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A number of significant challenges face graduate mental health nurses entering the workforce. In response, Transition to Practice programs have been promoted as a potential strategy for improving recruitment and retention within the mental health system. This review explores the experience of transition for mental health nurse graduates and identifies key aspects of Transition to Practice programs that facilitate the transition to practising professional. A comprehensive review of qualitative research, which sought to provide insight into the experience of transition for graduate mental health nurses, was conducted. Nine studies were identified through a search of MEDLINE, CINAHL, PsychINFO, PsychArticles, Psychology, AMED, EMBASE and Health Source: Nursing/academic edition. Findings showed a disparity between undergraduate perceptions of the mental health nurse role and what is actually observed during placement, highlighting the need for the positive contribution of preceptors and mentors within a transitional support model for newly graduated mental health nurses.

Dementia is a priority area for all countries as populations age and dementia prevalence increases. The use of physical restraint is a possible clinical practice for persons with dementia across settings when behaviours indicate a perceived need. Indeed, this may be the first choice in practice, occurring in part because of lack of education, safety concerns, perceived costs and staffing issues. This article reviews the literature on the issues surrounding, and use of, physical restraint for people with dementia, highlighting the rationales for use and the benefits and barriers to physical restraint. Recommendations include the importance of education and policy to reduce or eliminate physical restraint of persons with dementia to overcome identified barriers at the individual, cultural and organizational levels. An educational programme from the literature review is proposed specific to the reduction or elimination of physical restraint.

'This is the peer reviewed version of the following article: GERACE, A., CURREN, D. and MUIR-COCHRANE, E. AbstractRisk assessment and management are among the most important and complex tasks health professionals undertake in their practice to prevent harm to patients and ensure safe and effective treatment. The aim of this study was to examine how multidisciplinary team members use tools to assess and manage risk, through examination of how tools are used to gather, record and "score" risk information; and how this process impacts on the formulation of risk assessment and management plans, interaction with patients, and consensus with colleagues regarding patient care. Fourteen professionals completed an assessment for a hypothetical client using a risk assessment and management tool, and then discussed their assessment in semi-structured interviews. Professionals were in moderate agreement in their assessments of the client on the tool, and highlighted the complexity of their decision making.Clinical management decisions, such as the amelioration of particular risks, followed assessment of the patient in a consistent way. The tool was an important way to for clinicians to communicate their judgments to others and set plans to direct patient care. Implications for the use of clinical decision making tools and instruments in mental health care, and the need for a focus on multidisciplinary decision making, are highlighted.

Mental health care in Australia in the last 20 years has moved from stand-alone psychiatric hospitals to general hospitals and the community. This paper reports an action research project exploring the experiences of nurses on an acute mental health unit for older adults staffed with a skillmix of mental health and general nurses, which recently transitioned from a psychiatric to a general hospital. The new service provides comprehensive health care, including the management of physical co-morbidity and a recovery orientation. Recovery acknowledges the role and rights of consumers and carers in planning and management of care, choice and individual strengths (Shepherd). The new ward received additional resources to establish the model of care, including a broader skillmix. The paper explores the dynamics of development of a new model of care and of bringing together staff with different professional orientations, cultures and priorities. Focus groups and interviews were conducted with 18 staff. Analysis resulted in three themes relating to the impact of competing goals and foci of care upon professional boundaries; competing organisational cultures and the impact of service change upon work practices. The findings are explored in relation to ideas about health care delivery associated with neoliberalism.