers and information technologists. Educators can use this tool to teach student nurses, new graduates and experienced staff, about the patient information to be presented at handover. Relevance to clinical practice. The Nursing Handover Minimum Data Set for electronic nursing handover complements verbal handover and provides a tool to give clinicians access to comprehensive information about all patients within the ward area.

Aims and objectives. This paper aims to explore the effectiveness of the mental health nurse practitioner role in the emergency department in the context of the growing use of special units or segregated areas to manage particular kinds of mental health presentations, often complicated by substance use. Background. In recent years, there has been a significant increase in mental health presentations to emergency departments, often complicated by substance abuse. Emergency departments have introduced a variety of mechanisms to address this growing problem. With the introduction of mental health nurse practitioners, opportunities arise to reconsider these mechanisms. Design. Discursive paper. Methods. In this discursive paper, contemporary practices are described in relation to ‘special care areas’, ‘psychiatric emergency centres’ and ‘short-stay units’. The mental health nurse practitioner role in training and capacity building is also explored and the notion of ‘locational processes’ described. Rather than being presented as an alternative to short-stay units, the mental health nurse practitioner role is explored in its potential to enhance mental health nursing practice in a sometimes difficult clinical environment. Results. The paper provides evidence from literature and practice that the clinical outcome for consumers is enhanced through the mental health nurse practitioner role. Conclusions. It is argued that the introduction of the mental health nurse practitioner role in the emergency department leads to increased staff competence and confidence in interacting with those presenting with mental health issues. The mental health nurse practitioner role also addresses the serious problem of stigma associated with those with a mental health issue. Relevance to clinical practice. It is expected that those presenting with mental health issues to the emergency department will benefit through the increased assessment and management skills of staff.