Eimear Caitlin Muir-Cochrane

Flinders University · College of Nursing and Health Sciences

The aim of the study was to understand older Chinese migrants’ perceptions of social cohesion and access to health to manage chronic diseases during the COVID-19 pandemic in Australia. This study employed a qualitative descriptive study design. Participants were recruited from a Chinese community organisation in an Australian state. Data were colle...

Background Studies revealed that supporting residents fulfilling self-determination is positively associated with their health, wellbeing and quality of life. Cross-cultural care poses significant challenges for nursing home residents to fulfil their self-determination in control of own care and maintaining meaningful connections with others. The a...

This study explored the experiences of individuals who reported being negatively affected by Australia's international border closure during the COVID-19 pandemic. Qualitative data from 1930 adults who responded to a cross-sectional online survey exploring the mental health and wellbeing of individuals affected by border closure were analysed using...

Aims and objectives: To explore and compare staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes. Background: Staff and residents in ethno-specific and mainstream nursing homes in most developed countries have shown increased cultural and linguistic diversity. This s...

Background Studies revealed that supporting residents fulfilling self-determination is positively associated with their health, wellbeing and quality of life. Cross-cultural care poses significant challenges for nursing home residents to fulfil their self-determination in control of own care and maintaining meaningful connections with others. The a...

Restrictive Mental Health Practices in the Management of Acutely Unwell Patients

Background In many jurisdictions worldwide, individuals with a mental illness may be forced to receive care and treatment in the community. In Australia, legislation states that such care should be driven by a care plan that is recovery-focussed. Key components in the care planning process include engagement and decision-making about a person's sup...

With an imperative to reduce or eliminate the use of coercive practices in mental health care it is important to understand the experience of service users and staff. This review aimed to synthesise qualitative studies, published between 1996 and 2020, reporting on mental health service users’ and staff's experiences of chemical restraint. The data...

Community treatment orders (CTOs) require individuals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery-focused, although justification for use is predominantly risk-based, and care often coercive. Although CTOs are contested, individuals, fami...

Absconding from inpatient psychiatric care is a complex problem with significant and broad ranging effects for patients, staff, family/carers, and the broader community. Absconding includes leaving the ward without permission and failing to return from leave at an agreed time. This study is a retrospective chart audit of a data set of absconding ev...

Background Providing end-of-life care to patients and their families in the emergency department (ED) is challenging, with high workloads, the busy environment, and a focus on providing lifesaving treatments to patients at odds with providing end-of-life and palliative care. Aim The purpose of this study was to investigate nurses’ experiences of p...

Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental he...

It has been widely recognized that healthcare practices should be based on up‐to‐date high‐quality evidence; however, the implementation of evidence has been a slow process in nursing practice. It is crucial for clinical practitioners to be aware of the barriers to implementing evidence‐based nursing (EBN). The aim of the present study was to descr...

Background Chemical restraint (CR) is emergency drug management for acute behavioural disturbances in people with mental illness, provided with the aim of rapid calming and de-escalating potentially dangerous situations. Aims To describe a systematic review of Randomised Controlled Trials (RCTs) reporting on short-term safety and effectiveness of...

The prevalence of security guards in healthcare settings is growing worldwide and there is a need to explore and understand their role and actions to inform policy and training and support least restrictive practices in healthcare. The aim of this study was to conduct a retrospective chart audit of security guard logs to investigate security guard...

Introduction: Chemical restraint is used to manage uncontrolled aggression, agitation, or violent behaviours of consumers with mental health disorders admitted to acute psychiatric or emergency settings. Aim: This systematic review aimed to synthesise the international prevalence of chemical restraint for non-consenting adults. Method: PsychIN...

Objective: The aim of this review was to scope the literature for publications on the practice of screening for depression and anxiety in acute coronary syndrome patients in acute care by identifying instruments for the screening of anxiety and/or depression; determining if screening for anxiety and/or depression has been integrated into cardiac m...

Safety in health care settings is a multidimensional construct involving factors such as patient safety, occupational safety and quality improvement, all designed to protect hospital staff and the public. Traditionally, harms in hospital care were most commonly associated with errors in medication administration and poor staffing levels, however, r...

One approach to manage people with behaviours of concern including agitated or aggressive behaviours in health care settings is through the use of fast‐acting medication, called chemical restraint. Such management often needs to be delivered in crisis situations to patients who are at risk of harm to themselves or others. This paper summarizes the...

The dual-continua model of mental health suggests that mental illness and positive mental health reflect distinct continua, rather than the extreme ends of a single spectrum. The aim of this review was to scope the literature surrounding the dual-continua model of mental health, to summarise the evidence, highlight the areas of focus for individual...

It is mental health consumer's human right to lead a fulfilling life as they are empowered to actively manage their recovery. This can be facilitated through care planning, yet research suggests that the care plan is not routinely created, discussed, or updated in acute mental health settings. Research on care planning and the role of the mental he...

Recovery colleges are formal learning programs that aim to support people with a lived experience of mental illness. In this study, we aimed to explore the experiences of participants in a pilot recovery college that opened in Adelaide, South Australia, in 2016. A qualitative exploratory study was conducted involving interviews with learners (n = 8...

