Harm Reduction/CDSS
What is the goal of harm reduction?
To minimize the harmful consequences of drug and/or alcohol use, rather than eliminating the action altogether.
What is motivational interviewing?
An evidence-based approach to facilitate behavior change in clients with substance abuse by helping them explore and resolve ambivalence.
What is point-of-care leadership in nursing?
Point-of-care leadership is differentiated from other types of leadership in that the leadership activities relate directly or indirectly to the care process, and are carried out by point-of-care nurses who are not in a formal administrative role.
Name two skills/strategies involved in motivational interviewing.
Asking open-ended questions, affirmations, reflecting, summarizing, encouraging change talk, and/or exchanging information.
T/F: In motivational interviewing, the four processes are strictly linear and do not allow for fluid movement depending on the client's needs and circumstances.
False
What are the 4 components of the CDSS framework?
Prevention and education; Substance use services and supports; Evidence; and Substance control.
T/F: As nurses, our role involves directly motivating clients toward behaviour change.
False. As nurses, we do not directly motivate clients; instead, we assess motivation levels and apply the appropriate skills and strategies to address readiness to change.
Name two components of point-of-care nursing leadership.
Building relationships and trust; Empowering others; Contributing to an environment that supports knowledge integration; Leading, supporting and sustaining change; and/or Balancing complexities of the system and managing competing priorities.
What steps can nurses take to build a relationship of trust with their clients?
Nurses can start by validating clients' feelings and assessing their needs to create an empathetic and understanding environment.
What are some strategies/interventions to reduce the risk of substance abuse?
Address SDOH, access to health services, access to community resources and services, support system (family support and peer support), policy and regulation, screening and early interventions, and education and awareness programs.
Name three harm reduction programs in Ontario.
Needle exchange; Methadone maintenance; Outreach; Law-enforcement cooperation; Illicit drug prescription; Tolerance zones; Alcohol server intervention; Smoking control.
Name two underlying elements of motivational interviewing.
Partnership, acceptance, compassion, and/or evocation.
How can nurses validate a patient's feelings and assess their needs?
By actively listening, empathizing with their experiences, and engaging in open dialogue to understand their perspective.
How can affirmations be integrated into motivational interviewing sessions?
Affirmations are most effective when they acknowledge and appreciate the client's strengths and efforts for change. They can take the form of compliments or statements that convey understanding and appreciation for the client's journey.
During which process in motivational interviewing do healthcare providers collaborate with the client to define a shared goal?
Focusing
The main features of harm reduction include pragmatism, humane values, and a focus on harms. How do you explain 'Pragmatism'?
Harm Reduction recognizes that substance use is inevitable in a society and that it is necessary to take a public health-oriented response to minimize potential harms.
In which process of motivational interviewing do healthcare providers guide the client to explore their own motivations for change?
Evoking
How can nurses demonstrate a leadership role in caring for a patient with substance abuse?
Using non-judgemental approach, motivational interviewing, education, empowering informed decision-making, providing patient/client centered care, advocating for patient’s best interest, and interdisciplinary collaboration.
What is the goal of "demonstrating self-awareness through reflective practice" according to the CNO competencies?
Nurses can recognize their own biases or assumptions and enhance their ability to provide nonjudgmental care.
Why is summarizing important in motivational interviewing?
Summarizing ensures a shared understanding between the HCP and the client. It reinforces key points made by the client during the session, helping to clarify and solidify their thoughts and intentions.
What does the CDSS framework illustrate about recovery services?
The CDSS framework illustrates recovery services as a process or lifestyle change for individuals grappling with substance use-related challenges. This involves efforts to enhance health and well-being, which include accessing services supporting complete abstinence, various harm reduction and treatment services, as well as broader social services to address employment, housing, income, and cultural needs.
What does the planning process in motivational interviewing involve?
Discussing the practical aspects of change, assisting the client in solidifying their commitment to change, and developing a plan based on their own insights and expertise.
How can nurses contribute to creating an environment that supports knowledge integration?
Nurses can provide opportunities for clients to share their knowledge of health concerns and actively involve them in discussions about care plans.
What is patient-initiated discharge in the context of substance abuse, and what factors contribute to it?
- Patient-initiated discharge refers to when a patient chooses to leave a healthcare facility AMA.
- This decision can stem from various reasons, including experiencing withdrawal symptoms, inadequate pain management, facing discrimination and stigma, perceiving a lower quality of care, and a preference for leaving the hospital over community care settings.
How can nurses improve the care for people with substance abuse and prevent patient-initiated discharges?
- Acknowledge the social and contextual factors that often precipitate individuals’ substance use disorders.
- Be informed about substance use disorders through education and how to screen for them.
- Have an open-minded, non-judgmental approach.
- Be aware of medications, such as opioid agonist treatments, used to treat substance use disorders.
- Advocate for patients if they are not receiving evidence-based medications or sufficient withdrawal management.
- Advocate for harm reduction policies and practices within clinical settings.