title: Mental health nurses' dispositional decision-making for people presenting to the emergency department with deliberate self-harm: an exploratory study.
abstract: BACKGROUND
  There is no clear treatment pathway for people presenting to Australian emergency departments with deliberate self-harm.
  
  
  OBJECTIVE
  To explore variations in mental health nurses' disposition decisions for patients following risk assessment for deliberate self-harm.
  
  
  METHODS
  A survey was distributed to mental health nurses. This survey comprised demographic items and questions in response to nine vignettes describing episodes of deliberate self-harm. Dispositional decision and reasoning were also sought for each vignette.
  
  
  RESULTS
  Poor levels of agreement for disposition were found.
  
  
  CONCLUSIONS
  There was a lack of consensus regarding dispositional outcomes. This suggests a high level of subjectivity in decision-making which needs to be taken into account within clinical governance.
authors.affiliation: St. Vincent's Mental Health, Melbourne, Victoria, Australia.
authors.forename: Grant
authors.initials: G
authors.lastname: Phillips
authors.forename: Marie Frances
authors.initials: MF
authors.lastname: Gerdtz
authors.forename: Stephen James
authors.initials: SJ
authors.lastname: Elsom
authors.forename: Tracey J
authors.initials: TJ
authors.lastname: Weiland
authors.forename: David
authors.initials: D
authors.lastname: Castle
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D000066491:Clinical Decision-Making; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011568:Psychiatric Nursing / Q000592:standards*; D018570:Risk Assessment; D016728:Self-Injurious Behavior / Q000451:nursing*; D011795:Surveys and Questionnaires
keywords: Deliberate self-harm; disposition decision; emergency department; mental health nurse