Caring for the mental illness patient in emergency departments - an exploration of the issues from a healthcare provider perspective
Caring for the mental illness patient in emergency departments - an exploration of the issues from a healthcare provider perspective
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DOI：
10.1111/jocn.12437
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发表时间：
2014-07-01
影响因子：
4.2
通讯作者：
Munro, Ian
中科院分区：
文献类型：
--
作者：
Innes, Kelli;Morphet, Julia;Munro, Ian
目的和目标：从急诊科临床医生的角度，确定急诊科精神疾病患者的管理问题。背景尽管推出了几个全州和国家的倡议，障碍仍然影响到消费者的护理和管理提出了精神疾病的急诊科。提高心理健康服务的反应能力，包括为危机中的人提供更有效的应急反应，是一个关键目标。为了在急诊室提供反应迅速的精神卫生服务，需要各服务部门共同努力，确保在主流服务和为满足特定人群的独特需求而开发的服务之间进行适当的转诊。设计采用调查和焦点小组的混合方法。方法从精神疾病患者及其近亲/照顾者，以及急诊科和医疗保健网络的精神卫生服务工作人员那里收集数据。结果研究发现，有不一致和赤字的教育准备的急诊科工作人员管理消费者提出的精神疾病。此外，急诊室的物理环境不足，导致难以评估和管理这组患者。结论工作人员在精神卫生服务和急诊科总结了关键的改进领域，需要电子病历，改善急诊室的环境，精神卫生培训，实施转诊服务和增加工作人员的数量。与临床实践的相关性虽然已经实施了一些措施，但需要更加注重教育急诊科的工作人员，使他们了解旨在改善精神健康问题患者的护理和管理的政策和战略。
Aims and objectives To identify issues, from the emergency department clinicians' viewpoint, with the management of patients presenting to the emergency department with a mental illness. Background Despite the introduction of several statewide and national initiatives, barriers remain affecting the care and management of consumers presenting with an mental illness to the emergency department. Improving the responsiveness of mental health services, including the provision of more efficient emergency responses for people in crisis, is a key goal. To achieve responsive mental health services in emergency departments, services are required to work together to ensure appropriate referrals between mainstream services and to those services developed to meet the unique needs of specific population groups. Design A mixed method approach using surveys and focus groups. Methods Data were collected from patients with mental illness and their next of kin/carers, as well as staff working within the emergency department and the mental health services of the healthcare network. Results The study found that there were inconsistencies and deficits in the educational preparation of emergency department staff to manage consumers presenting with mental illness. Further, the inadequate physical environment of the emergency department contributed to difficulties in assessing and managing this group of patients. Conclusions Staff members working within mental health services and the emergency department summarised the key improvement areas as the need for electronic case notes, improvements to the emergency department environment, mental health training, implementation of a referral service and increasing the number of staff. Relevance to clinical practice Although initiatives have been implemented, there needs to be a greater focus on educating the staff in emergency departments in relation to the policies and strategies which aim to improve the care and management of patients presenting with a mental health problem.