A realist evaluation of weighted modalities as an alternative to pro re nata medication for mental health inpatients

2022 ◽  
Author(s):  
Suzanne Dawson ◽  
Candice Oster ◽  
Justin Scanlan ◽  
Jocelyn Kernot ◽  
Barry Ayling ◽  
...  
Keyword(s):  
Mental Health ◽  
Realist Evaluation ◽  
Pro Re Nata

scholarly journals Realist Evaluation of the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care (EURIPIDES) in England: study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e021013 ◽  
Author(s):  
Scott Weich ◽  
Sarah-Jane Hannah Fenton ◽  
Kamaldeep Bhui ◽  
Sophie Staniszewska ◽  
Jason Madan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Patient Experience ◽  
Study Protocol ◽  
Realist Evaluation ◽  
Inpatient Mental Health

scholarly journals Reducing the use of oral psychotropic PRN medication in acute mental health inpatients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S210-S210
Author(s):  
Zoe Moore ◽  
Rachel Morrow ◽  
Meta McGee
Keyword(s):  
Mental Health ◽  
Median Number ◽  
Hospital Environment ◽  
Process Time ◽  
List Type ◽  
Type Number ◽  
Negative Consequences ◽  
Nursing Administration ◽  
Pro Re Nata ◽  
The Impact

AimsProject aim:To reduce the use of oral psychotropic PRN* medication on Ward 3 AMHIC (Acute Mental Health Inpatient Centre) by 20% by May 2020(*PRN = Pro re nata/As required)On Ward 3, we identified a number of unintended negative consequences of PRN medication to both patients and staff.These included issues with over-use, dependence and side effects; as well as loss of staff ownership and challenging interactions with patients, (including escalation to aggression).Following the success of our Child and Adolescent Mental Health Inpatient colleagues in this area, we decided to embark on a project to change practice within our ward.MethodIn order to quantify the problem, we first collected baseline data on current use of psychotropic PRN medication.As a multidisciplinary project team, we then brainstormed potential contributory factors and displayed these visually as a driver diagram.This divided our project into 3 main areas: 1)Safe prescribing2)Safe administration,3)Safety culture.Project measures were also agreed as follows:Outcome: Number of doses of oral psychotropic PRN medication administered per weekBalancing: Violent incidents; IM administrations of psychotropic medicationProcess: Time taken to complete interventions; Patient and staff satisfaction. Change ideas were selected and implemented sequentially, using Plan-Do-Study- Act methodology.These included: 1)Weekly review of PRN prescribing2)Nursing administration sheetData were collected weekly and plotted on our run chart.ResultBy the end of May 2020, we had exceeded our initial goal, reducing the weekly median number of doses of oral psychotropic PRN medication administered by over 30%.Our balancing measures remained stable and we gained useful insights and development ideas from a staff survey.Further change ideas were planned for implementation over the months that followed, however, the impact of the COVID-19 pandemic meant that the project lost some momentum.ConclusionDespite running into some difficulty over recent months, the team remain motivated to maintain and build upon our previous success.In the past few weeks, “Calm Cards”, (a patient-centred intervention promoting use of individualised alternative coping strategies), have been introduced.We hope that the outcomes of this intervention will be positive, both in terms of further reducing use of PRN medication and encouraging development of skills which can be utilised beyond the hospital environment.We also intend to share our learning with colleagues and explore the possibility of introducing the project to other wards within the hospital.

scholarly journals A realist evaluation of the aboriginal alcohol and drug worker program for urban aboriginal people

2021 ◽  
Author(s):  
Caitlin Joy Davey
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Aboriginal People ◽  
Cultural Beliefs ◽  
Realist Evaluation ◽  
Self Awareness ◽  
Individual Interviews ◽  
Urban Contexts ◽  
Mental Health Client ◽  
Client Needs

Background: There is limited research evaluating addictions programs for Aboriginal people in urban contexts. Objective: The current project aimed to fill this gap by conducting an evaluation of the Aboriginal Alcohol and Drug Worker Program (AADWP), offered at Friendship Centres in Ontario. Methods: A realist approach was used to evaluate the AADWP. Client-targeted focus groups and staff questionnaires were conducted to develop preliminary theories regarding how, for whom and under what circumstances the program helps or does not help clients. Individual interviews were then conducted with clients and caseworkers to test these theories. Results: Mechanisms through which clients achieved their goals were related to client needs, trust, cultural beliefs, willingness, self-awareness, and self-efficacy. Clients’ goals related to sobriety status, renewing relationships, cultural connection and mental health. Client. Staff and setting characteristics were found to moderate development of mechanisms and outcomes. Results were congruent with existing literature.

scholarly journals A Mixed-Methods Realist Evaluation of the Implementation and Impact of Community Forensic CAMHS to Manage Risk for Young People With Forensic and Mental Health Needs: Study Protocol

2021 ◽  
Vol 12 ◽  
Author(s):  
Rebecca Lane ◽  
Sophie D'Souza ◽  
Maria Livanou ◽  
Jenna Jacob ◽  
Wendy Riches ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Realist Evaluation ◽  
Research Association ◽  
The Impact

Introduction: Young people in contact with forensic child and adolescent mental health services present with more complex needs than young people in the general population. Recent policy has led to the implementation of new workstreams and programmes to improve service provision for this cohort. This paper aims to present the protocol for a national study examining the impact and implementation of Community Forensic Child and Adolescent Mental Health Services (F:CAMHS).Methods and analysis: The study will use a mixed-methods Realist Evaluation design. Quantitative service activity and feedback data will be collected from all 13 sites, as well as questionnaires from staff. Non-participant observations and qualitative interviews will be conducted with staff, young people and parents/guardians from four focus study sites. An economic evaluation will examine whether Community F:CAMHS provides good value for money. The results will be triangulated to gain an in-depth understanding of young people's, parents/guardians' and staff experiences of the service.Ethics and dissemination: Ethical approval was granted by the Health Research Association and UCL Ethics. The results will be disseminated via project reports, feedback to sites, peer-reviewed journal publications and conference presentations.

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