There is growing evidence that service users are dissatisfied with the care they are receiving on mental health acute wards. Patient satisfaction appears to be a key driver for services in monitoring the effectiveness of services however how satisfaction is measured has also caused some controversy in the literature. Service users often feel de-valued and feel that they have no role in their care and treatment, often having to rely on the nursing team to co-ordinate their care leading to the service user’s individual outcomes being neglected. Literature suggests that mental health services need to make radical changes to practice to meet the complex needs of service users in today’s current climate.
To address the issue of satisfaction and to improve the delivery of care on acute wards, a steering group was created to address therapeutic one to one sessions with service users. Presently, these sessions focus on a wide range of topics however the majority of discussions held with service users are often system driven and neglect actual goals or outcomes for service users.
A project was devised to address how nurses interact with service users with a specific focus on the therapeutic one at one time. A brochure was developed for service users introducing them to the new structure of one at one time, and a guide also for nurses on a wide range of topics with prompts to help structure the individual sessions. The project was piloted on a male open acute ward for 12 weeks and was then evaluated using the Care Measure Questionnaire. In order to measure its effectiveness, the Care Measure Questionnaire was also implemented in the female open acute ward, however without the structured one to one time to see if there was any difference in patient satisfaction across the both wards.
A Literature review is a process of exploring existing literature on a specific topic. The purpose of the literature review is to examine critical points, methodology and theoretical information in order to provide a rationale for a project or thesis (Garrad, 2010).
A literature search was completed using the databases CINHAL full text, Psycinfo, Psycharticles, Medline and Medline plus Full Text. Keywords used were, patient satisfaction, experience, psychiatric hospitals, service delivery and therapeutic alliance. Full text and peer review articles were used. Articles were selected within the last 10 years and limited to articles from the USA, Australia and the UK. All other articles were withdrawn from the review. A total of 206 articles was retrieved, with 83 meeting the criteria for the project. A further 25 articles were withdrawn on the basis of not meeting the specific needs of the project. Therefore a total of 58 articles was reviewed.
Acute Mental Health Wards and the Therapeutic Milieu
The function of acute wards has dramatically shifted from a delivery of therapeutic programs to a more crisis function (Richards, Bee,...