The document summarizes a project that integrated an SBIRT curriculum into an undergraduate nursing program to increase students' skills and cultural competence in addressing substance use. The 11-module, 13-hour curriculum was delivered through seminars, clinical practice, simulation, and a booster session. Evaluation found that after the seminar, students significantly increased their perceptions of their role, knowledge, and legitimacy in addressing alcohol use with patients, demonstrating the curriculum increased students' use of the evidence-based SBIRT approach.
The Role of Health Services Research in a Learning Healthcare SystemAcademyHealth
Dr. David Atkins, U.S. Department of Veterans Affairs, presented at AcademyHealth's 2012 Capitol Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."
Tim Kendall: NICE patients' experience standardsThe King's Fund
Professor Tim Kendall, Director, National Collaborating Centre for Mental Health, introduces the new NICE quality standards for mental health service user experience.
The Role of Health Services Research in a Learning Healthcare SystemAcademyHealth
Dr. David Atkins, U.S. Department of Veterans Affairs, presented at AcademyHealth's 2012 Capitol Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."
Tim Kendall: NICE patients' experience standardsThe King's Fund
Professor Tim Kendall, Director, National Collaborating Centre for Mental Health, introduces the new NICE quality standards for mental health service user experience.
The Power of Choice in Achieving Recovery, by Joe Gerstein, MD, SMART RecoverySMARTRecovery
Presented at the 2017 NADCP Conference
SMART Recovery is an abstinence-based mutual-help group for dealing with all types of addiction including alcohol abuse, substance abuse, smoking, gambling and other addictions and compulsive behaviors.
SMART Recovery's 4-Point Program focuses on Increasing Motivation, Coping with Urges, Problem Solving, and Lifestyle Balance.
http://www.smartrecovery.org
Promoting the safe management of people with Severe Mental Illness by trainin...Mental Health Partnerships
This project, led by Dr Fiona Nolan, Camden and Islington NHS Foundation Trust, developed training for practice nurses and carried out research on the physical health needs of patients with Severe Mental Illness.
Previous research undertaken by Dr Sheila Hardy, Education Fellow, University College London Partners and Visiting Fellow for Primary Care, University of Northampton, found that contrary to popular belief, patients with serious mental illness will attend health checks, and proper training in this area for practice nurses increases the level of screening and lifestyle advice given.
Find out more at http://mentalhealthpartnerships.com/?p=13113
Palliative care applicable to all serious health related suffering.
Palliative care is the active total care applicable from the time of diagnosis, aimed at improving the quality of life of patients and their families facing serious life limiting illness, through the prevention and relief of suffering from pain and other physical disability.
Goals: The goal of this training is to help participants develop their knowledge, skills and abilities as Substance Use Screenng, Brief Intervention, and Referral to Treatment (SBIRT) Trainers.
At the end of this training participants will be able to understand the information screening does and does not provide,define brief intervention, describe the goals of conducting a BI, understand the counselor's role in providing BI, describe referral to treatment, identify SBIRT as a system change initiative, introduce the public health approach, and understand the continuum of substance use.
Audience: Social Workers, counselors and other behavioral health providers from all settings can benefit from understanding substance use across a continuum and its impact on clients behavioral health and other psychosocial interactions.
The Effectiveness of Music Therapy on Cerebral Palsy Patients Receiving Rehab...inventionjournals
Objective: To find out the effect of music therapy in cerebral palsy (CP) patients between who received conventional rehabilitation treatments and who additionally received music therapy Methods: In this retrospective study, 50 CP patients who received rehabilitation treatments on a day-ward basis for at least six months, between March 2013 and February 2015, were selected as subjects. Of the 50 patients, 25 received only conventional rehabilitation treatment (rehabilitation group), and the remaining 25 received both the conventional rehabilitation treatment and music therapy (music therapy group). In this study, the results of the Korean-version Denver Developmental Screening Test 2 (DDST-2) and the social quotient (SQ) were confirmed, before and after the treatments. Results: At baseline, no statistically significant differences were confirmed between the rehabilitation group and the music therapy group in terms of gender, age, and diagnosis. Korean-version DDST-2 scores and the SQ score also did not show statistically significant differences between the groups. With the intervention, the music therapy group showed more statistically significant improvements in the gross motor, fine motor, language, and personal-social parts than the rehabilitation group. The music therapy group also showed greater improvement in SQ score than the rehabilitation group, but the difference was statistically insignificant. Conclusion: This study was conducted to prove the effectiveness of the current music therapy program and to investigate the area in which the therapy produces the greatest effect. It is hoped that the therapy would find wider application among children in the future as it showed significant functional improvements in the gross motor, fine motor, language, and personal-social parts in this study
SBIRT is an evidence based approach to the delivery of early intervention and treatment to people with substance use disorders and those at risk of developing these disorders. Collaborative SBIRT Training for Maine’s Future Health Profession Leaders is a three-year grant totaling $870,000 from the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA). The first of its kind to be awarded in Maine, this grant utilizes an interprofessional approach to the development and implementation of training programs to teach UNE students across 8 health professions the skills necessary to provide evidence-based Screening and Brief Intervention as well as Referral to Treatment for patients who are at risk for a substance use disorder (SUD). Additionally, the training will develop the leadership skills needed in order to champion the implementation of SBIRT throughout our healthcare system with the ultimate goal of helping clients avoid substance use disorders.
