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Nurses' Time Use in Forensic Psychiatry

Core Interventions Outlined in the Finnish Clinical Practice Guideline on Schizophrenia

Tenkanen, Helena RN, MSc; Taskinen, Helena PhD; Kontio, Raija PhD; Repo-Tiihonen, Eila MD, PhD; Tiihonen, Jari MD, PhD; Kinnunen, Juha DSc

doi: 10.1097/JFN.0000000000000111
Original Articles

ABSTRACT Forensic psychiatric nurses are key in implementing the core interventions outlined in the clinical practice guideline on schizophrenia. This study endeavors to ascertain how these were implemented in routine practice in forensic psychiatry by measuring how nurses use their time. Data were collected from registered nurses and practical mental nurses in all forensic psychiatric facilities in Finland using self-report diary forms for 1 week. In total, nurses used 20% of their weekly working hours on core interventions. The differences between the nurse groups were statistically significant (p ≤ 0.05) regarding the following core interventions: (a) care planning with physicians, (b) pharmacotherapy, and (c) basic clinical care. Nurses' qualifications, types of facilities and units, working experience, gender, and staffing levels explained the time used on core interventions. In summary, forensic psychiatric inpatients received insufficient appropriate nursing services according to the relevant guideline regarding schizophrenia. Furthermore, managerial recommendations need to restructure nurses' time use to increase the proportion of productive working hours spent with patients.

Author Affiliations:1Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital; 2Department of Health and Social Management, University of Eastern Finland; 3Department of Psychiatry, University of Helsinki and Helsinki University Hospital; 4Department of Clinical Neuroscience, Karolinska Institutet; 5Central Finland Health Care District.

Conflict of interest and source of funding: J. T. reports serving as a consultant to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, F. Hoffman-La Roche, Janssen-Cilag, Lundbeck, and Organon. He has received fees for giving expert opinions to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Otsuka, and Pfizer; lecture fees from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Novartis, Otsuka, and Pfizer; and grant from Stanley Foundation and Sigrid Jusélius Foundation. He is a member of advisory board in AstraZeneca, Eli Lilly, Janssen-Cilag, and Otsuka.

The project was funded by the Finnish Ministry of Health and Social Affairs through the development fund for Niuvanniemi Hospital, Kuopio, Finland.

The remaining authors declare no conflict of interest.

Correspondence: Helena Tenkanen, RN, MSc, Department of Forensic Psychiatry, Niuvanniemi Hospital, FI-70240 Kuopio, Finland. E-mail:

Received January 25, 2016; accepted for publication April 7, 2016.

© 2016 by the International Association of Forensic Nurses. All rights reserved.
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