Introduction: The number of people dying in emergency departments (EDs) is increasing. However, EDs are not well designed or resourced for safe and effective End-Of-Life (EOL) care encounters, and there is little evidence regarding clinicians' perceptions and experiences of providing such care when the death is sudden and unexpected. Aim: This s...

Report of DFAT funded project on Pasung

Reducing and/or eliminating the use of coercive measures in psychiatric services is a priority worldwide. Chemical restraint is one such measure, yet to date has been poorly defined and poorly investigated. The aim of this study was to examine chemical restraint use in 12 adult acute inpatient psychiatric units in Adelaide, South Australia. Methods...

Background: Chemical restraint (CR) (also known as rapid tranquilisation) is the forced (non-consenting) administration of medications to manage uncontrolled aggression, anxiety, or violence in people who are likely to cause harm to themselves or others. Our population of interest was adults with mental health disorders (with/without substance abu...

The prisma diagram shows the results of our reviews of work on chemical restraint in non consenting patients. We have papers being reviewed concerned with the R CT studies, the prevalence studies, a synthesis review of all the systematic reviews undertaken associated with chemical restraint and a meta analysis of medications used in chemical restra...

Brief presentation about chemical restraint

Tips for early career researchers

High levels of positive mental health protect individuals from mental illness. This study investigates longitudinal change in positive mental health as a predictor of mental illness recovery in a cohort group. Using data from the 1995 and 2005 Midlife in the United States cross-sectional surveys (n=1,723), logistic regression was used to estimate...

Seclusion and restraint continue to be used across psychiatric inpatient and emergency settings, despite calls for elimination and demonstrated efficacy of reduction initiatives. This study investigated nurses’ perceptions regarding reducing and eliminating the use of these containment methods with psychiatric consumers. Nurses (n = 512) across Aus...

Nursing students, regardless of setting, require skills in working with people with mental health issues. One way to provide students with learning opportunities within the context of limited undergraduate mental health content and lack of mental health placements is through employment as assistants in nursing (AIN). The purpose of the study was to...

Fear and Blame in the use of restrictive interventions: keynote address presented at the Towards Elimination in Restraint Practices Conference Hobart November 2018

Objectives: This paper reports a pilot study exploring the benefits of offering sensory modulation within a mental health emergency setting for consumers experiencing distress during a psychiatric presentation. Methods: Seventy-four consumers with a mental health presentation reported on their sensory modulation use experiences during their stay i...

Since 2017, the Australian Institute of Health and Welfare has published national data about the use of restrictive practices in specialised public mental health services. Such practices include seclusion (confinement of a patient at any time of the day or night alone in a room or area from which free exit is prevented) and restraint (including phy...

Objective: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Austral...

Objective: The objective of this scoping review is to identify and map current recommendations and practices for the screening of depression and anxiety in acute coronary syndrome patients in the acute care setting.Specifically, the review questions are.

Chemical restraint in ED's with psychiatric consumers

Managing risk in acute mental ehalth settings

Empathy between nurses and consumers

Mental Health Practice Standards for Nurses in primary health care

Peer support is increasingly provided as a component of mental health care, where people in recovery from mental health problems use their lived experiences to provide support to those experiencing similar difficulties. In the present study, we explored the evolution of peer support workers’ (PSW) occupational identities. A qualitative study was un...

Australia is a country rich in cultural diversity, with Indigenous Australians having specific cultural values and a variety of spoken languages. In addition, the increasing number of people from migrant and refugee backgrounds requires that health professionals be able to communicate effectively with people from a wide range of cultural background...

Restrictive practices continue to be used in mental health care despite increasing recognition of their harms and an international effort to reduce and ultimately eliminate their use. The aim of this qualitative study was to explore mental health nurses’ views of the potential elimination of these practices. Nine focus groups were conducted with 44...

Empathy is a central component of nurse–consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in r...

Aims and objectives: To examine how clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation. Background: Family presence during resuscitation has important benefits for family and is supported by professional bodies and the public. Yet, many clinicians restrict family access to patien...

Role of Assistants in Nursing (nursing students) in Emergency Departments

Mental health care for older people is primarily delivered in the community and is largely dependent on informal carers. Mental health policy encourages partnerships between carers and service providers to facilitate service access, coordination and positive experience of care. However, carers often lack information and support from services, with...

Background Case management is the established model for care provision in mental health and is delivered within current care philosophies of person-centred and recovery-oriented care. The fact that people with a mental illness may be forced to receive care and treatment in the community poses challenges for clinicians aiming to engage in approaches...

Aim. To examine factors impacting family presence during resuscitation practices in the acute care setting. Background. Family presence during resuscitation was introduced in the 1980s so family members/significant others could be with their loved ones during life-threatening events. Evidence demonstrates important benefits; yet despite growing sup...

Research into the role of AIN"s in ED's in Australia

National OLT funded educational research project

Background: Chemical restraint (CR) is the forcible injection with psychotropic medication to sedate psychiatric consumers. There are serious ethical issues regarding its use and physical and psychological consequences for both consumers and staff. Despite the ethical uncertainty surrounding the use of CR and the potential for harm, there is little...

