Bee Penny, Richards David, Loftus Samantha, Baker John, Bailey Lorna, Lovell Karina
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
J Adv Nurs. 2005 Sep;51(5):529-38. doi: 10.1111/j.1365-2648.2005.03519.x.
This paper reports a study to ascertain the views of acute ward-based mental health nursing staff on the delivery, content and personal impact of an innovative 18-day, whole team educational intervention in acute mental health care.
There are grave concerns internationally about the quality of inpatient mental health care for people with acute psychiatric problems. Educational courses are needed to improve these services. However, existing schemes are often selective, hard to access and limited to developing highly specialist skills for senior nurses. They have also been criticized for making no difference to clinical practice. There is little evidence to guide the development of these or alternative team-based courses.
Qualitative data were collected over a 6-week period using 12 focus group interviews and individual questionnaires.
Four themes were identified. The joint education of nursing staff from different organizations was welcomed and reduced feelings of ward isolation. Mixing qualified and unqualified staff was not regarded positively. In terms of course content and learning themes, unqualified staff were more likely to report positive learning outcomes for knowledge, skills, attitude, morale and personal development; qualified nurses were more likely to indicate positive outcomes in anonymized data from questionnaires than from focus groups. Both groups reported little chance of knowledge implementation without changes in the organization of care.
Whilst it may be desirable to educate whole nursing teams, more benefit might be gained from shared education between several organizations and separating the education of qualified and unqualified staff before combining these groups in team education. Participants remained pessimistic about their chances of implementing new knowledge and skills in current acute inpatient mental health environments.
本文报告一项研究,以确定急性精神科病房的心理健康护理人员对一项创新的、为期18天的全团队教育干预在急性精神卫生保健中的实施情况、内容及个人影响的看法。
国际上对急性精神病患者的住院心理健康护理质量深感担忧。需要开展教育课程来改善这些服务。然而,现有的方案往往具有选择性,难以参与,且仅限于为高级护士培养高度专业化的技能。这些方案还因对临床实践没有产生影响而受到批评。几乎没有证据可指导这些课程或替代的团队式课程的开发。
在6周的时间内,通过12次焦点小组访谈和个人问卷收集定性数据。
确定了四个主题。来自不同组织的护理人员联合接受教育受到欢迎,并减少了病房内的孤立感。合格与不合格员工混合的做法未得到积极评价。在课程内容和学习主题方面,不合格员工更有可能报告在知识、技能、态度、士气和个人发展方面有积极的学习成果;在问卷调查的匿名数据中,合格护士比在焦点小组中更有可能表明有积极成果。两组均表示,如果护理组织不改变,知识应用的机会很少。
虽然对整个护理团队进行教育可能是可取的,但在团队教育中将这些群体合并之前,几个组织之间的共享教育以及将合格和不合格员工的教育分开,可能会带来更多益处。参与者对在当前急性住院心理健康环境中应用新知识和技能的机会仍持悲观态度。