What do mental health workers in the bush think about mental health nurse prescribing? A cross‐sectional study

Muyambi, Kuda; McPhail, Ruth; Cronin, Kathryn; Gillam, Marianne; Martinez, Lee; Dennis, Shaun; Bressington, Daniel; Gray, Richard; Jones, Martin

doi:10.1111/ajr.12435

Cited by 12 publications

(16 citation statements)

References 23 publications

(27 reference statements)

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“…Health care professionals perceive that patients would benefit from the proposed nurse prescribing in mental health in Australia (Muyambi et al, 2018). To advance future implementation of nurse prescribing under supervision, further research is warranted to ascertain not only the perceived merits of this model but also to evaluate the safety and impact of this model on patient care and population health outcomes in the longer term.…”

Section: Resultsmentioning

confidence: 99%

Evidence‐informed implementation of nurse prescribing under supervision: An integrative review

Fox

Joseph

Cardiff

et al. 2021

Journal of Advanced Nursing

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Aim To explore evidence reporting facilitators and barriers to implementation of nurse prescribing and provide practical recommendations for evidence‐informed implementation and adoption of nurse prescribing under a supervision model. Background As demand for access to quality health care services increases, health professional roles are expanding to meet population needs. Nurse prescribing has been effective in some countries and is being considered globally to address growing health care demand. Successful implementation of health service models requires careful planning and consideration. No existing reviews have examined implementation factors in the literature. Design Integrative review. Data sources CINAHL, MEDLINE, PubMed and EMBASE databases were searched from inception to 15 April 2020. Review methods This integrative review is guided by Whittemore and Knafl and adheres to PRISMA reporting guidelines. The sustainability of innovation framework was used to synthesize data concerning implementation and sustainability factors (i.e. innovation, organizational, political, workforce and financial) for nurse prescribing. Results A total of 39 articles were reviewed with literature predominantly reporting findings related to non‐medical and nurse prescribing under various models. Variable evidence was found to inform nurse prescribing across five implementation and sustainability factors identifying several areas that require in‐depth consideration. Very little evidence is available on nurse prescribing under supervision. Conclusion Introduction of service reform is often costly. This review highlights gaps in the literature and raises areas for consideration prior to implementation of this new service delivery model. The introduction of nurse prescribing must be planned and informed by available evidence to support effective adoption, practice and patient outcomes. Impact There are significant gaps in evidence related to nurse prescribing under a supervision model. Based on the evidence synthesized in this review, this paper provides practical recommendations for health service providers, managers, clinicians, educators and researchers to support implementation and adoption of nurse prescribing.

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Section: Resultsmentioning

confidence: 99%

Evidence‐informed implementation of nurse prescribing under supervision: An integrative review

Fox

Joseph

Cardiff

et al. 2021

Journal of Advanced Nursing

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“…The view by the metropolitan focus group does not reflect the attitudes of MHWs in country South Australia towards MHN prescribing. In an attitudinal survey of 93 MHWs employed by the Country Health South Australia Local Health Network for Mental Health, authors found that the respondents showed positive attitudes towards MHN prescribing although they expressed concerns about safety, educational preparation and supervision structures (Muyambi et al, ). Perhaps the shortage of psychiatrists in regional areas influenced the opinions of the regional group; similarly, the metropolitan group's opinions may have been affected by them practising in a healthcare environment that has adequate access to psychiatrists.…”

Section: Discussionmentioning

confidence: 99%

“…The regional focus group was more positive about granting prescribing rights for MHNs, while the metropolitan focus group adopted a more cautious view. (Muyambi et al, 2018). Perhaps the shortage of psychiatrists in regional areas influenced the opinions of the regional group; similarly, the metropolitan group's opinions may have been affected by them practising in a healthcare environment that has adequate access to psychiatrists.…”

Section: One State Two Worldsmentioning

confidence: 99%

Rural and metropolitan South Australian mental health workers’ views about nurse prescribing: A thematic analysis

Muyambi

Leach

Martinez

et al. 2018

Health Soc Care Community

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Almost one third of the South Australian population reside in regional locations, which are serviced by just 8% of the State's total psychiatrist workforce. Consequently, access to psychotropic medications in regional South Australia (SA) can be challenging. Granting prescribing rights to mental health nurses (MHNs) located in regional settings presents an opportunity to increase consumer access to psychotropic medications. The aim of the study was to understand the perspectives of mental health workers (MHWs) practising in regional and metropolitan settings towards MHN prescribing. The study adopted a qualitative approach. Seventeen MHWs participated in three focus groups, including two in regional SA and one in a metropolitan site within the State of SA. Participants reported difficulties in accessing medicines in regional areas. The regional focus groups indicated that MHN prescribing may help to release psychiatrists' time and provide quicker assessment and diagnosis. By contrast, the metropolitan focus group expressed reservations about MHN prescribing. Participants indicated that suitable governance structures supported by appropriate education programmes were a necessary prerequisite for MHN prescribing of psychotropic medications. MHN prescribing may help to mitigate the impact of psychiatrist shortages in regional South Australia and possibly in other areas of the world where recruitment is a challenge. The provision of adequate education and the establishment of a suitable governance and support framework are considered necessary steps to progress MHN prescribing.

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“…We revisited this topic in the context that the distribution of GPs is unbalanced across areas and does not correspond with need in Australia in recent years [12][13][14][15][16]. There is higher availability of GPs in urban and inner regional areas [17], although there is also variation within urban areas (as shown in our data).…”

Section: Introductionmentioning

confidence: 96%

What explains the regional variation in the use of general practitioners in Australia?

Hall

2020

BMC Health Serv Res

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Background: Regional variation in the use of health care services is widespread. Identifying and understanding the sources of variation and how much variation is unexplained can inform policy interventions to improve the efficiency and equity of health care delivery. Methods: We examined the regional variation in the use of general practitioners (GPs) using data from the Social Health Atlas of Australia by Statistical Local Area (SLAs). 756 SLAs were included in the analysis. The outcome variable of GP visits per capita by SLAs was regressed on a series of demand-side factors measuring population health status and demographic characteristics and supply-side factors measuring access to physicians. Each group of variables was entered into the model sequentially to assess their explanatory share on regional differences in GP usage. Results: Both demand-side and supply-side factors were found to influence the frequency of GP visits. Specifically, areas in urban regions, areas with a higher percentage of the population who are obese, who have profound or severe disability, and who hold concession cards, and areas with a smaller percentage of the population who reported difficulty in accessing services have higher GP usage. The availability of more GPs led to higher use of GP services while the supply of more specialists reduced use. 30.56% of the variation was explained by medical need. Together, both need-related and supply-side variables accounted for 32.24% of the regional differences as measured by the standard deviation of adjusted GP-consultation rate. Conclusions: There was substantial variation in GP use across Australian regions with only a small proportion of them being explained by population health needs, indicating a high level of unexplained clinical variation. Supply factors did not add a lot to the explanatory power. There was a lot of variation that was not attributable to the factors we could observe. This could be due to more subtle aspects of population need or preferences and therefore warranted. However, it could be due to practice patterns or other aspects of supply and be unexplained. Future work should try to explain the remaining unexplained variation.

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What do mental health workers in the bush think about mental health nurse prescribing? A cross‐sectional study

Cited by 12 publications

References 23 publications

Evidence‐informed implementation of nurse prescribing under supervision: An integrative review

Evidence‐informed implementation of nurse prescribing under supervision: An integrative review

Rural and metropolitan South Australian mental health workers’ views about nurse prescribing: A thematic analysis

What explains the regional variation in the use of general practitioners in Australia?

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