Abstract

Healthcare assistants are untrained and unregistered frontline staff but are expected to be proactive in preventing and responding to 'untoward' incidents quickly and efficiently when working within adult acute inpatient psychiatric settings. Healthcare assistants should be trained to provide enhanced care to service users residing in acute psychiatric settings. To date, a training programme in Psychological First Aid has not been expended in such a setting with nonregistered staff. The study demonstrates that training healthcare assistants in Psychological First Aid is useful in improving their confidence in caring for service users, therapeutic engagement with service users and ward culture in general. A training programme in Psychological First Aid for healthcare assistants to enhance ward culture can be implemented in different practice environments. Psychological First Aid is harmonious with nursing values and provides healthcare assistants with a relevant, useful and easily understood toolkit to apply in acute psychiatric settings. Introduction Healthcare assistants working within adult acute inpatient psychiatric settings are untrained and unregistered, however, they can contribute to quality service if they receive some training. Psychological First Aid training has never been expended in these settings, so this study intends to fill this gap in the existing evidence with this category of healthcare personnel. Aim The aim of this study was to introduce and evaluate first aid training for healthcare assistants. Method A pre/post design was adopted to gather data using questionnaires and interviews. The groups of participants included 16 healthcare assistants trained in Psychological First Aid, a sample of service users and four ward managers. Results Post-training, (a) healthcare assistants and service users ranked the therapeutic milieu of the ward more favourably, (b) the self-efficacy of the healthcare assistants increased, and the number of 'untoward' incidents decreased, and (c) health care assistants' confidence in their skills was high. The ward manager interviews post-training revealed four themes: (a) staff utilization of new skills and renewed enthusiasm, (b) calmer atmosphere on the ward and staff togetherness, (c) confidence and reflection on practice and (d) therapeutic engagement. Discussion Training healthcare assistants is useful in improving staff confidence, therapeutic engagement with service users and ward culture in general. Implications for practice Techniques and skills learnt are relevant and useful to healthcare assistants and provide an easily understood toolkit that is harmonious with nursing values. If executed correctly, the training can enhance practice and care outcomes and the overall service user experience.

Highlights

  • Healthcare assistants working within adult acute inpatient psychiatric settings are untrained and unregistered, they can contribute to quality service if they receive some training

  • Psychological First Aid is harmonious with nursing values and provides healthcare assistants with a relevant, useful and understood toolkit to apply in acute psychiatric settings

  • The training of nonregistered, frontline staff working in acute inpatient psychiatric settings can have positive impact for staff on a psychosocial personal level and for the ward culture and atmosphere

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Summary

Introduction

Healthcare assistants working within adult acute inpatient psychiatric settings are untrained and unregistered, they can contribute to quality service if they receive some training. Discussion: Training healthcare assistants is useful in improving staff confidence, therapeutic engagement with service users and ward culture in general. Working on a psychiatric ward requires many proficiencies including excellent communication and listening skills, an understanding and empathic manner, being warm and caring and having the ability to stay calm and in control in difficult situations (NHS Health Education England, 2018). The Mental Health Foundation (2013) recognizes that good listening skills and the ability to respond to complex needs are important skills needed by HCAs. Healthcare assistants (HCAs) working within psychiatric settings, where there are high levels of acute distress, disturbance, aggression and/or violence among those experiencing acute mental illness, need to be capable of acting independently and making the right judgements in what can be challenging and stressful situations (Bowers, 2011; Whittington & Richter, 2006). “The psychiatric ward is a pretty frantic place a lot of the time and the people who have

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