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Risk assessment and safety planning are central to mental health nursing practice but were seriously affected by the Covid-19 pandemic and associated lockdowns. In this study, we aimed to explore how the UK pandemic lockdowns affected risk assessment and safety planning from the perspective of mental health practitioners. A sequential, mixed methods study design was used. A link to an online survey questionnaire was distributed and semi-structured interviews with a subset of respondents were conducted. Survey data were analysed to describe perceived changes in the frequency and nature of risk assessment and safety planning during the pandemic lockdowns. This was supplemented by thematic analysis of qualitative interview data. In total, 106 practitioners were surveyed and 10 participated in semi-structured interviews. More respondents increased than decreased risk assessment frequency but there was no significant overall change. Remote contact was more common in community settings and largely involved telephone appointments. Participants did not wish to continue with remote working following the pandemic. Risk assessment practice changed in UK mental health services as a result of COVID-19 lockdowns. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Risk assessment and risk management are considered to be important practices carried out by mental health nurses.Risk assessment can help keep mental health service users' safe, but some nurses see it as a 'tick the box' exercise.Some studies have looked at nurses' attitudes to risk assessment but no one has systematically described all the studies. What the article adds to existing knowledge?: Mental health nurses' attitudes towards risk assessment are diverse with regard to its legitimacy, conduct and value.This study provides an organised framework to help understand the areas in which these different attitudes occur. What are the implications for practice?: Since attitudes can influence clinical practice, nurses need to reflect on how they view risk assessment. Further research is required to investigate whether particular attitudes are positive or negative and whether attitudes can be changed. Introduction: Understanding nurses' attitudes towards risk assessment could inform education and practice improvements. Aim/Question: To explore mental health nurses' attitudes towards risk assessment. Method: An integrative systematic review (PROSPERO: CRD42023398287). Multiple databases (PubMed, CINAHL, MEDLINE, EMBASE and PsycINFO) were searched for primary studies of mental health nurses' attitudes towards risk assessment. Qualitative studies were subject to inductive coding and thematic analysis; quantitative data were integrated with emerging themes. Results: Eighteen articles were included. Qualitative studies commonly lacked rigorous analyses. Four themes emerged: underlying purpose and legitimacy of risk assessment (philosophical orientation); use of structured approaches (technical orientation); value of intuition (intuitive orientation); and service user involvement (relationships orientation). There were contradictory study findings in each thematic category indicating different attitudes among mental health nurses. Discussion: Mental health nurses' attitudes towards risk assessment vary in four key domains. Survey studies suggest they are more approving of structured approaches to risk assessment than many qualitative studies suggest. There is a need to develop a valid measure of attitudes to risk assessment. Implications for Practice: This review could help health organisations to develop strategies to improve their risk assessment policies and practice. There is a need to develop structured training and education programmes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Well conducted randomized controlled trials provide the highest level of evidence of effectiveness of healthcare interventions, including those delivered by mental health nurses.Trials have been conducted over the years but there has not been a comprehensive review since 2005, and never one including studies conducted outside the UK. What the paper adds to existing knowledge?: The paper provides a comprehensive overview of results from randomized controlled trials of mental health nurse‐delivered interventions conducted in the UK, Ireland, US, Australia, New Zealand, or Canada and reported 2005 to 2020.It highlights that the trial evidence is limited and offers only partial evidence for interventions that are central to mental health nursing practice. What are the implications for practice?: Much mental health nursing practice is not supported by the highest level trial evidence. Mental health nurses need to carefully select evidence on which to base their practice both from the mental health nursing literature and beyond.Mental health nurses and other stakeholders should demand greater investment in trials to strengthen the evidence base. Introduction: Nurses are the largest professional disciplinary group working in mental health services and have been involved in numerous trials of nursing‐specific and multidisciplinary interventions. Systematic appraisal of relevant research findings is rare. Aim: To review trials from the core Anglosphere (UK, US, Canada, Ireland, Australia, New Zealand) published from 2005 to 2020. Method: A systematic review reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta‐Analyses. Comprehensive electronic database searches were conducted. Eligible studies were randomized controlled trials of mental health nurse‐delivered interventions conducted in relevant countries. The risk of bias was independently assessed. Synthesis involved integration of descriptive statistics of standardized metrics and study bias. Results: Outcomes from 348 between‐group comparisons were extracted from K = 51 studies (N = 11,266 participants), Standardized effect sizes for 68 (39 very small/small, 29 moderate/large) statistically significant outcomes from 30 studies were calculable. All moderate/large effect sizes were at risk of bias. Discussion: Trial evidence of effective mental health nurse‐delivered interventions is limited. Many studies produced few or no measurable benefits; none demonstrated improvements related to personal recovery. Implications for Practice: Mental health nurses should look beyond gold standard RCT evidence, and to evidence‐based interventions that have not been trialled with mental health nurse delivery. [ABSTRACT FROM AUTHOR]

