Mental Health Care in Emergency Settings

This assignment delves into the critical topic of providing mental health care within the often-stressful environment of emergency departments. Students are tasked with examining evidence-based practices for triaging clients experiencing mental health crises, ensuring patient safety during these interactions, and implementing effective interventions to address their immediate needs. The assignment emphasizes the importance of a compassionate and informed approach to mental health care in urgent situations.

Running head: EVIDENCE-BASED HEALTH RESEARCH AND PRACTICE 1
Evidence-Based Health Research and Practice
Student’s Name
Institution
Professor’s Name
Date

EVIDENCE-BASED-HEALTH RESEARCH AND PRACTICE 2
Introduction
 This journal article illustrates the implications of the emergency department(ED)
triage practice environment on the triage practice of nurses who triage clients with
a mental illness.
 This was necessary due to the increasing number of mental patients in Australian
emergency departments to improve their health care which brings about a positive
impact to the entire Australian nation thereby making it a highly regarded journal.
 It was published in Australia.
 The information in the journal is very imperative as it enlightens on the need for
the ED triage environment being set in a manner that ensures the mental patients
are secure and their privacy not invaded (Broadbent, Moxham & Dwyer, 2014).
 The authors used information from the first authors Ph.D.
 They are experts in this field since they engaged in their own research and did not
plagiarize the work of the other authors but only used the information to get their
facts right.
 This research was done as part of the requirement at the college of emergency
nursing in Australasia.
 The authors are Ph.D. holders who are very competent.
 The information about the authors brings about confidence in their research hence
promotes the need to implement what is entailed in the journal to help in assisting
the clients with mental illness.
Background Aims

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 The background research question is how will the triage nurses ensure the triage
emergency department environment to enhance better health care to the clients
with mental illness?
 The key points in the background of this article are the mental health, triage
nurses, health care, emergency department and the triage environment which are
all used to bring about the significance of this study. The research is to enhance a
triage environment with the infrastructure that favors the mental patient's security
and privacy so as to avoid exposing the patients to public scrutiny (Dobson &
Dobson, 2016). The infrastructure should be one that enables the mental patients
to be in an enclosed room which is visible to the triage nurses to observe their
progress before seeing the specialist.
 The literature review entails the redesigning and occupying the new emergency
departments. This was necessary due to the tension caused by the mentally ill
patients in the waiting room environment as they wait to be attended to by the
mental health specialist (Sandoval, 2016). For this reason, the emergency
department triage environment should be designed in such a manner that it
enhances the patient’s privacy, security and visualizing just to be sure they do not
harm themselves.
 The significance of this study is to redesign the emergency departments so as to
ease the processes in the ED and improve client health care (Townsend, 2014).
 This study explains how the triage nurses should not only engage nursing
activities such as assessment of clients but also providing the required care to the

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patients and their families in their waiting rooms and how they should manage
the patients with mental illness in the emergency department.
 The specific aims of the research were;
 To provide an emergency department environment that was easily accessible with
necessary equipment that is safe for both the mentally ill patients and the triage nurses.
 To engage the architectures in the designing of emergency departments in such a manner
that is private but visible to the triage nurses so as to enhance privacy of the mentally ill
patients as they wait to be attended to by the clinician (Pich, et.al., 2017).
Methods
 The research was done through ethnographic design to observe how the triaging
nurses offered their services at the triaging emergency department to the triaging
patients who suffered from mental illness (Broadbent, et.al., 2014). It has also drawn
findings from a broader ethnographic observation that was done to determine the
relationship between the triage nurse and the triage mental specialists making the data
very reliable and effective.
 Adequate time of eight weeks was used to engage the participants in data collection
process. The study participants were the forty-five staff who were qualified to
conduct triage during data collection. The participants were given roles to perform
and they had three shifts in a day to make sure they collected quality data for the
study. There was to be one nurse for the morning shift, two for the afternoon shift and
finally one for the night shift hence no particular was left out since patients are
brought into the hospital at any time.

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 The ethnographic design is the best design since it reflects on the real evidence
(Oliver, Lorenc & Innvær, 2014). This was enhanced through training of the nurses
for triage training and was qualified for the triage process.
 The population where data was collected was well described and the sample to be
used for the data collection process to represent the whole population of Australia.
 The sample was, therefore, a regional hospital in Australia that had a very large
emergency department that consisted of around forty-four thousand sections that are
well separated for clients.
 A desirable percentage of these patients were those with mental illness hence making
it a good sample to be used to represent the whole population thereby making it an
adequate sample size.
 The triage nurses took a sample of twenty eight clients to represent the whole
population of the clients who were mentally ill since they could not collect data from
all of them.
Assessment 3: Critique of qualitative research article
Data collection
 The methods of collecting data were very appropriate for this kind of research since it
was a qualitative research.
 The data collection process entailed different methods like observation, both the
formal and informal interviews with the triage nurses and some field findings.
 All these methods used to collect data were imperative in achieving triangulation.

