Aims and methodTo evaluate whether the implementation of the Rapid Assessment, Interface and Discharge (RAID) integrated model improves access to psychiatric assessment and reduces cost of health service provision in an acute hospital. Length of hospital stay was calculated using a case-by-case matched control design. Readmission rates were calculated and survival analysis was used to measure endurance in the community following discharge.ResultsIn an acute hospital with 600 beds, the total savings in bed days through reducing length of stay and readmissions was 43–64 beds per day. The elderly care wards provided the majority of bed savings.Clinical implicationsThe development of a rapid response, age-inclusive, comprehensive psychiatric team integrated in an acute hospital can lead to significant savings in health service provision.

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Background Self-confidence and self-efficacy are vital psychological constructs that can affect a student’s performance. Aims To measure the level of confidence in nursing students in managing challenging situations in clinical practice settings. Methods In order to develop the scale three focus groups were conducted: with registered nurses, third year student nurses and service users. Focus group frameworks included: challenging behaviours, managing challenging situations and preparing students to manage challenging situations. Themes in relation to challenging situations that emerged from the focus groups, in conjunction with Nursing and Midwifery Council standards and expert discussions were used to create the confidence scale. The Confidence in Managing Challenging Situations Scale consists of two parts with 21 items in total. Both parts were measured by way of a five-point Likert scale. The scale was utilised to determine the level of confidence of students both pre and post a teaching intervention. Results The confidence in managing challenging situations scale had good internal consistency, with a Cronbach’s alpha coefficient reported of 0.86. Exploratory factor analysis was used to support the scale validation process. Conclusions The Confidence in Managing Challenging Situations Scale is a successful measure of confidence for nursing students in healthcare settings. It can be applied in alternative healthcare settings for the identification of confidence levels in those student nurses learning in care settings.

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