An exploration of mental health skills in a generic advanced clinical practice programme

Background: Advanced practitioners (ACPs) are expected to be competent in their holistic assessment and management of individuals, which includes those with physical and mental health problems. A mental health component was introduced within a generic advanced practitioner programme to support the development of mental health skills required by advanced clinical practitioners in training (ACPiT). Aims: This research investigated the efficacy of mental health specific content within an MSc ACP generic programme. Methods: Single case study approach was adopted using a purposive sample of 10 ACPiT to explore personal beliefs and experiences using semi-structured interviews. Verbatim transcription was undertaken followed by content and thematic analysis. Findings: Themes emerged included communication skills, emergence of competence and self-awareness. Conclusion: Insights provided by ACPiT recognised the value of mental health teaching and exposure within their training programme for the advancement of knowledge, skill set and ultimately confidence in their clinical practice. Key Points: Synthesising mental health skills in generic nurse Advanced Clinical Practice. The conflation of communication and self-awareness with the improvement of clinical growth

The prevalence of non-cardiac chest pain (NCCP) using emergency department (ED) data: a Northern Ireland based study:Non-cardiac chest pain in the ED

Abstract Background The aim of this study was to assess the frequency of chest pain presentations and the subsequent non-cardiac chest pain diagnoses in an emergency department (ED) over a 3 year period. Methods Administrative data on ED attendances to an urban general hospital in Northern Ireland between March 2013 and March 2016 were used. Data were coded and analysed to estimate frequencies of ‘chest pain’ presentation and the subsequent diagnoses for each year. Results Both chest pain presentations and chest pain presentations with a subsequent diagnosis of unknown cause increased each year. In total, 58.7% of all chest presentations across 3 years resulted in a non-cardiac diagnosis of either ‘anxiety’, ‘panic’ or ‘chest pain of unknown cause’. Discussion There is a significant amount of patients in the ED leaving with a non-cardiac diagnosis, following an initial presentation with chest pain. Conclusion Given the link between non-cardiac chest pain and frequent use of services, the degree of repeat attendance should be investigated

Hyperventilation syndrome: diagnosis and reassurance

This article provides an overview of hyperventilation syndrome (HVS). Hyperventilation is to breathe in excess of metabolic requirements; in the absence of an underlying organic cause, it is defined as HVS. Alternative terms used in literature are panic or anxiety attack, panic or anxiety disorder, dysfunctional breathing and breathing pattern disorder. This article explores HVS signs and symptoms beyond the familiar clinical signposts of tachypnoea, chest tightness, paraesthesia and anxiety. It will also discuss differential diagnoses and pre-hospital treatment of HVS, focusing on reassuring patients and assisting them in establishing a good respiratory pattern. Patients with HVS use a significant amount of hospital and emergency service resources, ideally placing paramedics to diagnose and treat HVS in the pre-hospital setting to avoid unnecessary and costly hospital admissions. Further research is needed to evaluate the pre-hospital prevalence and diagnostic accuracy of HVS, identify clear diagnostic criteria and design screening tools