Example introduction. (Please note you should develop you own style of writing as this is only a suggestion and not meant to be prescriptive Evidence based practice is “the conscientious, explicit and...

Introducing Evidence Based Practice 17
    Assessment
Introducing Evidence based Practice (Mental Health Nursing)
Topic: How can nurses address the physical health needs of people with mental health problems?
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Introduction
Evidence Based Practice in Nursing refers to integration of clinical expertise with the best evidences in patient care (Salinas, 2017). Mentally ill people have lower levels of physical health than the normal people. It leads to higher rates of mortality and mo
idity in such people. The main causes of poorer physical health outcomes in the mentally ill people are due to a combination of socioeconomic factors, clinical risk factors and the factors related to healthcare system. The nurses can significantly help in early diagnosis and focused prevention of physical illness among the mentally ill people (Blythe and White, 2012).
In this assignment I will present a description of the process I followed in undertaking a literature search about the treatment and care of Afro-Cari
ean service users in a mental health service in United Kingdom using the CINAHL database. This will include a description of the results from the search, an overview of the evidence found and its relevance to my chosen topic. The results of the search with be recorded and a copy of the search will be included in the appendix as evidence.
Search Strategy
Search Strategy is a way to find the desired information with help of search engine using search terms (University of Johannesberg, 2019). It helps in locating relevant information while saving most of our time.
The search strategy involved exploring database CINAHL in addition to free text searches. The search was done using the key terms like “Physical Health needs” AND “Mental Health problems”, “Severe Mental*” AND “Physical Health”, “Mental Illness” AND “Physical Health” using OR Boolean operand.
Search Summary
    Database Searched
    Date Searched
    Search Strategy Used
(Keywords, phrases, subject terms)
    Limits
(Date range, language)
    No. Results
    Notes
Search strategy saved (name)?
    CINAHL
    20 March 2019
    “Physical Health needs” AND “Mental Health problems” AND “Afro-Cari
ean service”, OR
“Severe mental*” AND “Physical Health”, AND “Afro-Cari
ean service”
OR “Mental Illness” AND “ Physical Health”, AND “UK”
    March 2012- March 2017, UK, English
    388
    
Inclusion & Exclusion Criteria
The literature was selected on the basis of five selection criteria: the population having severe mental illness, interventions related to mental health, outcomes related to physical health, mental health care setting and study design. The data was extracted using CINAHL database. The accuracy of collected data was cross checked by another reviewer. All the healthcare services which involved interventions to address the physical needs of mentally ill people were included in the search. The study design involved exploring extensive literature including the guidelines documents, book chapters, primary studies, dissertations, feasibility studies and evaluative studies. The services other than those provided to Afro-Cari
ean service users in a mental health service in UK were not included in the study.
The research included the data from March 2012 to March 2017. The severe mental illness included schizophrenia, delusional disorder, and bipolar affective disorder. The physical health outcomes ranged from assessment of cardio metabolic risk factors, physical functioning and anthropometric measures.
Rationale for Using CINAHL Database
CINAHL (Cumulated Index to Nursing and Allied Health Literature) Database is the most widely used source of more than 3075 Nursing and Allied Health Literature Journals. It provides most in depth information while performing a review of qualitative evidence.
Results
According to PRISMA evaluation, the search identified 388 articles associated to mentally ill African-Cari
ean people in UK from 2012 to 2017, through CINAHL database search. Out of these, 152 articles were qualitative, 136 were quantitative and 100 were systematic reviews. The screening of these articles eliminated 311 duplicate articles. Some articles were removed as they did not involve any intervention for the treatment of mentally ill people and did not include physical illness. On the basis of eligibility of title and the abstract, around 77 articles were assessed. Out of these, 44 articles were eliminated from the review due to multiple reasons. Few articles were inadequate in exploring the intervention. Few were not peer reviewed journals. 24 articles were not written in English language and were publicized in a different time period than 2012 to 2017. Thus, only 09 full text articles were evaluated for their eligibility and were included in the final literature review.
How the Evidence is related to treatment of African Cari
ean Service Users and My role as a Nurse?
Despite the initiatives of Government policies, the Black and Minority Ethnic (BME) communities consistently experience inequalities in mental health system of UK. The literature was examined for causal factors in mental health inequalities faced by BME people and associated solutions. These communities also face ba
iers in availing culturally compatible services such as communication problems, shortage of cultural understanding and issues in seeking immediate help (Nursing Times, 2017).
There is need of compatible information sharing systems in the Healthcare Organizations which could help the nurses in identifying the BME people with severe mental illness who also need physical health support ( Kelly, Fulginiti, Pahwa, Tallen, Duan and Brekke, 2014).
Sewell (2012) identified 4 domains in which inequalities persist for BME communities:
1. Unfair experience of factors associated with poor mental health
2. Too high or low rates of availing mental health care services
3. Ineffective outcomes received from treatment in mental health settings
4. Unsatisfactory relationships of these communities with mental health nurses
BME people do not speak English as their first language. It makes difficult for them to avail mental health services. Research by Mind (2012) highlighted the persistent fear in BME people and also in mental health nurses because the BME people are mostly stereotyped and prejudiced. A recent policy ‘No Health without Mental health’ by Department of Health identified the need to address the determinants like Socio-economic factors which affect the mental and physical wellness (Grey, Sewell, Shapiro and Ashraf, 2013).
The published articles were in strong support of presence of physical liaison services in the psychiatric healthcare facilities and availability of psychiatric liaison services in the physical inpatient settings. Care coordinators are hired to negotiate the existing boundaries between the mental health and physical health services (Yale University, 2014).
Discussion
The study by Happell, Platania-Phung, Stanton and Millar (2015) postulated that the main reasons for the shorter life expectancy of mentally ill people in BME Communities are inactive lifestyle, poor diet, side effects of antipsychotic medicines, smoking and high...