INTRODUCTION Thousands of people suffer cardiac arrest in hospitals around the world each year. Around 90% of these people die, frequently separated from their loved ones. Family presence during resuscitation (FPDR) was introduced in the 1980s so family could be with their loved ones during life-threatening events. Evidence supports important benef...

Mental healthcare for older people is primarily delivered in the community with informal carers, usually family providing much of this. Older people often require input from a range of services across sectors.

Grounded Theory Method has been described extensively in the literature. Yet, the varying processes portrayed can be confusing for novice grounded theorists. This paper provides a worked example of the data analysis phase of a constructivist grounded theory study that examined family presence during resuscitation in acute healthcare settings. Core...

Aim: To discuss the theoretical framework of social constructivism and justify it s appropriateness for and compatibility with an interpretive approach to child adolescent mental health (CAMH) nursing research. Background: Recent changes to national nursing legislation in Australia have resulted in the removal of the separate register with regul...

Objective To test a management model of facilitated reflection on network feedback as a means to engage services in problem solving the delivery of integrated primary mental healthcare to older people. Design Participatory mixed methods case study evaluating the impact of a network management model using organisational network feedback (through soc...

Background: Family presence during resuscitation involves allowing loved ones into a location where they can see/touch the patient during resuscitation. Despite many reported benefits for families and support from professional bodies and the public, many health professionals are reluctant to allow family presence during resuscitation. However, rati...

Background: Australia is committed to reduce or eliminate the use of containment measures (seclusion and restraint) in mental health care. International research suggests that number of containment events and hours spent in containment are often concentrated in a small number of patients. Understanding the concentration of containment episodes can...

Aims and objectives: This paper reports mental health nurses' perspectives of absconding. The aims of the study were to explore nurses' perceptions of risk assessment and management practices regarding absconding from acute inpatient psychiatric settings, and their affective responses when patients absconded. Background: Nurses are directly involve...

While the decision to use restraint and seclusion was not taken lightly, nurse participants felt that there were no effective alternatives to the use of these measures.Adverse interpersonal, physical and practice environments contributed to the onset of aggression in old age psychiatry inpatient settings.Policies to reduce or eliminate the use of r...

Absconding, where patients under an involuntary mental health order leave hospital without permission, can result in patient harm and emotional and professional implications for nursing staff. However, Australian data to drive nursing interventions remain sparse. The purpose of this retrospective study was to investigate absconding in three acute c...

Introduction and problem: There is significant unmet need for mental health care for older persons in Australia, with those living in rural communities particularly disadvantaged in terms of availability and access to services. Linkages and collaboration between health and social services has been advocated in national policies, though integrated p...

There are significant issues associated with the use of restrictive measures, such as seclusion and restraint, in child and adolescent mental health care. Greater understanding of how restrictive measures are used is important for informing strategies to reduce their use. In this brief report we present a 12-month audit (1/1/2010-31/12/2011) of the...

Patients absconding while under psychiatric inpatient hospitalization experience disruption to their treatment and may come to harm. In spite of the importance of this topic, there have been no Australian interventions reported, and the published data is several years old with methodological weaknesses. This study was a five-year retrospective anal...

Introduction: An integrated approach to the mental healthcare of older people is advocated across health, aged care and social care sectors. It is not clear, however, how the management of integrated servicing should occur, although interorganisational relations theory suggests a reflective network approach using evaluation feedback. This research...

Reshaping curricula: integrating culturally diverse/mental health online content to prepare work ready health professionals Background and significance

The purpose of this study was to investigate restraint use in Australian emergency departments (EDs). A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011). The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained pati...

Patient aggression occurs in old age psychiatry and is problematic. The aim of this study is to identify the factors that influence clinicians' attitudes toward aggression in old age psychiatry. Eighty-five individuals, comprising nurses (n = 75) and medical and allied health staff (n = 10), completed the questionnaire. The results show that gender...

People hospitalised on acute psychiatric wards report mixed feelings of safety and vulnerability

In psychiatry, most of the focus on patient aggression has been in adolescent and adult inpatient settings. This behaviour is also common in elderly people with mental illness, but little research has been conducted into this problem in old age psychiatry settings. The attitudes of clinical staff toward aggression may affect the way they manage thi...

A positive ward social climate or atmosphere can help prevent aggression and improve patient outcomes in old age psychiatry inpatient settings. The study of staff perceptions of social climate took place in three old age psychiatry inpatient units in Melbourne, Australia. Clinical staff respondents, comprising mainly mental health nurses, perceived...

Objectives: Unmet mental health care needs of older people (aged 65 and over) have been identified as a serious problem internationally, particularly in rural areas. In this study we explored the views of health and social care providers of the barriers to effective mental health care for older people in a rural region in Australia. Method: Semi...

to examine how midwives and women within a continuity of care midwifery programme in Australia conceptualised childbirth risk and the influences of these conceptualisations on women's choices and midwives' practice. a critical ethnography within a community-based continuity of midwifery care programme, including semi-structured interviews and the o...