This presentation deals with SBIRT and Social Work in particular.
Interventions for preventing elder abuse: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of interventions for preventing elder abuse.
Philip Baker, Australia Regional Director APACPH, School of Public Health and Social Work Queensland University of Technology led the session and presented findings from their review:
Baker PRA, Francis DP, Hairi NN, Othman S, Choo WY. (2016). Interventions for preventing abuse in the elderly. Cochrane Database of Systematic Reviews, 2016, CD010321
http://www.healthevidence.org/view-article.aspx?a=interventions-preventing-abuse-elderly-29428
Many older adults experience some form of abuse (psychological, physical, and sexual) that often goes unreported. Elder abuse is associated with morbidity and premature mortality. This review examines the effectiveness of interventions for preventing elder abuse in the home, institutions and community settings. Findings of the review suggest there is uncertainty in the effectiveness of educational interventions to improve knowledge of caregivers about elder abuse and uncertainty on its effect of reducing abuse. This webinar will examine the effectiveness and components of interventions that prevent elder abuse.
Exercise programs for people with dementia: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of exercise programs for people with dementia. Click here for access to the audio recording: https://youtu.be/jC8HhC2XFrE
Dorothy Forbes, Professor, Faculty of Nursing, University of Alberta, Edmonton led the session and presented findings from her latest Cochrane review:
Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. Cochrane Database of Systematic Reviews, 2015(4), CD006489.
As the population ages, the number of people suffering with dementia will also rise. Not only will this affect quality of life of people with dementia but will also increase the burden of family caregivers, community care, and residential care services. Exercise interventions have been identified as a potential way of reducing or delaying the progression of dementia and its symptoms. This review examines two questions: do exercise programs for older people with dementia improve cognition, activities of daily living (ADLs), challenging behaviour, depression, and mortality in older people with dementia? and; do exercise programs for older people with dementia have an indirect impact on family caregivers' burden, quality of life, and mortality?
How can front-line professionals incorporate the emerging brain health ...SharpBrains
(Session held at the 2014 SharpBrains Virtual Summit; October 28-30th, 2014)
12:30-2pm. How can front-line professionals incorporate the emerging brain health toolkit to their practices?
- Elizabeth Frates, Director of Medical Student Education at the Institute of Lifestyle Medicine
- Dr. Catherine Madison, Director of the Ray Dolby Brain Health Center at California Pacific Medical Center
- Barbara Van Amburg, Chief Nursing Officer at Kaiser Permanente Redwood City
- Dr. Wendy Law, Clinical Neuropsychologist at Walter Reed National Military Medical Center
- Chair: Dr. Michael O’Donnell, Editor-In-Chief of the American Journal of Health Promotion
Learn more here:
http://sharpbrains.com/summit-2014/agenda/
The Power of Choice in Achieving Recovery, by Joe Gerstein, MD, SMART RecoverySMARTRecovery
Presented at the 2017 NADCP Conference
SMART Recovery is an abstinence-based mutual-help group for dealing with all types of addiction including alcohol abuse, substance abuse, smoking, gambling and other addictions and compulsive behaviors.
SMART Recovery's 4-Point Program focuses on Increasing Motivation, Coping with Urges, Problem Solving, and Lifestyle Balance.
http://www.smartrecovery.org
Promoting the safe management of people with Severe Mental Illness by trainin...Mental Health Partnerships
This project, led by Dr Fiona Nolan, Camden and Islington NHS Foundation Trust, developed training for practice nurses and carried out research on the physical health needs of patients with Severe Mental Illness.
