School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.
Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
Int J Ment Health Nurs. 2024 Aug;33(4):1073-1081. doi: 10.1111/inm.13312. Epub 2024 Feb 28.
In Australia, acute inpatient units within public mental health services have become the last resort for mental health care. This research explored barriers and facilitators to safe, person-centred, recovery-oriented mental health care in these settings. It utilised participant observations conducted by mental health nurses in acute inpatient units. These units were located in three distinct facilities, each serving different areas: a large metropolitan suburban area in a State capital, a mid-sized regional city, and a small city with a large rural catchment area. Our findings highlighted that, in the three inpatient settings, nurses tended to avoid common areas they shared with consumers, except for brief, task-related visits. The prioritisation of administrative tasks seemed to arise in a situation where nurses lacked awareness of alternative practices and activities. Consumers spent prolonged periods of the day sitting in communal areas, where the main distraction was watching television. Boredom was a common issue across these environments. The nursing team structure in the inpatient units provided a mechanism for promoting a sense of psychological safety for staff and were a key element in how safety culture was sustained.
在澳大利亚，公共精神卫生服务中的急性住院病房已成为精神卫生保健的最后手段。本研究探讨了在这些环境中实现安全、以患者为中心、以康复为导向的精神卫生保健的障碍和促进因素。它利用精神科护士在急性住院病房进行的参与式观察。这些病房位于三个不同的设施中，每个设施服务于不同的地区：一个州首府的大型都市区、一个中型区域城市和一个拥有大型农村服务区的小城市。我们的研究结果表明，在这三个住院环境中，护士往往避免与患者共用的公共区域，除非是短暂的、与任务相关的访问。行政任务的优先级似乎出现在护士缺乏替代做法和活动意识的情况下。消费者在公共区域度过一天的大部分时间，主要的消遣是看电视。在这些环境中，无聊是一个常见的问题。住院病房的护理团队结构为员工提供了一种促进心理安全感的机制，是维持安全文化的关键因素。
