Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing: A qualitative enquiry.

Maguire, T; Garvey, L; Ryan, J; Levett-Jones, T; Olasoji, M; Willetts, G

Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing: A qualitative enquiry.

Maguire, T Garvey, L Ryan, J Levett-Jones, T

Olasoji, M Willetts, G

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Int J Ment Health Nurs, 2023, 32, (2), pp. 544-555
Issue Date:: 2023-04

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Field	Value	Language
dc.contributor.author	Maguire, T
dc.contributor.author	Garvey, L
dc.contributor.author	Ryan, J
dc.contributor.author	Levett-Jones, T https://orcid.org/0000-0003-4279-8957
dc.contributor.author	Olasoji, M
dc.contributor.author	Willetts, G
dc.date.accessioned	2023-10-06T04:08:34Z
dc.date.available	2022-11-02
dc.date.available	2023-10-06T04:08:34Z
dc.date.issued	2023-04
dc.identifier.citation	Int J Ment Health Nurs, 2023, 32, (2), pp. 544-555
dc.identifier.issn	1445-8330
dc.identifier.issn	1447-0349
dc.identifier.uri	http://hdl.handle.net/10453/172547
dc.description.abstract	Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to 'own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Int J Ment Health Nurs
dc.relation.isbasedon	10.1111/inm.13096
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services, 1701 Psychology
dc.subject.classification	Nursing
dc.subject.classification	3904 Specialist studies in education
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.subject.mesh	Humans
dc.subject.mesh	Psychiatric Nursing
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Workforce
dc.subject.mesh	Caregivers
dc.subject.mesh	Humans
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Psychiatric Nursing
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Caregivers
dc.subject.mesh	Workforce
dc.subject.mesh	Humans
dc.subject.mesh	Psychiatric Nursing
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Workforce
dc.subject.mesh	Caregivers
dc.title	Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing: A qualitative enquiry.
dc.type	Journal Article
utslib.citation.volume	32
utslib.location.activity	Australia
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
utslib.for	1701 Psychology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-10-06T04:08:33Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	32
utslib.citation.issue	2

Abstract:

Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to 'own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team.

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http://hdl.handle.net/10453/172547