1. Recommended Interventions to Address the Education-Practice Gap in Mental Health Nursing
Marlena D’Agostin MS with Larry Maturin MSN, APN, ACNS-BC, CEN, CCRN
DePaul University School of Nursing, Chicago, IL 60604
1. Alexander, L., Sheen, J., Rinehart, N., Hay, M., & Boyd, L. (2017). Mental health simulation with student nurses: A qualitative review. Clinical Simulation in Nursing, 14:8-14. doi: /j.ecns
2. Butler, M.P., Begley, M., Parahoo, K., & Finn, S. (2013). Getting psychosocial interventions into mental health nursing practice: a survey of skill use and perceived benefits to service users. Journal of Advanced Nursing, 70(4): doi: /jan.12248
3. Cleary, M & Freeman, A. (2009). The cultural realities of clinical supervision in an acute inpatient mental health setting. Issues in Mental Health Nursing, 26:5, , doi: /
4. Eade, C. & Winter, C. (2017). Using simulated practice in pre-registration education to explore mental health issues. British Journal of Nursing, 26(12).
5. Munnukka, T., Pukuri, R., Linnainmaa, P., & Kilkku, N. (2003). Integration of theory and practice in learning mental health nursing. Journal of Psychiatric and Mnetal Health Nursing, 9(1). doi: /j x
6. Saifan, AbuRuz, & Masa-deh. (2015). Theory practice gaps in nursing education: A qualitative perspective. Journal of Social Sciences, 11(1): doi: /jssp
7. What is mental health. (n.d.). U.S. Department of Health & Human Services. Retrieved from
8. Weissman, J., Russell, D., Jay, M., Beasley, J.M., Malaspina, D., & Pegus, C. (2017). Disparities in health care utilization and functional limitations among adults with serious psychological distress, Psychiatric Services, 68(7): doi: /appi.ps
Background
Methodology
Nursing Implications
Mental health involves our emotional, physical, psychological, and social well-being7
The prevalence of mental illness has increased to 3.4% of the U.S. population and access to care for this population is decreasing making the use of evidence-based care imperative8
The education-practice gap, also known as the theory-practice gap, is identified as a barrier in translating knowledge taught in the classroom and what current empirical evidence shows compared to methods used in practice6
Research suggests this gap exists due to there being difficulty in forming a connection between theory and practice6
Some reasons for this problem in connection involves clinical instructor qualifications, student differences, lack of communication, material sequences, number of students, and poor time management6
Research design: Integrative literature review
Databases searched include CINAHL, PubMed, and PsycINFO
Key terms: mental health, nursing, and theory-practice gap
Conceptual framework: Knowledge to Action Framework
Nurses should use evidence-based practice (EBP) as part of their skill set in providing care to improve the translation of education in practice and address the needs of mental health patients more effectively
Student nurses should have the opportunity to engage in simulated practice as a means to improve their knowledge base and confidence in utilizing EBP in the clinical setting while improving mental health care
Instructors, preceptors, and seasoned nurses should work together in providing appropriate supervision to student nurses and new nurse graduates
Providing more opportunities for postgraduate training and involvement in training should be made a requirement at all facilities to facilitate the use of EBP among new and seasoned nurses as a means to address the education-practice gap
Results
Protocols:
Simulated practice1,4
Clinical supervision3,5
Involving students, nurse-preceptors, instructors, and nurse managers
Postgraduate training2
Benefits:
Patient: increased de-escalation4, improved therapeutic relationships, 73% increased awareness of relapse indicators2, 67.5% enhanced coping skills, 64.8% better understanding of illness, 45.9% increased social integration, 40.5% reduced inpatient admissions
Student Nurses/ Nurses: increased professional development5, 69% identified deficient areas of learning, 19-23% improvement in understanding of mental health problems and associated behaviors1, 32.4% promoted, 100% improved intervention skills, 94.6% had improved confidence, 94.6% improved clear assessment skills, 94.6% structured framework for practice, 90% agree that skills support families and careers were enhanced, 86.4% increased job satisfaction2
Conclusion
Utilizing protocols such as simulated practice, clinical supervision, and postgraduate training in a sequential approach is crucial in addressing the theory-practice gap in mental health nursing as a means to improve the implementation of EBP in the clinical setting
Benefits in implementing these protocols to improve the utilization of EBP were seen in both mental health patients, student nurses, and nurses in the clinical setting
There is a need for more research in solidifying current protocols and identifying additional protocols to be used to address this problem in mental health nursing, identifying how to overcome barriers in putting them into practice, and the impact of their sequential use
Purpose
Investigating the theory-practice gap in mental health nursing through the implementation of evidence-based practice (EBP) in the clinical practice setting following formal nursing education
Research Questions
How can evidence-based mental health nursing care be more efficiently translated into practice?
How would the use of current research and theory in mental health nursing practice impact patient outcomes as well as patient and nurse safety?
References
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