Previous research undertaken by Dr Sheila Hardy, Education Fellow, University College London Partners and Visiting Fellow for Primary Care, University of Northampton, found that contrary to popular belief, patients with serious mental illness will attend health checks, and proper training in this area for practice nurses increases the level of screening and lifestyle advice given.
Find out more at http://mentalhealthpartnerships.com/?p=13113
Palliative care applicable to all serious health related suffering.
Palliative care is the active total care applicable from the time of diagnosis, aimed at improving the quality of life of patients and their families facing serious life limiting illness, through the prevention and relief of suffering from pain and other physical disability.
Goals: The goal of this training is to help participants develop their knowledge, skills and abilities as Substance Use Screenng, Brief Intervention, and Referral to Treatment (SBIRT) Trainers.
At the end of this training participants will be able to understand the information screening does and does not provide,define brief intervention, describe the goals of conducting a BI, understand the counselor's role in providing BI, describe referral to treatment, identify SBIRT as a system change initiative, introduce the public health approach, and understand the continuum of substance use.
Audience: Social Workers, counselors and other behavioral health providers from all settings can benefit from understanding substance use across a continuum and its impact on clients behavioral health and other psychosocial interactions.
The Effectiveness of Music Therapy on Cerebral Palsy Patients Receiving Rehab...inventionjournals
Objective: To find out the effect of music therapy in cerebral palsy (CP) patients between who received conventional rehabilitation treatments and who additionally received music therapy Methods: In this retrospective study, 50 CP patients who received rehabilitation treatments on a day-ward basis for at least six months, between March 2013 and February 2015, were selected as subjects. Of the 50 patients, 25 received only conventional rehabilitation treatment (rehabilitation group), and the remaining 25 received both the conventional rehabilitation treatment and music therapy (music therapy group). In this study, the results of the Korean-version Denver Developmental Screening Test 2 (DDST-2) and the social quotient (SQ) were confirmed, before and after the treatments. Results: At baseline, no statistically significant differences were confirmed between the rehabilitation group and the music therapy group in terms of gender, age, and diagnosis. Korean-version DDST-2 scores and the SQ score also did not show statistically significant differences between the groups. With the intervention, the music therapy group showed more statistically significant improvements in the gross motor, fine motor, language, and personal-social parts than the rehabilitation group. The music therapy group also showed greater improvement in SQ score than the rehabilitation group, but the difference was statistically insignificant. Conclusion: This study was conducted to prove the effectiveness of the current music therapy program and to investigate the area in which the therapy produces the greatest effect. It is hoped that the therapy would find wider application among children in the future as it showed significant functional improvements in the gross motor, fine motor, language, and personal-social parts in this study
SBIRT is an evidence based approach to the delivery of early intervention and treatment to people with substance use disorders and those at risk of developing these disorders. Collaborative SBIRT Training for Maine’s Future Health Profession Leaders is a three-year grant totaling $870,000 from the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA). The first of its kind to be awarded in Maine, this grant utilizes an interprofessional approach to the development and implementation of training programs to teach UNE students across 8 health professions the skills necessary to provide evidence-based Screening and Brief Intervention as well as Referral to Treatment for patients who are at risk for a substance use disorder (SUD). Additionally, the training will develop the leadership skills needed in order to champion the implementation of SBIRT throughout our healthcare system with the ultimate goal of helping clients avoid substance use disorders.
This presentation deals with SBIRT and Social Work in particular.
Interventions for preventing elder abuse: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of interventions for preventing elder abuse.
Philip Baker, Australia Regional Director APACPH, School of Public Health and Social Work Queensland University of Technology led the session and presented findings from their review:
Baker PRA, Francis DP, Hairi NN, Othman S, Choo WY. (2016). Interventions for preventing abuse in the elderly. Cochrane Database of Systematic Reviews, 2016, CD010321
http://www.healthevidence.org/view-article.aspx?a=interventions-preventing-abuse-elderly-29428
Many older adults experience some form of abuse (psychological, physical, and sexual) that often goes unreported. Elder abuse is associated with morbidity and premature mortality. This review examines the effectiveness of interventions for preventing elder abuse in the home, institutions and community settings. Findings of the review suggest there is uncertainty in the effectiveness of educational interventions to improve knowledge of caregivers about elder abuse and uncertainty on its effect of reducing abuse. This webinar will examine the effectiveness and components of interventions that prevent elder abuse.
