Brief ReportBuilding a Model of Mental Health Nurse Practitioner–led Service Provision in Australia
Section snippets
The Local Context
The Royal Prince Alfred Hospital (RPAH) is an inner city teaching hospital affiliated with the University of Sydney, and the ED is a major trauma center that manages over 75,000 presentations per year. A mental health NP position has been embedded within the ED team for many years and is based on the principles of mental health liaison nursing (MHLN5). Developing this NP role has involved a systematic process of consultation with key stakeholders, evaluation, and publication. The mental health
Implementing an ED-based Mental Health NP Outpatient Service
The scope of the mental health NP role at RPAH was expanded through the establishment of a structured and formalized outpatient service. The mental health NP outpatient service provides an in-house referral service for ED nursing and medical staff and aims to provide prompt follow-up care. The outpatient service represents an extension of the existing mental health NP role and involves individuals who have presented with mental health concerns returning to the ED for consultation based on a
The NP-led Extended-hours MHLN Service Based in the ED
In recognition of the feedback obtained from staff and patients for an expanded MHLN service in the ED at RPAH, the authors acquired a grant from Health Workforce Australia (a federal government–funded body) as part of an Australia-wide program titled “Expanded Scope of Practice for Nurses in EDs.” Funding was provided for 18 months to implement and evaluate a mental health NP-led extended-hours MHLN service and to articulate a model of care that is transferable across a range of ED settings.
Planning Ahead
The specialized skill set of NPs and the in-depth knowledge of the particular health care context that NPs develop requires conscious consideration of how to transfer such knowledge and skills from 1 practitioner to another. Effective succession planning for NP roles is identified as key to promoting safe practice and the long-term survival of NP models.16 A transitional mental health NP role has been introduced to work in conjunction with the current mental health NP in the ED at RPAH. The 2
Conclusion
Jane-Llopis and Barry18 recognize the need to identify mental health programs that are effective, feasible, low cost, sustainable, and transferable across diverse cultures and settings. The model of ED-based mental health NP-led service provision described here is a safe, flexible, and cost-effective method of enhancing access to health care that is adaptable to a broad range of ED settings. Interest in contemporary evaluation research is concerned with documenting the process of successful
Acknowledgments
The evaluation of the NP-led MHLN team was funded by a grant from Health Workforce Australia as part of the Expanded Scope of Practice (ESoP) for Nurses in the Emergency Department Project. This article does not represent the views of Health Workforce Australia.
Timothy Wand, RN, NP, MN(Hons), PhD, is an associate professor at the University of Sydney and a Sydney Local Health District nurse practitioner at Royal Prince Alfred Hospital in Camperdown, NSW, Australia. He can be reached at [email protected].
References (18)
- et al.
The mental health nurse: contributing to improved outcomes for patients in the emergency department
Accid Emerg Nurs
(2001) - et al.
Why has the nurse practitioner been granted prescribing privileges?
J Pharm Pract Res
(2011) - et al.
Client’s understanding of the role of nurse practitioners
Aust Health Rev
(2010) - et al.
The status of Australian nurse practitioners: the first national census
Aust Health Rev
(2009) Nurse practitioners in Australia: strategic errors and missed opportunities
Med J Aust
(2014)Liaison mental health nursing: origins, definition and prospects
J Adv Nurs
(1997)Mental health liaison nurses in the emergency department: on-site expertise and enhanced coordination of care
Aust J Adv Nurs
(2004)- et al.
Consumer evaluation of a mental health liaison nurse service
Contemp Nurse
(2006) - et al.
The mental health nurse practitioner in the emergency department: an Australian experience
Int J Ment Health Nurs
(2006)
Cited by (8)
Involvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries
2018, Journal of Nutrition, Health and AgingBearing Witness: The Lived Experience of Sitting With Patients
2016, Archives of Psychiatric NursingCitation Excerpt :Anticipating and identifying patients who might be at risk for delirium or other behaviors and mitigating these factors must be the first step. Collaborative nursing models developed within general hospital settings that include consultation, coaching and education of nursing personnel have been successful (Johnston & Cowman, 2008; Lakatos, Mitchell, & Etheredge, 2012; Sharrock, & Happell, 2002; Wand & White, 2015). These unique practice models have been used for decades but many have vanished as hospital costs have grown and balance sheets tightened.
Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care
2016, Journal of the American Medical Directors AssociationImplementation of the Nurse Practitioner as Most Responsible Provider model of care in a Specialised Mental Health setting in Canada
2022, International Journal of Mental Health NursingResearch progress and enlightenment of multi- site practice of specialized nurses in foreign countries
2021, Chinese Journal of Practical Nursing
Timothy Wand, RN, NP, MN(Hons), PhD, is an associate professor at the University of Sydney and a Sydney Local Health District nurse practitioner at Royal Prince Alfred Hospital in Camperdown, NSW, Australia. He can be reached at [email protected].
Kathryn White, RN, MN, PhD, is a professor of nursing at Sydney Nursing School, University of Sydney.
In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.