TY - JOUR
T1 - Developing nurse-sensitive outcomes in acute inpatient mental health settings—A systematic review
AU - Ngune, Irene
AU - Myers, Helen
AU - Cole, Amanda
AU - Palamara, Peter
AU - Redknap, Robina
AU - Roche, Michael
AU - Twigg, Diane
N1 - Funding Information:
The authors would like to thank Yvonne Kutzer for assistance with the literature search. Open access publishing facilitated by Edith Cowan University, as part of the Wiley - Edith Cowan University agreement via the Council of Australian University Librarians.
Publisher Copyright:
© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
PY - 2023/9
Y1 - 2023/9
N2 - Background: While nurse-sensitive outcomes (NSOs) are well established in numerous health settings, to date there is no indicator suite of NSOs for inpatient mental health settings. Aim: To assess the relationship between nursing variables and patient outcomes in acute inpatient mental health settings to determine which outcomes can be used as indicators of the quality of nursing care. Methods: Databases accessed were CINAHL, MEDLINE, PsycINFO and EMBASE, last searched in May 2022. The review followed the 2020 PRISMA checklist for systematic reviews. Papers published between 1995 and 2022, conducted in acute mental health care units were included. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool. A meta-analysis was not possible because of the large number of variables and measurement inconsistencies. Results: A total of 57 studies were reviewed. Studies were categorised according to whether they found a significant or non-significant relationship between nurse variables and patient outcomes. Seven outcomes—aggression, seclusion, restraint, absconding, pro-re-nata medications, special observations and self-harm—were identified. For each outcome, there were significant findings for several nurse variables indicating that all included outcomes could be used as NSOs. However, evidence for aggression, seclusion and restraint use as suitable NSOs was more robust than the evidence for self-harm, absconding, pro-re-nata medications and special observations. Conclusion: All the seven outcomes can all be used to develop an NSO indicator suite in mental health inpatient settings. More work is needed to establish high-quality studies to clearly demonstrate the relationship between these outcome measures and changes in nurse variables such as nurse staffing, skill mix, work environment, nurse education and nurse experience. Patient and Public Contribution: Patient or public contribution was not possible because of the type of the variables being explored.
AB - Background: While nurse-sensitive outcomes (NSOs) are well established in numerous health settings, to date there is no indicator suite of NSOs for inpatient mental health settings. Aim: To assess the relationship between nursing variables and patient outcomes in acute inpatient mental health settings to determine which outcomes can be used as indicators of the quality of nursing care. Methods: Databases accessed were CINAHL, MEDLINE, PsycINFO and EMBASE, last searched in May 2022. The review followed the 2020 PRISMA checklist for systematic reviews. Papers published between 1995 and 2022, conducted in acute mental health care units were included. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool. A meta-analysis was not possible because of the large number of variables and measurement inconsistencies. Results: A total of 57 studies were reviewed. Studies were categorised according to whether they found a significant or non-significant relationship between nurse variables and patient outcomes. Seven outcomes—aggression, seclusion, restraint, absconding, pro-re-nata medications, special observations and self-harm—were identified. For each outcome, there were significant findings for several nurse variables indicating that all included outcomes could be used as NSOs. However, evidence for aggression, seclusion and restraint use as suitable NSOs was more robust than the evidence for self-harm, absconding, pro-re-nata medications and special observations. Conclusion: All the seven outcomes can all be used to develop an NSO indicator suite in mental health inpatient settings. More work is needed to establish high-quality studies to clearly demonstrate the relationship between these outcome measures and changes in nurse variables such as nurse staffing, skill mix, work environment, nurse education and nurse experience. Patient and Public Contribution: Patient or public contribution was not possible because of the type of the variables being explored.
KW - inpatients
KW - mental health nursing
KW - mental health services
KW - nurses
KW - outcomes assessment
UR - http://www.scopus.com/inward/record.url?scp=85150627559&partnerID=8YFLogxK
U2 - 10.1111/jocn.16679
DO - 10.1111/jocn.16679
M3 - Article
C2 - 36915223
AN - SCOPUS:85150627559
SN - 0962-1067
VL - 32
SP - 6254
EP - 6267
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
IS - 17-18
ER -