Exercise programs for people with dementia: What's the evidence?Health Evidence™
Health Evidence hosted a 90 minute webinar examining the effectiveness of exercise programs for people with dementia. Click here for access to the audio recording: https://youtu.be/jC8HhC2XFrE
Dorothy Forbes, Professor, Faculty of Nursing, University of Alberta, Edmonton led the session and presented findings from her latest Cochrane review:
Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. Cochrane Database of Systematic Reviews, 2015(4), CD006489.
As the population ages, the number of people suffering with dementia will also rise. Not only will this affect quality of life of people with dementia but will also increase the burden of family caregivers, community care, and residential care services. Exercise interventions have been identified as a potential way of reducing or delaying the progression of dementia and its symptoms. This review examines two questions: do exercise programs for older people with dementia improve cognition, activities of daily living (ADLs), challenging behaviour, depression, and mortality in older people with dementia? and; do exercise programs for older people with dementia have an indirect impact on family caregivers' burden, quality of life, and mortality?
How can front-line professionals incorporate the emerging brain health ...SharpBrains
(Session held at the 2014 SharpBrains Virtual Summit; October 28-30th, 2014)
12:30-2pm. How can front-line professionals incorporate the emerging brain health toolkit to their practices?
- Elizabeth Frates, Director of Medical Student Education at the Institute of Lifestyle Medicine
- Dr. Catherine Madison, Director of the Ray Dolby Brain Health Center at California Pacific Medical Center
- Barbara Van Amburg, Chief Nursing Officer at Kaiser Permanente Redwood City
- Dr. Wendy Law, Clinical Neuropsychologist at Walter Reed National Military Medical Center
- Chair: Dr. Michael O’Donnell, Editor-In-Chief of the American Journal of Health Promotion
Learn more here:
http://sharpbrains.com/summit-2014/agenda/
Person Centered Care through Integrating a Palliative Approach: Lessons from ...BCCPA
Aging adults are entering residential care facilities with more advanced disease than in the past and their length of stay is shorter. Most health care providers in these facilities do not receive targeted education and training in palliative care, nor are they confident to have crucial conversations about goals of care and end of life challenges with residents and their families. Due to limited capacity to manage predictable symptoms related to end of life and insufficient planning, many residents are transferred to hospital in crisis and die in the Emergency Department or acute care wards.
This presentation will showcase some of the initiatives by identifying common themes, unique features of each and strategies for success. Opportunity will be given for delegates to ask questions and brainstorm how lessons learned from these initiatives could inform the care provided at their own facility.
Presented by:
- Jane Webley, RN LLB Regional lead, End of Life, Vancouver Coastal Health (EPAIRS and the Daisy project)
- Dr Christine Jones, Island Health (SSC project: Improving end of life outcomes in residential care facilities: A palliative approach to care)
- Kathleen Yue, RN, BSN, MN, CHPCN (c) Education Coordinator, BC Center for Palliative Care
NONPF - 1NURSE PRACTITIONER CORE COMPETENCIES April 201.docxkendalfarrier
NONPF - 1
NURSE PRACTITIONER CORE COMPETENCIES
April 2011
Amended 2012*
Task Force Members
Anne C. Thomas, PhD, ANP-BC, GNP - Chair
M. Katherine Crabtree, DNSc, FAAN, APRN-BC
Kathleen R. Delaney, PhD, PMH-NP
Mary Anne Dumas, PhD, RN, FNP-BC, FAANP
Ruth Kleinpell, PhD, RN, FAAN, FCCM
M. Cynthia Logsdon, PhD, WHNP-BC, FAAN
Julie Marfell, DNP, FNP-BC, FAANP
Donna G. Nativio, PhD, CRNP, FAAN
Note: Terms in bold are defined within the glossary found at the end of the competencies.
Preamble
In August 2008, NONPF endorsed the evolution of the Doctorate of Nursing Practice (DNP) as the entry
level for nurse practitioner (NP) practice (NONPF, 2008a). Nurse practitioner education, which is based
upon the NONPF competencies, recognizes that the student’s ability to show successful achievement of
the NONPF competencies for NP education is of greater value than the number of clinical hours the
student has performed (NONPF, 2008b).
