McAdam M, Wright N
Clinical Governance and Risk Management Department, Nottinghamshire Health Care NHS Trust, Duncan MacMillan House, Mapperley, UK.
J Psychiatr Ment Health Nurs. 2005 Dec;12(6):648-60. doi: 10.1111/j.1365-2850.2005.00889.x.
A review of the literature considering the role of mental health nurses in assertive outreach Assertive outreach teams are a central component of the UK government vision for Mental Health. The general aim of such services is to engage with clients who for one reason or another lose contact with traditional services and require a more flexible approach to care. Researchers and the Government recognize that nurses who work within Assertive Outreach need specialist skills, knowledge and personal attributes to carry out their work. A comprehensive review of the literature was carried out via computer search engines, an Internet search and a hand search of pertinent references. Two screens were applied to the literature to make sure only the highest quality information was evaluated. The results of the literature search were presented in tabular format and three key themes were identified as being important for mental health nurses working in assertive outreach services. These themes were clinical knowledge and skills, successful outcomes for assertive outreach services and personal attributes of practitioners. Multidisciplinary working within assertive outreach services allows for some of the ethical dilemmas to be resolved. However, the competing demands placed on nurses, including risk assessment verses engagement, may lead to high stress levels and burnout. Research studies highlight that without experienced and knowledgeable staff the provision of an assertive outreach model is in jeopardy. The Government and service providers need to ensure that practitioners within assertive outreach services receive sufficient training, managerial and clinical supervision, in order to do the best for a very challenging and chaotic client group.
关于心理健康护士在主动外展服务中作用的文献综述 主动外展服务团队是英国政府心理健康愿景的核心组成部分。此类服务的总体目标是接触那些因某种原因与传统服务失去联系且需要更灵活护理方式的客户。研究人员和政府认识到，在主动外展服务中工作的护士需要专业技能、知识和个人特质来开展工作。通过计算机搜索引擎、互联网搜索以及对相关参考文献的手工检索，对文献进行了全面综述。对文献应用了两道筛选程序，以确保仅评估最高质量的信息。文献检索结果以表格形式呈现，确定了三个对在主动外展服务中工作的心理健康护士至关重要的关键主题。这些主题是临床知识与技能、主动外展服务的成功成果以及从业者的个人特质。主动外展服务中的多学科协作有助于解决一些伦理困境。然而，对护士的相互冲突的要求，包括风险评估与接触客户，可能导致高压力水平和职业倦怠。研究表明，没有经验丰富且知识渊博的工作人员，主动外展模式的提供将面临风险。政府和服务提供者需要确保主动外展服务中的从业者接受充分的培训、管理和临床监督，以便为极具挑战性且混乱的客户群体提供最佳服务。
