Begum R, Riordan S
Clinical and Corporate Nursing, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.
School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
J Psychiatr Ment Health Nurs. 2016 Feb;23(1):45-53. doi: 10.1111/jpm.12276.
Through their gatekeeping role, CRHTT aim to reduce inappropriate admissions, facilitate early discharge from hospital and maximize the ability of service users to live independently within their own communities. It is evident that there is a vast array of literature on CRHTT internationally, however, little evidence on nurses experiences of working within CRHTT and gatekeeping. Therefore, in the light of limited research, this study aims to expand the current evidence base by exploring nurse's experiences of working in CRHTT with its additional gatekeeping responsibilities.
Six nurses working across two CRHTT's were interviewed using semi-structured interviews. Data were analysed through the use of thematic analysis.
Four key themes emerged which were, 'CRHTT as a specialist role', 'core principles of the gatekeeping role', 'redefining risk management for gatekeepers in CRHTT' and 'the future of gatekeeping'.
It is evident through nurse's experiences of working within CRHTT and gatekeeping that their roles were very dynamic and challenging. A positive risk-taking approach contributed towards the success of CRHTT as gatekeepers. Family members played a significant role in ensuring gatekeeping remained a priority consistent with Government targets. Clinical Implications and recommendations for future research are discussed.
危机解决与家庭治疗小组（CRHTT）通过其把关作用，旨在减少不适当的住院情况，促进患者早日出院，并最大限度地提高服务使用者在其社区内独立生活的能力。显然，国际上有大量关于CRHTT的文献，然而，关于护士在CRHTT内工作及把关方面的经验的证据却很少。因此，鉴于研究有限，本研究旨在通过探索护士在承担额外把关职责的CRHTT中的工作经历，来扩充当前的证据基础。
对在两个CRHTT工作的六名护士进行了半结构化访谈。通过主题分析对数据进行了分析。
出现了四个关键主题，即“CRHTT作为一种专业角色”、“把关角色的核心原则”、“为CRHTT中的把关者重新定义风险管理”以及“把关的未来”。
从护士在CRHTT内工作及把关的经历可以明显看出，他们的角色非常动态且具有挑战性。积极的冒险方法有助于CRHTT作为把关者取得成功。家庭成员在确保把关与政府目标一致并始终作为优先事项方面发挥了重要作用。讨论了临床意义和对未来研究的建议。
