Emergency Department Mental Health Triage and Consultancy Service: An advanced practice role for mental health nurses

Stuart McDonough
Directorate of Mental Health, Fremantle Hospital and Health Service, Fremantle WA

Dianne Wynaden
School of Nursing, Curtin University of Technology, Perth; Directorate of Mental Health, Fremantle Hospital and Health Service, WA

Michael Finn
Inpatient Manager/Coordinator of Mental Health Nursing, Directorate of Mental Health, Fremantle Hospital and Health Service, WA

Sunita McGowan
Director, Nursing Research and Evaluation, Fremantle Hospital and Health Service; Adjunct Research Fellow, School of Nursing and Midwifery, Curtin University of Technology, Perth WA

Rose Chapman
School of Nursing and Midwifery, Curtin University of Technology; Nurse Research Consultant ED, Curtin University, Joondalup Health Campus, Perth WA

Shirilee Gray
Fremantle Hospital and Health Service, WA

PP: 138 - 144

Abstract

This paper describes a four-month preparatory training program for mental health nurses to provide an Emergency Mental Health Triage and Consultancy Service in the emergency department. The emergency department is an important gateway for patients presenting with psychiatric/psychosocial problems and mental health professionals need to provide prompt and effective care to this group of patients.

Prior to the implementation of the service, it was acknowledged that occupational stress and burnout could affect the turnover of mental health nurses in the department. Therefore, a training program was employed to prepare a number of experienced mental health nurses to work at an advanced practitioner level. The four-month training program developed at Fremantle Hospital in Western Australia provided support, guidance and clinical supervision. In the first 12 months of the service, five mental health nurses completed the program, thus creating a pool of nurses who were able to provide the service.

The results demonstrated that providing mental health nurses with a structured program was instrumental in facilitating their movement to an advanced practitioner level. The nurses were able to apply advanced knowledge and skills to assess and manage clients with complex mental health/psychosocial problems. Furthermore, on leaving the emergency department these nurses were able to utilise the advanced skills in other areas of mental health nursing practice.

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Keywords

mental health nurse; advanced practitioner; emergency department; psychiatric/psychosocial problems


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References

Australian Health Ministers (1992): National Mental Health Policy: National Mental Health Strategy, Canberra: Commonwealth Department of Health and Family Services.

Bolton J. (2001): Liaison psychiatry. British Medical Journal 10th Feb, 2-3.

Happell B, Summers M, & Pinkahana J (2002): The triage of psychiatric patients in the hospital emergency department: A comparison between emergency department nurses and psychiatric nurse consultants. Accident and Emergency Nursing 10: 65-71.

Hood S, McDonough S, & Finn M (2001): Emergency department mental health triage and consultancy service 'EMTaCS'. Pilot phase: June - August 2001. Unpublished Report the Directorate of Mental Health, Fremantle Hospital and Health Service.

Hurry J, & Storey P. (2000): Assessing young people who deliberately harm themselves. British Journal of Psychiatry 176:126-131.

McAllister M, Creedy D, Moyle W, & Farrugia C (2002): Study of Queensland emergency department nurses' actions and formal and informal procedures for clients who self-harm. International Journal of Nursing Practice 8: 184-190.

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Wynaden D, Chapman R, McGowan S, McDonough S, & Finn M. (2003): Emergency department mental health triage consultancy service: A qualitative evaluation. Accident and Emergency Nursing (In press).



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