The Nurse Practitioner Core Competencies (NP Core Competencies) integrate and build upon existing
Master’s and DNP core competencies and are guidelines for educational programs preparing NPs to
implement the full scope of practice as a licensed independent practitioner. The competencies are
essential behaviors of all NPs. These competencies are demonstrated upon graduation regardless of the
population focus of the program and are necessary for NPs to meet the complex challenges of translating
rapidly expanding knowledge into practice and function in a changing health care environment.
Nurse Practitioner graduates have knowledge, skills, and abilities that are essential to independent
clinical practice. The NP Core Competencies are acquired through mentored patient care experiences
with emphasis on independent and interprofessional practice; analytic skills for evaluating and
providing evidence-based, patient centered care across settings; and advanced knowledge of the
health care delivery system. Doctorally-prepared NPs apply knowledge of scientific foundations in
practice for quality care. They are able to apply skills in technology and information literacy, and engage
in practice inquiry to improve health outcomes, policy, and healthcare delivery. Areas of increased
knowledge, skills, and expertise include advanced communication skills, collaboration, complex decision
making, leadership, and the business of health care. The competencies elaborated here build upon
previous work that identified knowledge and skills essential to DNP competencies (AACN 1996; AACN,
2006; NONPF & National Panel, 2006) and are consistent with the recommendations of the Institute of
Medicine’s report, The Future of Nursing (IOM, 2011).
At completion of the NP program, the NP graduate possesses the nine (9) core competencies regardless
of population focus.
* Amended as result of additional validation through the 2011-2012 Population-Focused Competencies Task Force.
Competencies 7, 6, & 7 .
2021-2022 NTTAP Webinar: Building the Case for Implementing Postgraduate NP R...CHC Connecticut
Join us as we discuss the drivers and processes of implementing a postgraduate nurse practitioner residency program at your health center, the benefits of implementing a postgraduate residency program, and the residency tracks for Family, Psychiatric/Mental Health, Pediatric, and Adult-Gerontology Nurse Practitioners.
We will be joined by Charise Corsino, Program Director of the Nurse Practitioner Residency Program, and Nicole Seagriff, Clinical Program Director of the Primary Care Nurse Practitioner Residency Program, from the Community Health Center Inc.
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Resi...CHC Connecticut
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Residency Training Programs
Presented by CHC. Inc. and the Weitzman Institute
January 9, 2019 3:00pm (EST)
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Resi...CHC Connecticut
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Residency Training Programs
Presented by CHC. Inc. and the Weitzman Institute
January 9, 2019 3:00pm (EST)
This poster is about how Shenandoah University's Graduate Program of the Division of Nursing incorporates the Institute of Medicine Rural Relevant Competencies into its curriculum for Advanced Practice Nurses
End-of-life care in postgraduate critical care nurse curricula: An evaluation...Jamie Ranse
Ranse K, Delaney L, Ranse J, Coyer F, Yates P. (2018). End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice. Poster presented at the ANZICS/ACCCN Intensive Care Annual Scientific Meeting, Adelaide, 11th - 13th October.
The scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice and hence improve the quality and effectiveness of health services
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Teaching Undergraduate Nursing Students to use SBIRT in a Culturally Competent and Relevant Manner
1. Teaching Undergraduate Nursing Students to use
SBIRT in a Culturally Competent
and Relevant Manner
Holly Hagle, PhD, Institute for Research, Education and
Training in Addictions (IRETA)
Dawn Lindsay, PhD, Institute for Research, Education and
Training in Addictions (IRETA)
Ann M. Mitchell, PhD, RN University of Pittsburgh
School of Nursing
2. Project Team
Kathryn Puskar, DrPH, RN, FAAN Project Director
Ann M. Mitchell, PhD, RN, AHN-BC, FAAN Project Coordinator
Holly Hagle, PhD IRETA Trainer
Betty Braxter, PhD, RN Obstetrics Primary Teacher
Marie Fioravanti, MSN, RN Medical Surgical Primary Teacher
Irene Kane, PhD, MSN, RN, CNAA, HFI Psychiatric Nursing Primary Teacher
Gail Ratliff Woomer, MN, RN, IBCLC Community Nursing Clinical Instructor
Martin Houze, PhD Project Statistician
Kimberly Talcott, MPA Project Manager
Heather J. Gotham, PhD Project Evaluator
Helen K. Burns, PhD, RN, FAAN Consultant
Dawn Lindsay, PhD IRETA staff
This project is supported by funds from the Division of Nursing (DN), Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department
of Health and Human Services (DHHS) under Grant D11HP14629 Nurse Education, Practice, and Retention. The information or content and conclusions are those of the
author and should not be construed as the official position or policy of, nor should any official endorsement be inferred by, the DN, BHPr, HRSA, DHHS, or the US
Government.
