Evidence indicates that while service users are dissatisfied with current ward round practices, studies of how professionals experience this practice are sparse. This study highlights staff view of the once-a-week psychiatric ward round compared to a reformed ward round taking place every weekday. Interviews were conducted at one acute psychiatric ward in north-west England. Our analysis revealed a core theme, 'forming a new way of working', which could be understood from three themes. The theme, 'bound by tradition', emphasized how the traditional ward round represented a double-edged sword: it provided a safe structure, but it also highlighted a shared awareness of an urgent need to leave old ways of working behind. The process of change became discernable in the themes 'juggling the change' and 'light at the end of the tunnel', which showed that restructuring the traditional ward round was both possible and valued. We found that staff views on ward rounds are more complex than had been earlier understood, but new ways of working can be implemented, if the impact of tradition, the process of change, and the time to bed down are taken into account.
Aims and MethodThe need for training to prepare mental health professionals to assess and manage risks is now well established. This paper reports on the development, delivery and evaluation of interprofessional clinical risk training in Salford and Manchester since 1998. A training-needs analysis was carried out, followed by post-training evaluation and an impact-monitoring questionnaire.ResultsThe training was very well received by participants, with over 90% of them meeting the objectives and 100% of respondents reporting that the training had a positive impact on their clinical practice more than 12 months afterwards.Clinical ImplicationsThe evaluation of the training demonstrates that a properly planned and delivered 2-day clinical risk assessment course can have a positive impact on the practice of clinicians in mental health services. However, this should be seen only as an introductory course, as more advanced risk training is required. This is currently being delivered and planned.
Admission to a mental health inpatient setting is one important aspect of care which requires collaborative working between Community Mental Health Teams (CMHTs) and ward staff. However, links are not always formalized. The failure of effective gatekeeping coupled with inconsistent admission and discharge practices further complicates the situation for all those involved. A number of local changes, for example, adoption of a centralized bed bureau, together with policy changes, initiated a nurse-led practice development project. It was predicted that by creating a framework for more formalized communication between the different disciplines admission and discharge processes would be improved, thus enhancing service users' satisfaction and empowering all staff participating in the process. During the project, 132 service users were notified as potentially requiring admission. Admissions were avoided and diverted for 22 of them. The quality of the communication and information shared between the CMHTs and ward staff was significantly improved. Accessing inpatient beds, at times still remained problematic, as beds could only remain ring-fenced on 65% of occasions. This initiative, conducted within a 'real world setting', showed that it is possible to improve admission and discharge practices by creating a framework for a formalized communication process between disciplines.
Aims and MethodThe need for training to prepare mental health professionals to assess and manage risks is now well established. This paper reports on the development, delivery and evaluation of interprofessional clinical risk training in Salford and Manchester since 1998. A training-needs analysis was carried out, followed by post-training evaluation and an impact-monitoring questionnaire.ResultsThe training was very well received by participants, with over 90% of them meeting the objectives and 100% of respondents reporting that the training had a positive impact on their clinical practice more than 12 months afterwards.Clinical ImplicationsThe evaluation of the training demonstrates that a properly planned and delivered 2-day clinical risk assessment course can have a positive impact on the practice of clinicians in mental health services. However, this should be seen only as an introductory course, as more advanced risk training is required. This is currently being delivered and planned.
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