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 A sufficient amount of data was collected within that specified period and it was
adequate to bring about the required findings.
 The data collected had sufficient richness and relevance, for instance, the interview
gave the researcher easy time to confirm the records of the observation made in the
field hence making the recording process appropriate (Messac et.al., 2013).
Procedures
 The data collection and recording procedures were very accurate since they relayed
first-hand information from the clients with mental illness.
 Tape recording and transcribing verbatim of interviews before analysis portrayed a
fewer bias data.
Enhancement of trustworthiness
 The researchers engaged in some critical strategies that enhanced integrity and
trustworthiness of the study which were very adequate as they ensured the ethical
standards were well observed.
 The nurses who collected data like interviewing were engaged in triage training and
it was ensured that they were fit for the triage activity. In addition to that their
qualifications and experience was significant in generating confidence in their
findings and interpretations.
Results
 The data analysis method that was used to analyze the data collected from the field was a
constant comparative method which is an appropriate method for analyzing qualitative

EVIDENCE-BASED-HEALTH RESEARCH AND PRACTICE 7
data. This type of analysis is a systematic and integrated approach since it is used to
analyze narratives that consist of people’s ideas and their intuitions of the relevant data
from the field (Palinkas, et.al, 2015).
 The analysis yielded various theories through analysis of one data and comparing it to
other sources of data hence making it the most critical method for analyzing this data.
 The analytic procedure was not biased since the authors analyzed and compared them to
other sources of data and did theoretical coding independently and later compared for the
purpose of consistency and ensuring there is no biasness.
Findings
 The findings were effectively summarized into three categories that are the triage
environment, the triage assessment, and the client management. The use of excerpts to
support the arguments in the findings is marvelous and they are well quoted to show they
are words said by someone during the research process and the person who said the
words is indicated (Hamer & Collinson, 2014).
 The three themes in the findings adequately capture the meaning of the data like the
triage environment highlights the requirements need in the environment and how best
possible it should be located, the client management encompasses the emergency
department nurses elaborating how they think the clients with mental illness should be
well taken care of in a manner that is reassuring to them and their families (Sandoval,
2016).
 This, therefore, shows that the researcher satisfactorily conceptualized the themes in the
data so as to enhance effective care and management of the clients with mental illness by

EVIDENCE-BASED-HEALTH RESEARCH AND PRACTICE 8
structuring triage environment that ensures their privacy and safety as they wait to be
attended to by the mental specialists.
 The analysis yielded a meaningful, insightful and provocative view of the case under
study hence the need for the necessary changes.
Summary Assessment and Conclusion
 The study findings are very trustworthy and have important facts that make the
reader have a lot of confidence in it since it has illustrated the research process
accurately revealing a detailed literature review, data collection process, and
analysis methods and discussed the findings effectively by providing facts and
providing their basis of argument. It has clearly stated the desired architectural
steps that will create a triage environment for the triage nurse to provide optimal
health care to the mental patients (Grove, Burns & Gray, 2014). This enhances
room for good communication as well as privacy and security of the patients
which was the need for the study.
 The study has brought about meaningful evidence in the field of nursing like the
need to have a triage environment to enable the nurses to manage the
overcrowded waiting rooms effectively and enhance a rapid decision-making
process. Furthermore, this reduces the tension caused by clients who are mentally
ill in the waiting rooms as they wait to be attended to hence reducing the stress
that arises between the client and the staff or nurses. In conclusion, mentally ill
clients can be facilitated with better care through a good emergency department
triage environment that suits them hence hospitals should adopt this strategy.

EVIDENCE-BASED-HEALTH RESEARCH AND PRACTICE 9
Relevance to Nursing and Case Study
Principles of evidence-based practice
a) Patient values
This research focuses its argument on the mental health patients hence the patient values. The
patient should be the first priority hence hospital should be patient-centered. The patient-centered
approach is very effective and essential especially in cases of complex diseases like mental
health (Montori et.al., 2013). The nurses should, therefore, ensure they consider patient values
and preferences before any other interest. For this reason, the research shows patient-centered
approach leads to positive outcomes, rapid decision making and good communication with the
staff and the clients thereby facilitating evidence-based practice.
b) Clinical expertise
Clinical expertise is one of the best evidence-based practices. It incorporates the acquired
knowledge and skills that one has learned in health care activities and applying the experience
gained to make informed clinical decisions (DiCenso et.al., 2014). Clinical expertise enhances
the ability of the nurse to manage and improve the patients care. This research provides clinical
expertise in managing the mental patients in the emergency department through their experience
and qualifications to provide quality healthcare which is a significant role in the evidence-based
practice. This can be enhanced through the application of the findings of the study in the
research.
c) Available evidence

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Evidence from other sources, for example, the scientific sources, case studies, and information
from experts should be made available for the purposes of research. They provide enough
evidence that can be referred to by the nurses to improve or provide better health care to clients
who are mentally ill or rather those with complex conditions. The available evidence helps in
improving the communication between the patient and the nurses hence reducing the
unnecessary stress that is caused by the tension. They should consider incorporating the available
evidence from the research into practice for the better health care facilities (Schneider &
Whitehead, 2013).
d) Context
For the evidence-based practice to be put into practice, then the context of the practice should be
taken into account. For the implementation process of the evidence-based practice to be
successful then a very supportive context should be considered (Hall & Roussel, 2016). The
important aspects of the context should be drawn from the research findings and be implemented
in the current practice to enhance better health care for the clients who are mentally ill.

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Bibliography
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Sandoval, D.. (2016). Implementing Change to Decrease the Emergency Department Visits for Pediatric
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