3. Presentation Objectives
• Describe the undergraduate nursing school curriculum
on SBIRT.
• Explain the instructional methods used for curriculum
delivery in relation to SBIRT and cultural competency.
• Demonstrate that the SBIRT curriculum increased
student’s use of an EBP, SBIRT in relation to delivering
culturally competent and relevant services.
• Identify ways other programs can replicate this
curriculum project.
4. School of Nursing
• Vision: Advancing Nursing Science, Education and Practice
• Educates approximately 600 undergraduate students at any point in
time
• Academic Programs:
BSN (first-degree, second-degree, and RN-BSN)
MSN (Nurse Practitioner, Clinical Nurse Specialist, Nurse
Anesthesia and Advanced Specialty Roles, RN-MSN)
Doctor of Nursing Practice (DNP)
PhD (including BSN-PhD)
• Ranked 5th in National Institutes of Health (NIH) research dollars
• Ranked 7th in U.S. News & World Reports “America’s Best
Graduate Schools”
5. Institute for Research, Education
and Training in Addictions (IRETA)
• 501c3 Non-profit research and education institute
• Mission: To improve the recognition, prevention, treatment,
research and policy related to addiction and recovery
• Conduct over 60 training events annually training over 2,000
individuals
• Conduct a variety of applied research and evaluation
activities
• Provide a range of professional consulting services such as
•Training and technical assistance
•Process improvement and performance measurement
•Clinical quality improvement programs
•Program development
•Program evaluation
•Strategic planning
6. Background
Stigmatization of substance use disorders is a major
public health issues IOM, 2011
Alcohol is the leading risk factor for disease burden in
the Americas, third leading risk factor worldwide
WHO, 2011
7. Background
• Of all general hospital admissions, 25% involve
complications related to substance use (Hyman,2004)
• 20.5 million individuals age 12 and older (approximately
7% of the population) who were identified as needing
treatment for alcohol and/or drug problems (SAMHSA, 2011)
• 68 million Americans have risky or ‘unhealthy use’ of
alcohol and drugs (Humphreys, 2010)
8. What is Evidenced-based Practice?
• Key elements:
• Screening
• Brief Intervention
• Referral to Treatment
• An evidence-based practice to address risky
substance use
• Designed for general medical and community
settings
9. What is SBIRT?
Screening
Universal screening identifies patients who may
be at risk for problems related to substance use
Brief Intervention Referral to Treatment
Brief intervention is provided for If screening indicates possible
patients with mild risk. This involves a substance abuse or dependence, a
brief discussion to raise patient referral to specialized treatment is
awareness of substance use and its provided. Proactive assistance in
consequences and develop accessing care increases the chances of
motivation for behavior change. follow through.
12. ATN-SBIRT Project
Goals & Objectives
• Goal 1: Integrate a sustainable and replicable
substance use educational and skill-building
component within an undergraduate nursing
curriculum
– Increase faculty knowledge and competence to train
others in SBIRT
– Integrate the ATN-SBIRT program within the Pitt SoN
– Disseminate information for replication at other
nursing schools
13. ATN-SBIRT Project
Goals & Objectives
• Goal 2: Add 140 nurses annually to the
workforce who are able to identify and provide
service to patients with substance use, abuse or
dependence
– Increase student knowledge and awareness of:
• The continuum of substance use, abuse and dependence
• SBIRT
• Culturally appropriate care
19. Mixed-Method Evaluation Design
• Questionnaires
• Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ)
(pre/post class seminar)
• Drug and Drug Problems Perception Questionnaire (DDPPQ)
(pre/post class seminar)
• Training satisfaction
• Focus groups
• Cultural Competence Assessment
20. Results
• 572 BSN (traditional and 2nd degree) students
have been trained
• 38 faculty and preceptors have been trained and
received continuing education units
• 429 have attended the Senior year booster
session
21. Student Demographics (N=517*)
Percent
Gender
Female 88%
Male 12%
Hispanic/Latino 2%
Race
African American 4%
Asian 5%
White 91%
Other 1%
*517 of the 572 students who were trained completed this survey
22. Alcohol and Alcohol Problems Perception
Questionnaire (AAPPQ; Shaw et al., 1976):
Subscale Sample Items, 30 Total Items
• Role Adequacy
• I feel I have a working knowledge of alcohol and alcohol related problems.
