Leveraging Nurses to Improve Care for Patients with Concurrent Disorders in Inpatient Mental Health Settings: A Scoping Review

Abstract

Objective: Several challenges have been identified for patients with concurrent disorders and the providers that care for them, contributing to a pressing need for interventions to improve outcomes, particularly within inpatient mental health settings. Methods: A systematic search of peer-reviewed literature was conducted using four online databases: CINAHL, MEDLINE (Ovid), PsycInfo and Web of Science. Articles were selected based on inclusion criteria and additional articles were identified through hand searches. Study details were charted and qualitative synthesis was conducted. Results: Thirty two articles met inclusion criteria. A substantial focus within the literature was education, with higher levels of education shown to improve healthcare provider attitudes and practices. Within this overarching focus, four themes were identified: 1) education as an intervention to improve attitudes and increase confidence and knowledge; 2) strategies to support practice change, including interventions aimed at clinical leaders and methods to address substance use among inpatients; 3) frameworks to guide care; and 4) opportunities to expand nursing scope of practice. Conclusions: Given the substantial evidence indicating that education improves nurses’ knowledge, attitudes and practices, there is great promise in expanding educational intervention opportunities for nurses to improve care and outcomes for patients with concurrent disorders—a priority patient population.

Keywords:

• Concurrent disorders
• dual diagnosis
• mental health
• substance use
• addiction
• nursing
• education
• patient care
• harm reduction

Acknowledgments

We would like to acknowledge Katherine Miller, Reference Librarian, for her support in developing the search strategy. We would also like to acknowledge all the nurses providing excellent care to patients with concurrent disorders and striving for change as well as the patients who inspire us to conduct this research.

Disclosure statement

None of the authors report conflicts with regards to the subject of this article. None of the authors report any compensation for professional services in last three years.

Additional information

Funding

This study was funded in part by the Michael Smith Foundation for Health Research, BC Nursing Research Initiative program [Grant #17531].