title: Impact of a nurse practitioner role on metabolic monitoring completion and referrals for consumers admitted to the intensive care area of an acute inpatient psychiatric unit.
abstract: Mental illness increases a person's risk of physical health issues, including cardiovascular disease, leading to premature morbidity and mortality. Screening for cardiovascular disease through metabolic monitoring is recommended to aid in early detection. The aim of the present study was to ascertain whether consumers admitted to an inpatient mental health unit receive routine metabolic monitoring, and to explore the contribution of a nurse practitioner to metabolic monitoring and the actioning of abnormal results. The present study used a retrospective mirror image cohort method to look at clinical consumer files for two separate 6-month periods before and after a nurse practitioner role commenced. Metabolic monitoring variables were computed as completion frequencies and percentages. Univariate analyses were computed to describe differences among metabolic monitoring variables. A total of 497 consumers were admitted to the mental health inpatient unit's intensive care area across the two 6-month data-collection periods. Prior to the nurse practitioner role, only 2% of consumers had their body mass index (BMI) risk calculated; less than 1% had their waist circumference measured, and no abnormal results were referred to a general practitioner (GP). After the nurse practitioner role commenced, BMI risk was calculated for 67% of consumers, waist circumference recorded for 68%, and referrals for abnormal results were forwarded to 37 consumers' GPs. A nurse practitioner on the inpatient mental health unit has allowed for a considerable increase in the metabolic screening of admitted consumers resulting in a number of referrals being forwarded to consumers' GPs to be acted upon.
authors.affiliation: Northern Area Mental Health Service, The Northern Hospital, Epping, Melbourne, Victoria, Australia.|NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Trudy
authors.identifier: http://orcid.org/0000-0003-2255-5579
authors.initials: T
authors.lastname: Brown
authors.affiliation: School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.|Auckland Regional Forensic Psychiatry Services, Auckland, New Zealand.
authors.forename: Brian
authors.initials: B
authors.lastname: McKenna
authors.affiliation: NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.|School of Nursing, Midwifery, and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.
authors.forename: Trentham
authors.initials: T
authors.lastname: Furness
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009722:Nurse Practitioners; D024802:Nurse's Role; D011567:Psychiatric Department, Hospital; D012017:Referral and Consultation; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D055105:Waist Circumference; D055815:Young Adult
keywords: inpatient; mental health; metabolic syndrome; nurse practitioner