• I feel I know how to counsel drinkers over the long term.
• Role Legitimacy
• I feel I have a clear idea of my responsibilities in helping drinkers.
• I feel I have the right to ask patients questions about their drinking when
necessary.
• Role Support
• If I felt the need when working with drinkers, I could easily find someone who
would help me clarify my professional responsibilities.
• If I felt the need, I could easily find someone who would be able to help me
formulate the best approach to a drinker.
23. Pre- to Post-Seminar Changes in Student Perceptions
with Regard to Alcohol-Using Patients (n=486)
Significance (pa) Effect Size (rb)
Role Adequacy <.001* .76
Role Legitimacy <.001* .61
Role Support <.001* .29
Motivation .754 -.01
Work Satisfaction <.001* .34
Task-specific Self-
<.001* .35
esteem
a
Wilcoxon Signed Ranks test. Alpha adjusted using Bonferroni correction due to series of
analyses; p-values less than .004 considered significant
b
Cohen, 1988, r > 0.10, small effect; >0.30, medium effect; >0.50 large effect
*486 of the 572 students who were trained completed this survey
24. With Regard to Alcohol-Using Patients,
Following Training, Students…
• Role Adequacy – perceived themselves as more prepared to work with
patients who use alcohol
• Role Legitimacy – perceived a greater responsibility to deal with alcohol
use in their patients
• Role Support – felt more support from colleagues in dealing with alcohol
use in their patients
• Work Satisfaction - felt more work satisfaction related to dealing with
alcohol-using patients
• Task-specific Self-esteem - felt more confident to deal with alcohol-using
patients
• *Motivation – no significant change. Need for further practice to increase
feelings of confidence and competence
25. Drug and Drug Problems Perception
Questionnaire (DDPPQ; Watson et al., 2003):
Subscale Sample Items, 22 Total Items
• Work Satisfaction
• In general, one can get satisfaction from working with drug users.
• In general, it is rewarding to work with drug users.
• Task Specific Self Esteem
• I feel I do not have much to be proud of when working with drug users (reverse
scored).
• On the whole, I am satisfied with the way I work with drug users.
• Motivation
• I want to work with drug users.
• I feel that there is little I can do to help drug users (reverse scored).
26. Pre- to Post-Seminar Changes in Student Perceptions
with Regard to Drug-Using Patients (n=486)
Significance (pa) Effect Size (rb)
Role Adequacy <.001* .73
Role Legitimacy <.001* .45
Role Support <.001* .25
Motivation .023 .10
Work Satisfaction <.001* .18
Task-specific Self-
<.001* .22
esteem
a
Wilcoxon Signed Ranks test. Alpha adjusted using Bonferroni correction due to series of
analyses; p-values less than .004 considered significant
b
Cohen, 1988, r > 0.10, small effect; >0.30, medium effect; >0.50 large effect
*486 of the 572 students who were trained completed this survey
27. With Regard to Drug-Using Patients, Following
Training, Students…
• Role Adequacy – perceived themselves as more prepared to work with
patients who use drugs
• Role Legitimacy – perceived a greater responsibility to deal with drug use
in their patients
• Role Support – felt more support from colleagues in dealing with drug
use in their patients
• Work Satisfaction - felt more work satisfaction related to dealing with
drug-using patients
• Task-specific Self-esteem - felt more confident to deal with drug-using
patients
• *Motivation – no significant change. Need for further practice to increase
feelings of confidence and competence
28. Training Satisfaction (N=488*)
Percent “Very Satisfied’ or
How satisfied are you with…
“Satisfied”**
…the overall quality of this training 88%
…the quality of the instruction 94%
…quality of the training materials 86%
…your training experience 88%
*488 of the 544 students who were trained completed this survey
**Scored on a 5-point scale where 5 = Very Satisfied and 1 = Very Dissatisfied
29. Training Satisfaction
• The most useful aspects of the training
were:
• Educational tools
• Learning how to screen and intervene
• Learning how to communicate with patients
about substance use
30. Focus Groups (Total=54)
1st Group: 11 students
2nd Group: 13 students
3rd Group: 15 students
4th Group: 15 students
31. Focus Group Quotes:
• The material was really good because it’s such an awkward subject to
bring up
• I think it showed me that asking the questions are my responsibility
• I feel very comfortable with screening people now for drug and alcohol
use, whereas before, I hesitated to ask
• I think overall it taught you that…the middle ground of being at-risk
provides you an opportunity to give more patient education
32. Focus Group Themes
• Students saw the training as linked to their development and role as
health educators
• SBIRT needs to be mandated hospital-wide or it will not be done
• Good to be taught moderation or harm reduction strategies instead of
just abstinence
34. Culturally competent and
relevant activities
• In-class activities
– Milton Bennett’s (1993) Developmental Model
of Intercultural Sensitivity and examined the
cultural competency continuum.
