Touching their lives: North Western Mental Health’s approach to practice development in aged mental health

Abstract

The ongoing development of mental health practice is an important issue for consumers, carers, and clinicians. This paper outlines a practice development project undertaken by North Western Mental Health. The aim of the project was to assist nurses and direct care staff working in a residential facility to provide individualized, sensitive, therapeutic, and responsive care for long-term clients with severe mental illness. A clinical nurse educator was engaged to help facilitate changes to both attitudes and practices in a specialist environment catering to those with psychiatric, cognitive, and physical health concerns. The project identified institutionalized routines and practices that were entrenched within the setting and, with support and guidance from a clinical nurse educator, encouraged enhancement of clients' experience and choice. Nurses' clinical reasoning skills were also extended through this process. The project encouraged all staff to develop and maintain an awareness of residents' experience of receiving care in a potentially disempowering environment. In particular, nurses were challenged to consider how nursing, realized to its full potential, can touch the lives of residents and families.

Developing practice in mental health settings

“…Fortune et al . (2007) also outline a local planned approach to PD, including a top‐level management commitment, a newly‐appointed change agent, and establishing experiential learning opportunities for staff.…”

“…A pre‐implementation audit ascertained the psychiatric knowledge and skills of all staff employed in a small residential aged‐care facility prior to the appointment of a CNC who reviewed nursing notes (care plans) and observed practice in situ. Within 6 months, senior registered nurses took more responsibility for supporting staff to reflect on, understand, and change practice (Fortune et al . 2007).…”

“…There was more communication between workers and residents' family members, care planning became more collaborative, residents' preferences were taken into account, and care plans were better documented. The most significant change was towards humanistic person‐centred care, with staff using interpersonal skills constructively to encourage resident behaviour change rather than merely carrying out physical care, practical tasks, and adhering to rituals (Clarke & Wilcockson 2001; Fortune et al . 2007; Wilson et al .…”

“…In the preceding two exemplars, some structural changes with the involvement and ongoing support of management have resulted in the incorporation of evidence‐based research into practice (Henderson et al . 2005) and improved client outcomes (Fortune et al . 2007).…”