Perspectives of community mental health nurses as care coordinators within a multidisciplinary team: A systematic review

A multidisciplinary approach has been identified as the optimal strategy for addressing the complex health and social needs of community mental health service users. Designating a care coordinator within the multidisciplinary team has been suggested to improve cooperation and communication. However, evidence on the experiences of community mental health nurses (CMHNs) as care coordinators is limited. This systematic review and thematic synthesis aimed to investigate CMHNs’ experiences and identify enablers and obstacles to effective implementation. We searched PubMed, CINAHL, Scopus, and Web of Science for peer-reviewed primary papers published in English between 1990 and 2022, as well as gray materials from ProQuest Dissertations and Theses, and Google Scholar. After the screening process, only nine studies were deemed eligible for inclusion in the review. The quality of the included studies was assessed using the JBI critical evaluation checklist for qualitative studies, and data were analyzed using NVivo software and thematic synthesis based on Thomas and Harden’s method. Our analysis reveals that CMHNs perceive the care coordinator role as a link to service users and as an added burden, including high demand for administrative tasks. CMHNs reported a lack of role clarity, leading to blurred boundaries within the multidisciplinary team, loss of professional identity, and decreased confidence. Role ambiguity and variability in team collaboration were significant contributors to role conflict. These findings indicate a critical need for role definition and clarity within community mental health multidisciplinary teams as it affects team functioning and the professional identities and confidence of CMHNs. It is recommended that healthcare management, clinical leaders, and professional nursing bodies reconsider their vision for the care coordinator role. This could be done through clear role definitions, training programs, and policy changes that ultimately enhance CMHNs’ confidence and reaffirm their professional identities.