Better responses to Alcohol and other Drug presentations in Victorian Emergency Departments

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1 Better responses to Alcohol and other Drug presentations in Victorian Emergency Departments Jo Colvin Nurse Practitioner Candidate Latrobe Regional Hospital

2 Overview Government funding My role Strategies

3

4

5 Latrobe Regional Hospital Provides a public health service for Gippsland in regional Victoria 18.3% of Victoria from metro Melbourne to NSW border Is a purpose built 270-bed, fully integrated health service Has eight Community Mental Health Centres located across Gippsland Is a teaching hospital affiliated with the Monash University School of Rural Health, which is located at the hospital in Traralgon Operates collaboratively with sub-regional hospitals in Gippsland Recently opened HDAU and Mother & Baby Unit

6

7 Project overview 2012 Victorian State Budget allocated $12.0 million over four years to support better management of Alcohol and Other Drug (AOD) related presentations to emergency departments (EDs). This initiative supports selected hospital EDs in enhancing treatment options for people presenting with AOD related issues, including risky behaviours and co-morbid mental health concerns.

8 About me.. Bachelor of Nursing Post Graduate Diploma Mental Health Diploma in Alcohol & Other Drugs Masters of Nursing (Monash) Currently completing Masters of Nurse Practitioner (Latrobe University) Alcohol & Other Drug Nurse Practitioner Candidate LRH (Emergency Department)

9 My role & key areas AOD Nurse Practitioner Candidacy position Specialist AOD interventions Implementing standardised and evidence based AOD tools Education for ED staff to build capacity to deliver AOD screening, assessment and referral Service co-ordination and developing integrated pathways with AOD providers and other services external to LRH Developing strategies to meet the four-hour NEAT guidelines for AOD presentations Developing and implementing a secondary AOD consultation program to sub-regional EDs across Gippsland

10 AOD screening, assessment and referral Implementation Initial AOD screen on all nursing observation charts in ED. Objective: Every patient assessed for AOD use and recreational drugs. To prompt all ED clinician to ask the question of ALL clients regardless of presentation. Overall Capacity building ED staff to take ownership of AOD presentations.

11 Service co ordination Networking with local police and ambulance aimed at achieving better outcomes for patients with AOD issues who present to ED. Providing education to local police on methamphetamine. assisting with management risks for patients presenting to ED in police presence. Participating in Emergency Liaison Services meeting Mental Health/AOD/ED Meeting with Ambulance Victoria to facilitate management plans for frequent presenters to the ED. information sharing, with consent, on needs of frequent flyers Collaborating with the Gippsland Pharmacotherapy Network as well as AOD Nurses regional meetings

12 Networking Liaising with other ED clinicians in this role throughout the state. This prevent silos; encourages information sharing so that all the good work being done can be shared

13 Collaboration with external agencies Latrobe Community Health Services is our local AOD service for counselling and Withdrawal nursing. Regular referral pathway meetings with external stakeholders AOD & Clinical Mental Health Managers meeting Bi monthly Supervision provided for Community AOD nurses Information sharing of clients with MOU for smoother and faster referral process Better patient outcomes

14 Australian Community Support Organisation (ACSO) New AOD reform - many changes to existing referral pathways. My role is liaising and forming strong links with ACSO as our regional service provider for AOD Intake and Assessment. ACSO now attend LRH once a week and conduct face- to- face assessments if required; plus, direct phone access to a local contact person who can take consented referral from our clients wanting to access ACSO services The client now has direct access to AOD services with minimal delays

15 Conclusion The combination of alcohol, drug and mental health issues is incredibly complex and calls for a greater level of intervention and treatment. Tackling someone s drug or alcohol addiction in the ED is not a quick fix for improving their mental state and vice versa but can be a first step to accessing the appropriate services. It is about treating everybody with respect, dignity and understanding of their particular situation. The key to this success is to treat people the same way you would like to be treated and without judgement. This innovative role is helping to address gaps in the management of screening, referral and interventions for clients using alcohol and other drugs. It provides a way forward to address these challenges and to provide better outcomes for clients with AOD issues who attend Latrobe Regional Hospital, often in crisis.

16 Contact:

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