Objectives: Self‐efficacy is important for adherence to transmission‐reducing behaviours (e.g., physical distancing) as also shown in the CHARIS project. We aimed to show that a theory‐based short message can increase physical distancing self‐efficacy and intentions to keep physical distance. Design: Structured telephone surveys with a randomly selected nationally representative sample of adults in Scotland (N = 497). Methods: Participants were randomly assigned to one of two experimental conditions: message condition (short message to increase self‐efficacy via vicarious experiences, verbal persuasion and emotional arousal) or control condition (no message). Followed by measures for self‐efficacy and intention for physical distancing on 4‐point scales. Adherence to physical distancing was assessed on a 5‐point frequency scale (never – always). Results: Using mediation analyses with bootstrapping procedures, we first confirmed that self‐efficacy was associated indirectly with adherence, via higher intentions in a partial mediation (unstandardized indirect effect.21, 95% CI.18–.25). The message increased self‐efficacy; participants receiving the message reported higher self‐efficacy (M = 4.23, SD =.80) compared to participants in the control condition (M = 4.08, SD =.77; standardized regression coefficient =.19, p <.05) and self‐efficacy affected intention (.48, p <.001). There was a small significant indirect effect of the message on intention via self‐efficacy (unstandardized indirect effect.07, CI.01–.14). Conclusions: Increasing self‐efficacy for physical distancing with a short message can successfully increase intention to physical distance via increased self‐efficacy. As both self‐efficacy and intentions are important predictors of adherence to transmission‐reducing behaviours short messages have potential to limit the spread of COVID‐19. [ABSTRACT FROM AUTHOR]

Summary: In the past few years, there has been a very significant rise in the number of children and young people seeking treatment for gender dysphoria This area is the subject of much discussion, as evidenced in a recent court case in the UK which examined competence and capacity of young people to consent to potentially irreversible interventions. Clinicians involved in gaining consent to puberty blockers for gender dysphoric young people, must understand the evidence in this area and be aware of the heavy burden of accountability placed upon them. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To understand that new preregistration nursing courses in the UK must still comprise four specialisms: adult, child, mental health, and learning disability • To familiarise yourself with the issues facing nurse educators preparing new mental health preregistration programmes • To understand how upskilling the mental health nursing workforce can improve the experiences of service users According to the Nursing and Midwifery Council (NMC), universities across the UK must develop and implement new preregistration nursing programmes by the end of 2020. Unlike the rest of the world, where initial nurse training is generic, preregistration education in the UK enables students to specialise in one of four fields of nursing practice: adult, child, mental health or learning disability. The recent NMC standards of proficiency for registered nurses confirmed the continuation of these specialist fields at undergraduate level. Considering these recent standards, nurse educators across the UK have an opportunity to review their existing educational provision. This article explores three issues facing nurse educators as they prepare new mental health nursing courses: how to respond to adverse life experiences or trauma; how to address the ethical tensions inherent in the use of coercive practices; and how to make a difference to people's physical health and to mortality statistics, which indicate that people with longstanding mental health issues die at a much younger age than their contemporaries. These areas need to be systematically addressed across mental health preregistration nursing programmes to improve the lives of service users and determine the future of the specialty. [ABSTRACT FROM AUTHOR]

The article offers information on several aspects associated with the Gosport War Memorial Hospital at Gosport in Hampshire, England comprising death of patients due to opioid drugs and profound implications for nursing. The topics addressed include details on the use of the diamorphine usage in patients with a stroke.

Objective: The individual recovery outcomes counter is a 12-item personal recovery self-assessment tool for adults with mental health problems. Although widely used across Scotland, limited research into its psychometric properties has been conducted. We tested its' measurement properties to ascertain the suitability of the tool for continued use in its' present form. Materials and methods: Anonymised data from the assessments of 1743 adults using mental health services in Scotland were subject to tests based on principles of Rasch measurement theory, principal components analysis and confirmatory factor analysis. Results: Rasch analysis revealed that the six-point response structure of the individual recovery outcomes counter (I.ROC) was problematic. Re-scoring on a four-point scale revealed well-ordered items that measure a single, recovery-related construct, and has acceptable fit statistics. Confirmatory factor analysis supported this. Scale items covered around 75% of the recovery continuum; those individuals least far along the continuum were least well addressed. Conclusions: A modified tool worked well for many, but not all, service users. The study suggests specific developments are required if the I.ROC is to maximise its' utility for service users and provide meaningful data for service providers. Implications for Rehabilitation: Agencies and services working with people with mental health problems aim to help them with their recovery. The individual recovery outcomes counter has been developed and is used widely in Scotland to help service users track their progress to recovery. Using a large sample of routinely collected data we have demonstrated that a number of modifications are needed if the tool is to adequately measure recovery. This will involve consideration of the scoring system, item content and inclusion, and theoretical basis of the tool. [ABSTRACT FROM AUTHOR]