title: Does an educational intervention improve the usefulness of the Health of the Nation Outcome Scales in an acute mental health setting?
abstract: The purpose of the current study was to measure the effect of an educational intervention on the Health of the Nation Outcome Scales (HoNOS) completion rates. Additionally, interrater reliability and accuracy amongst nurses completing the instrument was assessed. We used a pre- and post-intervention design with videoed vignettes providing the basis for the educational intervention. Mental health nurses were assessed four times: at baseline, immediately after the intervention, 1 week later and again, 2 months after the intervention. There was a non-statistical increase in the number of patients assessed on admission using the HoNOS from 12.5% to 22.6%. Interrater reliability was low and did not improve through the course of the study. Intraclass correlation coefficients ranged 0.41-0.48. Accuracy was poor when discrete scoring between 0-4 was analyzed but improved when scores were dichotomised to reflect a clinically significant cut-off of 2 or more. The intervention improved completion rates marginally but interrater reliability and accuracy were low and did not improve over the study period. Opportunities for improvement were identified.
authors.affiliation: Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland, Australia. joan_webster@health.qld.gov.au
authors.forename: Joan
authors.initials: J
authors.lastname: Webster
authors.forename: Fiona
authors.initials: F
authors.lastname: Bretherton
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Goulter
authors.forename: Lisa
authors.initials: L
authors.lastname: Fawcett
mesh_terms: D000328:Adult; D003419:Crisis Intervention; D005260:Female; D006760:Hospitalization; D006801:Humans; D007318:Inservice Training; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D008875:Middle Aged; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital; D011568:Psychiatric Nursing / Q000193:education*; D011594:Psychometrics / Q000706:statistics & numerical data; D011793:Queensland; D015203:Reproducibility of Results; D055815:Young Adult