Experiences of mental health nurses on the assessment and monitoring of adverse side effects of antipsychotic medication

Date of Award


Document Type

Thesis - ECU Access Only


Edith Cowan University

Degree Name

Master of Nursing (Research)


School of Nursing and Midwifery

First Supervisor

Lisa Whitehead

Second Supervisor

Irene Ngune


The purpose of this quantitative cross-sectional research study was to investigate the knowledge, attitudes, confidence, and practices of mental health nurses in relation to the assessment and monitoring of adverse side effects of antipsychotic medications. The target population was Enrolled Nurses and Registered Nurse working within a large mental health service in Western Australia. A total of six mental health inpatient settings and nine community mental health clinics with approximately 600 nursing staff were invited to participate in the study. A survey was developed to collect information on the Knowledge, Attitudes, confidence, and Practices of nurses. All domains and questions were assessed using a ‘likert scale’ with a rating of 1-5. Demographic data were collected on age, gender, years of experience, mental health training qualification and three ‘yes and no’ variables. Descriptive statistics were used to explore perceived knowledge, attitude, confidence, and practice of mental health nurses assessing and monitoring for adverse side effects of antipsychotic medication. One hundred and thirty-four completed questionnaires were returned, a response rate of (22%). The majority of nurses (n=80, 60%) held a mental health qualification. Most (n-113, 84%) reported receiving undergraduate education on adverse side effects. Participants who had received undergraduate education on the side effects of antipsychotic medication reported higher levels of knowledge which was highly significant and had the most impact on the results. The majority (n=103, 77%) reported not regularly using side effect assessment tools and their confidence improved with education. Higher confidence levels in screening for side effects of antipsychotics and educating consumers about side effects of medications were important. However, the culminative effect of these variables did not yield significant results.

Implications for clinical practice should include planning ongoing education and training for nurses in adverse side effects of antipsychotic medication. Therefore, strengthening undergraduate nurse training in pharmacological education is vitally important.

The findings indicate gaps in knowledge and skills among a significant proportion of nurses working in the field of mental health in relation to the side effects of antipsychotic medication. There is a clear need for education and training for nurses in adverse side effects of antipsychotic medication.

Within Western Australia mental health services, no training is currently offered in the use of screening tools, despite there being 52 different side effect rating scales available globally. In Western Australia mental a modified version of the Glasgow Antipsychotic Side-effect Scale (GASS) is available for nurses to use for patients prescribed the antipsychotic medication Clozapine. However, there is a need to educate staff and promote the use of the GASS as most have no awareness of the existence of this assessment tool. Therefore, it is the intention of the researcher to introduce a Quality Improvement initiative into her current mental health inpatient setting to implement the use of the GASS.



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