Building the Community Mental Health Nursing Workforce Through a Supported Transition Programme: An Evaluation of a Competency Framework Implementation.

Abstract

There is a growing focus in the Australian healthcare system of providing mental health care in a community setting. A key feature of the Royal Commission into Victoria's mental health system was to prioritise community-based care 'a system with community at its core'. Developing a skilled, flexible and competent nursing workforce is a key objective for any community-based mental health service as nurses provide a vital role in healthcare delivery. The 3-year comprehensive nursing qualification has little to no mental health curriculum leaving nursing graduates unprepared for work in mental health, while hospital-based training for graduate nurses doesn't prepare them for the realities of community-based work. Significant work in Victoria to develop, refine and implement a competency framework for transition from acute mental health inpatient settings into community-based services has been undertaken. The aim was to evaluate the effectiveness of this framework in preparing nurses for the community workforce, as well as the barriers and enablers of implementation. A qualitative method investigated experiences of mental health staff who had participated in the transition programme in either aged, adult or a homeless outreach team. Interviews were conducted with transition nurses (n = 5), mentors (n = 4), Clinical managers (n = 3) educators/coordinator (n = 2). The framework structure helped mitigate role stress, allowed for consolidation of theory into practice providing learning opportunities, provided clinical oversight for safe practice, supported autonomous practice, critical thinking, staff wellbeing and demonstrated positive outcomes for consumers and carers. It also had a positive impact on retention and recruitment. Whilst there were limited barriers, the framework implementation relied on organisational support with staff resourcing. Evaluation findings demonstrate the importance of this framework. This structured programme helped facilitate professional development with an integration of knowledge, skills, attitudes and confidence along with staff wellbeing, leading to enhanced clinical practice and outcomes for clients and carers.