Holloway, Aisha

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     Edinburgh Research Explorer                                      Nursing delivery of ABIs in primary careCitation for published version:Holloway, A 2015, Nursing delivery of ABIs in primary care: Evidence, practice, challenges and solutions. inABI Primary Care Event.Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher's PDF, also known as Version of recordPublished In:ABI Primary Care EventPublisher Rights Statement:© Holloway, A. (2015). Nursing Delivery of ABIs in Primary Care: Evidence, Practice, Challenges andSolutions.In ABI Primary Care Event: 22nd January, Edinburgh.General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 05. Apr. 2019Nurse delivery of ABIs in primary care: Evidence, Practice, Challenges and Solutions Dr Aisha HollowayClinical Academic Research FellowOverview• Evidence• Challenges• Nurses Role• SolutionsResponding to alcohol-related harm• Nurses are largest group of health care professionals - over 670,000 (NMC, 2015)• Nurses from all fields of practice, are well placed to identify patients’ levels of alcohol consumption, offering advice in relation to reducing levels of alcohol consumption (Watson et al 2010)• Delivering brief interventions where necessary (Nkowane & Saxena. 2004; Murray & Li 2007; Holloway et al. 2007; Littlejohn & Holloway 2008)• Nurses are not engaging with this important role (Tsai et al 2010) Empirical evidence• Typically nurses receive little education and training about alcohol issues (Lock, Kaner, Lamont and Bond, 2002). • The alcohol component of the curriculum for nurses lags behind (Rassool & Rawaf 2008, Holloway & Webster, 2013). • Lack of confidence and experience can allow a nurse to feel anxious about their role (Lock et al., 2002; Holloway et al, 2014). • Low Therapeutic Commitment – role support, role legitimacy, role adequacy (Shaw, 1978)• Alcohol education within curriculum improves student nurses attitudes and knowledge (Arthur, 2001) Context• Alcohol-related knowledge weak• Lower reported clinical confidence in patient-centred care items e.g. identifying and assessing patients drinking behaviour and adapting nursing interventions• Higher reported clinical confidence in recognising, explaining and describing relationships between alcohol-related conditions e.g. alcohol-related conditions, pharmacology and tasks that did not involve a patientLawrence & Holloway (2005); Flynn & Holloway (2008); Holloway & Webster (2013)Catalyst for Change: NMC review of pre-registration education• Generic competencies – all nursing students• Field specific competencies – adult, child, mental health, learning disability• Competencies organised under 4 Domains• Each Domain sets out an overall standard of competence• Essential Skills ClustersDomain – Communication and Interpersonal Skills• Point 6– “Identifies opportunities for health promotion and health education activities”Essential Skill Cluster (ESC)• ESC 9– Make a holistic systematic assessment of their needs and develop a comprehensive plan of nursing care that is in their best interests and which promotes their health and well-being and minimises the risk of harmProgression point 1• Contributes to the assessment of physical, emotional, psychological, social, cultural & spiritual needs, including risk factors by identifying, recording, sharing and responding to clear indicators and signs• Understands the concept of public health and the benefits of a healthy lifestyle and the potential riskfactors involved with various lifestyles or behaviours• Recognises the indicators of unhealthy lifestylesEntry to Register• (xxv) Works within a public health framework to assess needs and plan care for individuals, communities and populations• (xx) Discusses sensitive issues in relation to public health and provides appropriate advice and guidance e.g. contraception, substance misuse, impact of lifestyle on healthImplementation FrameworkWorkforce development:– education & training (Roche, 1998)– supervision (Kavanagh et al, 2002)– partnerships (Wilkinson et al, 2002)– leadership (de Crespigny, 2003)– active dissemination of research findings (de Crespigny, 2003)Education & Training• Delivery of Alcohol brief interventions: A competency Frameworkhttp://www.nes.scot.nhs.uk/media/3125/Delivery_of_Alcohol_brief_Interventions_spring_2010.pdf• NHS Health Scotlandhttp://elearning.healthscotland.com/course/index.php?categoryid=108Supervision & PartnershipHealth Promotion Team NHS Lothianhttp://www.nhslothian.scot.nhs.uk/HealthInformation/RecoveryInLothian/Training/AlcoholBriefInterventionsPoster.pdfLeadership• Joint approach• Practitioners, Clinicians, Academics, Researchers, Policy Makers, 3rd Sector, NGOs• Professional bodiesActive Dissemination of Research Findings• Scottish Alcohol Research Network (SARN)www.sarn@ed.ac.uk• Scottish Health Action on Alcohol Problems (SHAAP) www.shaap.org.uk• International Network on Brief Interventions for Alcohol & Other Drugs (INEBRIA) www.inebria.net• UK Centre for Alcohol & Tobacco Studies (UKCTAS) www.ukctas.ac.uk/ukctas/index.aspxGuidanceBrief Intervention For Hazardous and Harmful Drinking: A Manual for Use in Primary Care (Babor and Higgins-Biddle, 2001)PH24 Alcohol-use disorders: preventing harmful drinking (NICE, 2010) Alcohol related harm in the practice. Journal of Practice Nursing, Vol.26, No.1 (Holloway, 2015)Thank You!Aisha.holloway@ed.ac.uk

Nursing delivery of ABIs in primary care:Evidence, practice, challenges and solutions

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Nursing delivery of ABIs in primary care:Evidence, practice, challenges and solutions

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