Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: A mixed methods evaluation study

Lavelle, Mary; Attoe, Chris; Tritschler, Christina; Cross, Sean

doi:10.1016/j.nedt.2017.09.009

Cited by 41 publications

(104 citation statements)

References 28 publications

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“…Simulation training has been highlighted as an appropriate vehicle through which to deliver training interprofessionally, and the limited literature on mental health simulation has yielded promising findings relating to attitudes and the potential to enhance patient care (Attoe et al, 2016;Baker et al, 2008;Boet et al, 2014;CAIPE, 2013;Ker et al, 2003). In recent times the literature base for interprofessional simulation in mental health has grown, further advocating the potential of this modality (Attoe et al, 2016;Billon et al, 2016;Fernando et al, 2017;Kowalski et al, 2017;Lavelle, Attoe, Tritschler & Cross, 2017). However these findings relate to healthcare professionals rather than students and trainees.…”

mentioning

confidence: 99%

Student interprofessional mental health simulation (SIMHS): evaluating the impact on medical and nursing students, and clinical psychology trainees

Attoe

Lavelle²,

Sherwali

et al. 2019

JMHTEP

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Purpose Mental health simulation is the educational practice of recreating clinical situations in safe environments using actors, followed by structured debriefing, to foster professional development and improve care. Although evidence outlines the benefits of simulation, few studies have examined the impact of interprofessional mental health simulation on healthcare trainees, which is more reflective of clinical care. The purpose of this paper is to evaluate the impact of mental health simulation training on students’ confidence, attitudes, knowledge and perceived professional development and anticipated clinical practice. Design/methodology/approach Participants (n=56) were medical (41 per cent) and mental health nursing students (41 per cent), and clinical psychology trainees (18 per cent). Six simulated scenarios, involving one to three trainees, were followed by structured debriefs with trained facilitators. Scenarios, using actors, reflected patient journeys through emergency, medical and psychiatric settings. Participants’ confidence, knowledge and attitudes were measured quantitatively using pre- and post-course self-report questionnaires. Perceptions of impact on professional development and clinical practice were assessed using thematic analysis of post-course questionnaire responses. Findings Knowledge, confidence and attitudes scores showed statistically significant increases, with large effect sizes. Thematic analyses highlighted themes of: interprofessionalism, communication skills, reflective practice, personal resilience, clinical skills and confidence. Research limitations/implications Further research should clarify the impact of interprofessional simulation training on mental health practice in the context of other training received. Practical implications Simulation training may begin to influence participants’ professional development and future clinical practice and subsequently care delivered, supporting its increased use in mental health. Originality/value This study adds to nascent understandings of the use and potential of interprofessional mental health simulation, outlining innovative training, its positive outcomes and implications.

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confidence: 99%

Student interprofessional mental health simulation (SIMHS): evaluating the impact on medical and nursing students, and clinical psychology trainees

Attoe

Lavelle²,

Sherwali

et al. 2019

JMHTEP

Self Cite

View full text Add to dashboard Cite

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“…Two studies focused on change implementation 249 250. One study focused on the role of training 251. Safety culture was featured in 18 publications relating to the management of serious incidents,252–254 stress and burnout,255–257 staff258 and patient perspectives of safety259–263 and communication264; there were also three papers that explored safety culture more generally 265–267.…”

Section: Resultsmentioning

confidence: 99%

Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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ObjectivesPatients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.DesignSystematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.ResultsOf the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.ConclusionsPatient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration numberCRD42016034057.

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“…As noted in the paper, the ipsative nature of the OCAI results in data that cannot be verified as suitable for use as a continuous measure. Findings based on the LTIQ data (Lavelle et al, 2017) were attained using an unvalidated measure and we acknowledge this as a limitation of the study.…”

Section: Limitationsmentioning

confidence: 99%

“…Lambeth Triage In situ Questionnaire (LTIQ) (Lavelle, Attoe, Tritschler, & Cross, 2017) Knowledge and self-confidence about providing care for medically deteriorating patients was measured using the LTIQ, a tool developed for use in UK-based research evaluating simulation-based physical healthcare skills training (Lavelle et al 2017). The tool was specifically developed due to the lack of alternatives and has not been subject to psychometric evaluation.…”

Section: Demographic and Employment Detailsmentioning

confidence: 99%

Safety attitudes, perceived organizational culture and knowledge of the physiologically deteriorating patient among mental health nurses: Cross‐sectional, correlational study

Dickens

Salamonson

Ramjan

et al. 2019

Int J Mental Health Nurs

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Mental health nurses have traditionally lagged in terms of physical healthcare skills and have been found to have poorer cultural safety‐related attitudes relative to other nurses. Organizational culture, including safety‐related culture, is associated with important aspects of care quality. The aim of the current study was to examine the relationships between safety‐related attitudes, physical healthcare‐related knowledge and organizational culture among mental health nurses. By doing so, the intention was to inform decisions about interventions to improve attitudes and care related to severe physiological deterioration among mental health nurses. The study design was cross‐sectional and correlational. The safety‐related attitudes of N = 133 nurses from the inpatient mental health services of one Local Health District in New South Wales, Australia, were examined in terms of a range of potential predictor variables of safety attitudes (Safety Attitudes Questionnaire) including individual organizational‐perceiver type (Organisational Climate Assessment Inventory), knowledge of emergency medical healthcare (Lambeth In situ Training Questionnaire), use and perception of medical emergency teams (purpose‐designed questionnaire) and a range of demographic variables. Regression analyses revealed that those who perceived the organization to have a primarily market‐oriented culture had poorer safety‐related attitudes than those who perceived a more clan‐type culture. Number of years qualified was negatively associated with safety attitudes. To our knowledge, this is the first study in mental health which demonstrates a link between organizational culture‐perception and safety attitudes related to physical healthcare. Results suggest that, among nurses, individuals have quite different perceptions of the organizational culture. In turn, this suggests that the ‘one‐size fits all’ approach to changing organizational culture may be inappropriate.

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Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: A mixed methods evaluation study

Cited by 41 publications

References 28 publications

Student interprofessional mental health simulation (SIMHS): evaluating the impact on medical and nursing students, and clinical psychology trainees

Student interprofessional mental health simulation (SIMHS): evaluating the impact on medical and nursing students, and clinical psychology trainees

Patient safety in inpatient mental health settings: a systematic review

Safety attitudes, perceived organizational culture and knowledge of the physiologically deteriorating patient among mental health nurses: Cross‐sectional, correlational study

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