An emergency department-based mental health nurse practitioner outpatient service: Part 2, staff evaluation

Abstract

The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care.

Evaluating a new model of nurse-led emergency department mental health care in Australia; perspectives of key informants

“…Initial evaluations of the service provided by the MHNP identified reduced waiting times, therapeutic engagement and enhanced co-ordination of care as the main benefits of the role (Wand, 2004;Wand and Schaecken, 2006). The scope of the MHNP role at RPAH has expanded through the establishment of a structured and formalised outpatient service (Wand et al, 2011a(Wand et al, , 2011b(Wand et al, , 2012 whereby referred patients return to the ED for brief intervention within a mental health promotion and solution focused therapy framework.…”

Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department

“…4 In Australia, the added value associated with establishing MHNP positions based on the MHLN model is emerging. [5][6][7][8][9] However, there is great variation in the way MHLN services are configured and how they operate within the ED context, such as team structure, reporting mechanisms, referral and follow-up processes. Therefore, a more standardised model of MHLN service delivery that best meets the needs of the ED and the public is required.…”

Outcomes from the evaluation of an emergency department‐based mental health nurse practitioner outpatient service in Australia

“…The ED staff were instilled with more confidence when discharging patients home and recognized that the MHNP took responsibility for referred patients. Furthermore, the ED staff considered that overall ED service provision was improved and a more holistic approach to patient care was being applied (Wand, White, Patching, Dixon, & Green, 2011b).…”