Effectiveness and experiences of mental health nurses in cases of medical emergency and severe physiological deterioration

Geoffrey L. Dickens, Lucie Ramjan, Gihane Endrawes, Emily-May Barlow, Bronwyn Everett

Research output: Contribution to journalArticle

Abstract

Background
From a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses’ delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, this evidence-base has not been systematically identified, appraised, and integrated.

Objectives
To systematically identify, appraise and synthesise the available empirical evidence about mental health nurses, medical emergencies, and the severely physiologically deteriorating patient.

Design
A systematic review in accordance with relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources
Multiple electronic databases (CINAHL; PubMed; MedLine; Scopus, ProQuest Dissertations and Theses) were searched using comprehensive terms.

Review methods
Inclusion criteria: English language papers describing empirical studies (any design) about i) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of emergency medical care or care for the severely deteriorating patient; or ii) mental health nurses’ emergency medical care-related knowledge, skills, experience, attitudes, or training needs. Further information was sought from study authors. Included studies were independently assessed for quality. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative synthesis of study findings was conducted.

Results
A total of 22 studies, all but one published since 2011, met inclusion criteria. Ten were intervention studies and twelve were cross-sectional observational or qualitative studies. Intervention studies were all of weak quality overall and utilised pre- post designs mostly with limited post intervention follow-up time. Observational and qualitative studies were generally of good quality but only parts of the evidence from these studies were relevant to emergency physical care since most focused on mental health nurses and their routine physical healthcare practice.

Conclusions
There are currently no validated instruments to investigate mental health nurses’ emergency medical care-related attitudes. More rigorous controlled trials of interventions are needed to better establish an evidence-base for educational interventions to improve this groups’ emergency care-related practice.
Original languageEnglish
JournalInternational Journal of Nursing Studies
Early online date1 May 2019
DOIs
Publication statusE-pub ahead of print - 1 May 2019

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Emergency Medical Services
Mental Health
Emergencies
Nurses
Delivery of Health Care
PubMed
Observational Studies
Meta-Analysis
Language
Databases
Guidelines

Cite this

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title = "Effectiveness and experiences of mental health nurses in cases of medical emergency and severe physiological deterioration",
abstract = "BackgroundFrom a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses’ delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, this evidence-base has not been systematically identified, appraised, and integrated.ObjectivesTo systematically identify, appraise and synthesise the available empirical evidence about mental health nurses, medical emergencies, and the severely physiologically deteriorating patient.DesignA systematic review in accordance with relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMultiple electronic databases (CINAHL; PubMed; MedLine; Scopus, ProQuest Dissertations and Theses) were searched using comprehensive terms.Review methodsInclusion criteria: English language papers describing empirical studies (any design) about i) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of emergency medical care or care for the severely deteriorating patient; or ii) mental health nurses’ emergency medical care-related knowledge, skills, experience, attitudes, or training needs. Further information was sought from study authors. Included studies were independently assessed for quality. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative synthesis of study findings was conducted.ResultsA total of 22 studies, all but one published since 2011, met inclusion criteria. Ten were intervention studies and twelve were cross-sectional observational or qualitative studies. Intervention studies were all of weak quality overall and utilised pre- post designs mostly with limited post intervention follow-up time. Observational and qualitative studies were generally of good quality but only parts of the evidence from these studies were relevant to emergency physical care since most focused on mental health nurses and their routine physical healthcare practice.ConclusionsThere are currently no validated instruments to investigate mental health nurses’ emergency medical care-related attitudes. More rigorous controlled trials of interventions are needed to better establish an evidence-base for educational interventions to improve this groups’ emergency care-related practice.",
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Effectiveness and experiences of mental health nurses in cases of medical emergency and severe physiological deterioration. / Dickens, Geoffrey L.; Ramjan, Lucie; Endrawes, Gihane; Barlow, Emily-May; Everett, Bronwyn.

In: International Journal of Nursing Studies, 01.05.2019.

Research output: Contribution to journalArticle

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AU - Endrawes, Gihane

AU - Barlow, Emily-May

AU - Everett, Bronwyn

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N2 - BackgroundFrom a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses’ delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, this evidence-base has not been systematically identified, appraised, and integrated.ObjectivesTo systematically identify, appraise and synthesise the available empirical evidence about mental health nurses, medical emergencies, and the severely physiologically deteriorating patient.DesignA systematic review in accordance with relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMultiple electronic databases (CINAHL; PubMed; MedLine; Scopus, ProQuest Dissertations and Theses) were searched using comprehensive terms.Review methodsInclusion criteria: English language papers describing empirical studies (any design) about i) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of emergency medical care or care for the severely deteriorating patient; or ii) mental health nurses’ emergency medical care-related knowledge, skills, experience, attitudes, or training needs. Further information was sought from study authors. Included studies were independently assessed for quality. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative synthesis of study findings was conducted.ResultsA total of 22 studies, all but one published since 2011, met inclusion criteria. Ten were intervention studies and twelve were cross-sectional observational or qualitative studies. Intervention studies were all of weak quality overall and utilised pre- post designs mostly with limited post intervention follow-up time. Observational and qualitative studies were generally of good quality but only parts of the evidence from these studies were relevant to emergency physical care since most focused on mental health nurses and their routine physical healthcare practice.ConclusionsThere are currently no validated instruments to investigate mental health nurses’ emergency medical care-related attitudes. More rigorous controlled trials of interventions are needed to better establish an evidence-base for educational interventions to improve this groups’ emergency care-related practice.

AB - BackgroundFrom a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses’ delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, this evidence-base has not been systematically identified, appraised, and integrated.ObjectivesTo systematically identify, appraise and synthesise the available empirical evidence about mental health nurses, medical emergencies, and the severely physiologically deteriorating patient.DesignA systematic review in accordance with relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMultiple electronic databases (CINAHL; PubMed; MedLine; Scopus, ProQuest Dissertations and Theses) were searched using comprehensive terms.Review methodsInclusion criteria: English language papers describing empirical studies (any design) about i) the effectiveness of interventions to improve any outcome related to mental health nurses' delivery of emergency medical care or care for the severely deteriorating patient; or ii) mental health nurses’ emergency medical care-related knowledge, skills, experience, attitudes, or training needs. Further information was sought from study authors. Included studies were independently assessed for quality. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative synthesis of study findings was conducted.ResultsA total of 22 studies, all but one published since 2011, met inclusion criteria. Ten were intervention studies and twelve were cross-sectional observational or qualitative studies. Intervention studies were all of weak quality overall and utilised pre- post designs mostly with limited post intervention follow-up time. Observational and qualitative studies were generally of good quality but only parts of the evidence from these studies were relevant to emergency physical care since most focused on mental health nurses and their routine physical healthcare practice.ConclusionsThere are currently no validated instruments to investigate mental health nurses’ emergency medical care-related attitudes. More rigorous controlled trials of interventions are needed to better establish an evidence-base for educational interventions to improve this groups’ emergency care-related practice.

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