• Simulation
– The simulation lab was specifically designed
for junior level students to have supervised
practice delivering SBIRT skills in a culturally
competent manner.
35. Simulation Lab
• Multiple case scenarios were presented to students
during a 7.5 hour day in the simulation lab.
• Case scenarios were based on the Scope and Standards of
Practice for Psychiatric-Mental Health Nursing (2007)
and included:
– 1) a middle-aged man with acute pancreatitis and alcohol
withdrawal; 2) a young, pregnant woman with bipolar disorder
and sporadic cigarette use; 3) an elderly man with congestive
heart failure and a history of depression and previous overdose
on tricyclic antidepressants; and 4) an elderly woman who was a
victim of domestic violence with a dependence on prescription
medications.
36. The Cultural Competence
Assessment (CCA)
• Consists of 44 items.
• Comprising two subscales: the Cultural
Awareness & Sensitivity Subscale and the
Cultural Competence Behavior Subscale
• Items ask about experience with culturally
diverse groups, including self-ratings of cultural
competence.
37. Survey Administration
• The survey instrument was administered
by paper-and-pencil at baseline (beginning
of Junior year) and following the end of
the simulation lab experience.
• Instrument from pre to post simulation
experience (n= 119)
38. Results of the CCA subscales
Mean Pre-test Mean Post-test t, p-value
Cultural
Awareness & 4.0993 4.3205 -7.071, p=.000
Sensitivity
Subscale
mean score
Cultural
Competence 3.4222 3.7243 -5.869, p=.000
Behavior Subscale
mean score
n=119, Paired-sample t tests
39. Culturally competent and
relevant services
• Through specific class activities on cultural
issues students can become
– more culturally aware,
– sensitive and
– demonstrate competent cultural behavior with
practice (simulation).
• Short video demonstration of simulation lab
41. In other schools
• Publications:
•Journal of Nursing Education and Practice
– published in open access journal Volume 2, Issue 4
•Substance Abuse Journal of AMERSA
– in press
•Develop partnerships
•Look for innovative ways to partner
43. Draw your culture
• May draw pictures of events in your life that have influenced you in
your culture
• May draw symbols that are particularly meaningful in your culture
• Any combination of designs, doodles or lines that have meaning
• However may not write or draw any words
• Present drawing with explanations of what symbols or drawings
mean to the group
Program consists of a total of 13 hours of education: during the junior years this includes 6 hours of didactic and experiential instruction via an in-class seminar, 3 hours of practice and supervised feedback during clinical rotations, and 2 hours of practice with culturally diverse scenarios in the simulation lab, and in the senior year students receive 2 hours of didactic and experiential instruction via an in-class booster session.
Program consists of a total of 13 hours of education: during the junior years this includes 6 hours of didactic and experiential instruction via a class seminar, 3 hours of practice and supervised feedback during clinical rotations, and 2 hours of practice with culturally diverse scenarios in the simulation lab, and in the senior year students receive 2 hours of didactic and experiential instruction via an in-class booster session.
Motivation subscale questions on AAPPQ (5 total): I am interested in the nature of alcohol related problems and the responses that can be made to them. I want to work with drinkers. I feel that the best I can personally offer drinkers is referral to somebody else. I feel that there is little I can do to help drinkers. Pessimism is the most realistic attitude to take toward drinkers.
There is only one question on the motivation subscale for DDPPQ: I feel that there is little I can do to help drug users.