Credentialing Objectives Mental Health and Addictions Credential In Primary Healthcare Introduction The following objectives are designed to guide the education/training provider and Primary Healthcare Agency to enhance the skills of nurses working in the Primary Care sector. These objectives will assist nurses to meet the requirements of the Evidence Based Record and Application for credentialing. Objectives 1. To routinely screen for and recognise signs of depression, anxiety, addiction and harmful substance use in people. 2. To feel confident talking to and supporting people with signs of depression, anxiety, addiction and harmful substance use. This includes feeling confident about inquiring about and addressing concerns about risk. To include screening, brief assessment and interventions, ongoing monitoring (psychosocial, physical, and pharmacological), and promoting self management strategies within daily practice. 3. To be familiar with referral pathways within communities that are culturally appropriate, and meet the needs of individuals, families and whānau. 4. To understand the concepts of recovery and wellbeing 5. To incorporate the principles of a motivational approach within therapeutic relationships. 6. To understand societal influences that impact on people s mental health and journeys of recovery including stigma and discrimination Outcome criteria Objectives will be met when 1. People with mental health and addiction issues and their family/whānau report that they have felt listened to, their views respected, and their contact with the primary care nurse was helpful in meeting their mental health and addiction needs. 2. Nurses report an increase in their confidence and competence in assisting people with mental health and addiction issues. 3. Nursing practice reflects enhanced skills in screening, brief assessments and interventions relevant to the primary care 4. Principles of supporting recovery are incorporated into practise
5. Mental health promotion strategies are integrated into practise and incorporate a wide range of activities aimed at promoting health and wellbeing, and reducing stigma and discrimination 6. Nurses access community resources and referral pathways. Objectives may be met by 1. A range of education resources including online resources 2. Clinical supervision/mentoring via a variety of mechanisms
Credentialing Gap Analysis Mental Health and Addictions Credential In Primary Healthcare The following outlines a framework for organisations and Registered Nurses that will assist to identify gaps (capacity and capability) in the workplace and in practice, prior to application for a mental health credential. Capacity of Organisation Organisation and GP expectations of 1) Enhanced role of nurses in day to day practice 2) Level of knowledge and skills required to develop 3) Resource requirements Time/other resources available for nurses to gain required knowledge and skills and to implement in practice and continue to enhance confidence and competence To champion credentialing programme, recruit, manage requirements and process within the organisation and link with NZCMHN Credentialing staff Clinical accountability, clinical review mechanisms and role relationships between practice nurses, GPs, other staff or external linkages including with mental health nurses, community resources and NGOs (Mental Health Foundation, SPINZ, Like Minds Like Mine, Lifeline, CASA, Skylight etc) Current mental health and addiction (substance use including nicotine, gambling) screening mechanisms/instruments in use and intervention frameworks in place within the organisation Current patient pathways, consultation and referral processes, internal and external community resources utilised Professional development systems that could be utilised within organisation or external to the organisation E-tools available to meet education/skill enhancement requirements Avenues for reflective practice e.g. supervision/coaching/other mechanisms - i.e. to assist nurses to gain confidence and competence and ensure implementation and enhancement of practice. This could include GP mentoring/supervised practice, case reviews with peers, group supervision, mentoring with nurse educator or in-house structure and many more options
Practice Nurses Profile qualifications, current mental health and addiction capabilities and gaps Nurses expectations of how they would utilise enhanced skills in day to day practice Readiness and willingness to participate in education and to utilise enhanced skills in practice
Credentialing Education Criteria Guidelines Mental Health and Addictions Credential In Primary Healthcare The following is a framework for Education it outlines the knowledge and skills required (including of local services and community resources) and should be considered in conjunction with the Gap analysis Overview Mental health and addiction in the NZ context Commonly presenting issues in primary care e.g. nicotine, alcohol, anxiety and depression, including age and lifecycle considerations Mental health and suicide prevention Mental health and the law, NZ Drug Policy Co-existing problems Medications commonly used in primary care and side effects Stigma and discrimination and underpinning attitudes, myths and misperceptions Early intervention Guidelines Screening and brief assessment tools and frameworks Brief intervention tools and frameworks Consultation and referral thresholds Engagement and therapeutic alliance within primary care setting How to broach subject Motivational principles and dialogue to promote lifestyle and health behaviour change Long term management - people who have more severe and complex mental health and addiction problems Overview of conditions and symptoms Co-existing substance use/addictions, mental health, and physical health problems Evidence based best practice including for co-existing disorders Recovery and wellbeing Case management approaches and strategies e.g. strengths based approaches Self-help including on-line, community services and resources Medications and side effects
Commonly experienced issues e.g. medication adherence, missed appointments and approaches, and managing challenging behaviours Consultation and Referral thresholds de-escalation, crisis and risk management ASSESSMENT 25 hours of mixed theory and supervised practice ( negotiable) Online assessment