The mental health nurse practitioner in the emergency department: An Australian experience

Abstract

This paper describes the establishment of a mental health nurse practitioner (MHNP) position in New South Wales, Australia. The authors report on a MHNP role that functions collaboratively within a large inner city emergency department. Attention is centred on what constitutes advanced mental health nursing practice in the emergency department setting. Three areas associated with the work of MHNPs--therapeutic techniques, prescribing and care coordination and referral--are highlighted to explore the scope of the MHNP role. The authors propose that the success of this position is based on a process of consultation and evaluation, partnership between disciplines and clinical services and the role maintaining a truly nursing focus rather than attempting to replace or replicate psychiatric medicine.

Establishing a nurse-based psychiatric CL service in the accident and emergency department of a general hospital in Germany

“…Our results are in line with the literature on successful psychiatric CL-nurse-based A&E services in English-speaking countries [7,12]. Of note, the emergency setting in which our service was established showed a referral rate of 20% of A&E patients to psychiatry which is high in comparison to an estimated prevalence of 7% of mental disorders in A&E settings as reported in the literature [10].…”

“…This was the starting point for the development of CL-nursebased services. In the UK and Australia, nurses may even qualify for the status of Mental Health Practitioners (MHP) by which they become authorized to manage patients autonomously and even are allowed to prescribe a restricted choice of drugs by themselves [9,12]. The safety of nurses' assessments of psychiatric patients could be demonstrated in a randomized controlled trial [1].…”

Hospital Staff Nurse Perceptions of Competency to Care for Patients With Psychiatric or Behavioral Health Concerns

“…In a systematic review of hospitalized medicalYsurgical patients with psychiatric comorbidity, use of liaison services improved patient and nurse satisfaction but did not improve patient outcomes or cost savings (Zolnierek, 2009). Enhanced service models are also offered in emergency departments (EDs), ED-based psychiatric emergency services (Woo, Chan, Ghobrial, & Sevilla, 2007), ED-based advanced practice nurses (Wand & Fischer, 2006), and on-call nurse liaisons (Wand, 2004). The Behavioral Emergency Response Team, a psychiatric evaluation team, has successfully tried using psychiatric nurses to assist staff nurses working in nonpsychiatric settings (Loucks, Rutledge, Hatch, & Morrison, 2010).…”

Prescribing by mental health nurses in acute general hospitals

“…MHN NMPs have an opportunity to enhance care for patients with mental health problems in the acute hospital. There is clear evidence that with the correct support from colleagues within the MHLT and collaboration with other health care professionals MHN NMPS can develop their roles in the acute environment successfully (Wand & Fisher 2006). Wainwright and Canning (2008) identified NMP as a positive move away from traditional nursing boundaries providing the patient with consistency, less time waiting for prescribing, and more information given to the patient on prescribing, possible side-effects and how long to wait before any therapeutic effects occur.…”

“…Therefore there can be an inference that MHN NMPs working within acute environments add value to patient care and the multidisciplinary team. There are numerous articles and research based on MHLTs and their positive impact on the acute environment (Baldwin 2004, Wand & Fisher 2006, Tadros 2013 ).…”