Medication management: an exploratory study into the role of community mental health nurses

Abstract

The recent emphasis on community care for those with mental illness has changed working patterns and modified inter-professional role boundaries within multi-disciplinary teams. Clients with serious mental illness are usually prescribed medications, which have a wide range of side effects. However, it is uncertain who is responsible for monitoring clients for the side effects of their medications, ensuring clients' and carers' understandings of their prescribed medications and optimizing compliance with medication. This paper discusses the findings of the first phase of an ongoing study designed to assess the role of community mental health nurses (CMHNs) in managing clients' medication and the provision of appropriate continuing professional education. Our respondents were 14 CMHNs, seven of whom were preparing to undertake a pharmacology module as part of a higher education diploma, and seven who were to act as comparators. Data from questionnaires, interviews and clinical observations were triangulated. All respondents felt that issues surrounding clients' medication were not accorded a sufficiently high profile and that it was, in part, their responsibility to expand their roles to meet these unmet needs of clients. Administering and managing clients' medications were considered to be the main area of 'occupational territory' which distinguished CMHNs from social workers. However, the nurses felt that their practice was limited by lack of appropriate educational preparation.

Medication Monitoring for People with Dementia in Care Homes: The Feasibility and Clinical Impact of Nurse-Led Monitoring

“…Francis Report, Recommendation 94) [59]. Before undertaking larger studies, we tested the feasibility and clinical impact of our approach to the “ADR problem” [60–64]. Objectives of this pilot were to appraise the logistics of (1) recruitment, retention, and implementation and (2) assessment of clinical benefits of the profile for people with dementia prescribed antipsychotic, antidepressant or antiepileptic medication.…”

Exploring the Expanded Practice Roles of Community Mental Health Nurses

“…For example, the nurse must exercise judgment as to when to enlist the intervention of specialist medical staff (Jordan et al, 1999). This exercise of judgment is particularly apparent in rural and remote areas where full time psychiatrists are frequently not available and the primary monitoring of psychiatric treatment is often undertaken by general practitioners (GPs).…”

Medication decision-making by persons with serious mental illness

“…In an exploratory study into the role of community mental health nurses, Jordan et al (1999) found that nurses are expected to manage and monitor medications accurately and adequately, are responsible for assessing any contraindications, recognizing and assessing side effects, and treatment responses. Marland (1999) looked carefully at the question of depot medication and medication compliance.…”