Mental health nurses' knowledge and attitudes toward clozapine management protocols challenges and implications for clinical practice: A narrative review

Clozapine is an atypical antipsychotic primarily used in cases of treatment-resistant schizophrenia, showing significant clinical efficacy. However, a major challenge in its administration is the requirement for systematic monitoring, which necessitates nurses to possess documented knowledge and skills. In this study, we aimed to synthesize nurses' knowledge and attitudes toward clozapine administration protocols and the importance of education for ensuring safe clinical practice. A literature review spanning the past decade was conducted using PubMed, Google Scholar, and Scopus databases, focusing on English terms related to nurses' understanding of clozapine administration protocols and the associated needs and implications in clinical settings to construct a comprehensive narrative review on this subject matter. Findings revealed that approximately half the nurses surveyed reported inadequate knowledge regarding the side effects of clozapine, leading to significant implications for patient monitoring, treatment, and medication adherence. Nurses with higher levels of education exhibited greater knowledge levels. Factors such as lower education levels, limited clinical experience, high workload, fatigue, and blind adherence to medical instructions were found to influence nurses' knowledge and attitudes. Training programs were shown to reduce stress, enhance nurses' knowledge and confidence, and foster trust in patient care. Nurses were identified as playing a crucial role in the safe administration of clozapine, both within hospital settings and in the community. Education was highlighted as a key factor in improving knowledge levels and shifting attitudes among nurses and patients toward the safe use of clozapine.