Breaking Practice Barriers: Bringing an Integrative Approach to PMH Nursing. Shared Connections. Presentation Objectives

Transcription

1 Breaking Practice Barriers: Bringing an Integrative Approach to PMH Nursing Merrie J. Kaas, Ph.D, RN, PMHCNS, FAAN Kristin Hjartardottir, DNP, RN, PMHCNS Gisli Kristofersson, Ph.D, RN, PMHCNS Barbara Peterson, Ph.D, RN, PMHCNS University of Minnesota School of Nursing Dawn Vanderhoef, Ph.D, DNP, RN, PMHCNS/NP Vanderbilt University School of Nursing Shared Connections Presentation Objectives Identify evidence to support integration of integrative content into graduate psychiatric/mental health curriculum Describe an innovative educational model for graduate psychiatric/mental health nursing practice Identify challenges and future directions 1

2 Role of Advance Practice Psychiatric/Mental Health Nursing in the US 1950s: Traditional role was Clinical Nurse Specialist (CNS) Direct patient care Education Consultation Research Leadership 2001: Psychiatric/Mental Health Nurse Practitioner (PMHNP) certification includes: Advanced health assessment Psychotherapy Prescribing medications Support for Integrative Psychiatric/Mental Health Nursing 38% of adults and 12% of children use CAM approaches (Barnes et al., 2008). 53% of persons age 50 and older report using CAM Herbal products and supplements are most commonly used (AARP & NCCAM, 2011). Persons with self identified anxiety and depression are more likely to use CAM treatments then conventional therapies (Saris et al, 2013). Integrated OR Integrative Integrated services are those where the patients physical and mental health needs are addressed by the same provider/service 2

3 Integrative OR Integrated Integrative mental health care is a philosophy not just the use of complementary and alternative medicine approaches Complementary and Alternative Medicine CAM therapies are specific approaches not usually considered conventional, medically based interventions: mind/body practices biologically based approaches energy therapies manipulative/body-based therapies Why Minnesota? Growing workforce of integrative health practitioners in MN UMN Center for Spirituality and Healing established in 1995 UMN SON has the first BS-DNP Integrative Health and Healing specialty area/program in survey of Minnesota advanced practice PMH nurses who stated they wanted more knowledge and expertise in CAM (Zimmer et al., 2010) MN Board of Nursing Practice supports the use of integrative therapies within scope of practice 3

4 Partnership between UMN SON and Center for Spirituality and Healing September 2010 UMN SON retreat Consultation of experts IPMH nurses and other providers Literature review Curricular evaluation and mapping Journey Toward Integrative Psychiatric Mental Health BS-DNP Curriculum Principles of Integrative PMH Nursing Whole person approach to understanding mental illness Prevention and treatment of mental illness Evidence-based conventional and non-conventional approaches Least intensive/invasive therapies to more intensive Health and well-being of the professional caregiver PMHNP Program Definition of Integrative PMH Nursing holistic practice that addresses the interactive systems of the body to promote patients physical and mental well-being within the context of their environment the intentional use of the Nurse/Patient relationship using existing and emerging evidence to prevent and treat mental health challenges provides a combination of conventional and nonconventional interventions using a patient-centered approach 4

5 BS-DNP Psychiatric/Mental Health Nurse Practitioner Curriculum 82 semester credits for DNP Program 47 Core DNP credits 10 DNP project credits 25 PMH graduate credits PMH NP specialty area 25 graduate credits, both clinical and didactic courses across the lifespan 1000 supervised clinical hours 6 credits of didactic about complementary and alternative therapies (Intro to healing practices course and 3 cr. Elective, or 12 cr. graduate minor in integrative therapies and healing practices) Examples of CAM Electives Art of Healing: Self as Healer Meditation Yoga Functional Nutrition Clinical Aromatherapy Intro to Energy Healing Reiki Mind/body Healing Therapies Music Health and Healing Healthy Humor Integrative PMH Nursing Student Activities Clinical experiences throughout the continuum of mental health care Intentional focus on the stages of the clinical interview Presence / intention / listening / silence Integration of reflective practice activities in all clinical courses Identification and implementation of personal plan for self care as a PMHNP Development of a personal philosophy of integrative psychiatric mental health nursing practice 5

6 Challenges Defining integrative psychiatric/mental health advanced nursing practice Integrating integrative evidence based practices into coursework Identifying clinical placement sites Preparing clinical preceptors Structuring clinical experiences Defining IMP DNP scholarly projects Progress and Products cohorts of BS-DNP PMHNP students (n= 37) Graduates (n=7) all working in PMH clinical sites 3-4 full- time faculty who have worked to redesign the PMHNP curriculum (11 courses) using IMH principles Dissemination of educational outcomes of our program at national professional meetings Co-creation and delivery of 2 annual integrative PMH conferences in MSP with Allina Behavioral Health 3 book chapters about IPMH and/or use of CAM in PMH care Funded 3 yr. HRSA grant to teach IPMH care in new interprofessional teams at 2 psychiatric clinical sites Kristin Hjartardottir: Student Experience DNP graduate 2012 from the PMH program. How the program influences my current work with students at the Boynton Student Health Services Stress reduction Encouraging and supporting self-care Empowering for role as APRN 6

7 Our Team Our Icelandic giant and 4 gay elves 7