The presentation is for a PICOT Question on how would I educate other nurses tha

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The presentation is for a PICOT Question on how would I educate other nurses that I work with on the importance of continuing psych medications for people with substance use disorder. P-Nurses at my facility
I-In service on screening on psych-add a form to be completed every day
C-Refer to DDU level of care
O-To increase screening and management of patients with psych issues that need meds
T-1-6 weeks-this is the timeline.
Questioned asked and answered by nurses in the facility:
1. Do you think we should resume psych meds on detox level of care
2. How frequently do you thingk patients should be seeing their outpatient provider if they are on CSS.
3. What are your impressions on how Addiction Treatment Centers manage psychiatric disorders for our patients with substance use disorder.
4. Do you think mental health struggles correlate with substnace use disorder.
Answers:
Yes, I think often times mental health struggles correlate with substance use disorder. Certain patients may use drugs to cope with mental health struggles
We should absolutely resume psych meds on detox level of care. The benefits of continuing psych meds outweigh any risks of not being compliant with meds significantly
Patients should be seeing their outpatient provider as soon as possible while at CSS to ensure great care
BATC is making progress in managing psych disorders for our patients. However, there’s still more to be done. Answer:
Yes, i think people with substance use disorders and mental health struggles self medication with illicit substances instead of prescribed medication for multiple reasons, many do not have health insurance or pcp and they are not aware of medications that are available, some are not honest with providers about symptoms they experience due to stigma, some are unaware that symptoms they experience are related to underlying mental health issues. yes, i think that people who have a psych diagnosis but are not currently being treated with medication should be able to access that medication on detox level of care. Once they have completed detox, they tend to experience more severe psych symptoms because they are no longer “numbing” their feelings with illicit substances, providing medication will reduce symptoms and the need to self medicate
I think pt should be seen by their provider on a weekly basis unless they are requesting to be seen more frequently. I think that HPTC BATC does not do enough to manage psych d/o in detox pt’s. when a patient comes in to detox with a psych diagnosis but is not currently taking medication, once they complete their detox, they are not able to cope with how they feel causing some to become aggressive, anxious, depressed and the need to feel better and wanting to self medicate. If they start psych medication treatment once they arrive in detox the medication should help minimize their symptoms allowing them to cope, along with medication they should also receive behavioral therapy so they can better understand what they are feeling and how to manage.
Answer:
1. yes they go hand in hand. Alot of addicts treat their mental health with ilicit drugs or alcohol instead of pharmaceuticals due to the side effects of many psych meds. ie gives them flat affect/ impotence/ can’t cry
2. Yes addicts have a better chance at recovery if they have their mental health stable. Since most psych meds also need time to build up to therapeutic levels in their body
3. There is no need for a pt to be seen by their PCP while inpatient.
4. Diagnosing someone and treating someone for their psych diagnosis is difficult on this level of care d/t their detox .PAWS and the type of shock the body is going through during this time can mimic GAD, MDD, and possibly bipolar Answer:
Yes!! I believe a lot of our patients are suffering from mental health issues that cause them to seek relief with substances
For the most part, yes. I think there are some medications that shouldn’t be evaluated to start until after detox (IE Wellbutrin, Stimulants such as adderall, vyvanse, strattera etc.) but generally getting someone back to being maintained on their psych meds.
I think every patient on CSS should see the provider within 24 hours of admission to CSS and again every week for stabilization.
I do not agree with not having a psych NP on detox. I think there are a lot of missed opportunities to get patients on the road to stabilization faster. I like that we can reach out to CRISIS, but that is only for HI and SI, not the no sleeping for days, manic episodes, and unmanaged anxiety that would do fantastic with a paxil or celexa rx.
The above are answers from the nurses at the facility.

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