Full Course Description

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Managing Challenging Patient Behaviors: 101 De-escalation Strategies for Healthcare Professionals

Program Information

Objectives

1. Determine criteria for high-risk behavior.
2. Apply interpersonal effectiveness skills to patient evaluation.
3. Analyze effective strategies to de-escalate dangerous behavior.
4. Assess for the symptoms of major illness that interfere with treatment.
5. Evaluate the effectiveness of your communication skills to de-escalate aggressive behavior.
6. Categorize approaches to various high-risk patient profiles.

Outline

Lowering Risk for Dangerousness in Patient Encounters

• Priority is Safety
  • Understanding Risk for Dangerousness
  • Mechanisms for Coping
  • Strategies to Deal with the Angry Patient

Healthcare Goals

• Treatment Focused
• Do No Harm
• Clear Boundaries

Evaluating the Patient

• Ask the Right Questions
• Understand Patient’s Motivation
• Motivational Interviewing: Asking, Listen, Inform
• Engage Patients in Focused Communication
• Listen with Empathy
• Empower the Patient

Interpersonal Effectiveness Skills

• Self-Awareness
• What Type of Communicator Are You?
• Reciprocal Communication Strategies
• Clinician Self-Care

Engage Patients in Focused Communication

• Understand Patient’s Level of Communication
• Support the Patient’s Goal
• Multi-Disciplinary Intervention

Treatment Team Concept

• Navigating Difficult Dynamics
• Mediation & Leadership Roles
• Engage Families Constructively

Understanding Challenging Symptoms

• The Mentally Ill Patient
• Know Your Limits
• Understand Chronic & Severe Mental Illness

Severe Mental Illness

• Schizophrenia/Schizoaffective Disorders
• Substance-Induced Psychosis
• Bipolar Disorder
• Major Depression
• Anxiety Disorder
• Obsessive-Compulsive Disorder
• Antisocial Personality Disorder
• Borderline Personality Disorder

Disorders with Unique Risk

• Developmental Disabilities
• Delirium
• Dementia
• Substance Abuse
• Special Considerations for Violent Patients

Acute Crisis

• Sexual Assault
• Domestic Violence
• Suicidal Ideation & Risk

Copyright : 05/13/2020

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Substance Abuse Among Medical Patients: A Hidden Truth

Program Information

Outline

Case Studies of Hidden Substance Use Disorders in Medical Patients: What Does it Look Like?

• In pregnant patients
• In general medical patients
• In surgical patients

Why is This Topic so Important? And so Challenging?

• Biostatistics
• Actual relevance in practice
• Morbidity and mortality - complications of substance use disorders

What Do These Substances Actually Do Within the Body?

• Pharmacokinetics and pharmacodynamics principles
• Reinforcement
• Tolerance and cross-tolerance
• Physical dependence
• Conditioning
• Sensitization
• Pregnancy-related complications

What Substances Are We Talking About?

• Alcohol
• Sedative/Hypnotics
• Opioids
• Stimulants
• Dissociatives
• Inhalants
• Cannabinoids
• Anabolic steroids
• Club drugs
• Nicotine

Street Drugs and Terminology

• Interpreting patient language
• What drugs are they talking about?

Neurobiology of Substance Abuse: You Mean it’s Not a Choice?

• Neurobiology and anatomy of the normal brain
• Substance abuse as a brain disease
• Genetic and environmental influences

Mental Illness and Substance Abuse “Dual Diagnosis”

• Co-occurring illnesses
• Traits and theories surrounding the two

Screening and Assessment Techniques

• Effective questionnaires to screen for substance use
• Techniques to promote open and honest communication from the patient
• Working with the pregnant patient who uses substances
• Assessing your own biases – and how to not let them interfere with your work

The Patient with an Underlying Substance Use Disorder: Withdrawal Symptoms & Emergency Treatments

• Anticipation/prevention of withdrawal symptoms
• Withdrawal protocols
• Medications to treat withdrawal symptoms
• Emergency treatments
• Treatment of the newborn following exposure to substances
• Safety for patients/family/staff
• Effective pain management
• Motivational interviewing - Assessing how to refer the patient following discharge from the hospital

 

Objectives

1. Evaluate the epidemiological trends of substance use disorders and how these disorders affect our medical patients.
2. Differentiate between the substances of abuse seen presently in practice to understand the pharmacology of these substances.
3. Distinguish the terminology used to refer to street drugs today.
4. Argue the neurobiology of substance abuse.
5. Assess and screen for substance use disorders.
6. Formulate an appropriate treatment plan for patients with a history of substance use disorder, including managing pain effectively.
7. Analyze the relationship between various medical complications associated with substance use.
8. Manage your own identified biases when working with patients who have substance use disorders.

Copyright : 04/20/2016

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Patients in Crisis: Life Threatening Risks of Opioids, Medical Marijuana, Vaping

Program Information

Objectives

1. Evaluate how opioids are affecting the brain and mental health.
2. Differentiate between substance use disorder and common co-occurring disorders.
3. Analyze the benefits of inpatient versus outpatient treatment, medication and behavioral treatment options.
4. Catalog the conditions benefited by medical marijuana use and ramifications of legalization.
5. Determine pain treatment options for a patient with an opioid addiction.
6. Choose patient teaching based upon what we know and what we don’t know regarding vaping.

Outline

The Opioid Crisis: Dealers, Doctors and Drug Companies

• Are there really gateway drugs?
• The path from post-op pain treatment to heroin
• Saving our “children”
• Opioid use amongst healthcare providers

Risks of the Opioid Options

• Natural vs. synthetic options
• Opioids for treatment of pain
• Genetic risks coming to light
• Why fentanyl is scarier than heroin

Opioids ARE Changing the Brain

• Effect of different drugs on brain neurons
• MRI’s before and after opioid abuse
• Pleasure center in the brain – is it just willpower?
• Can the effects be reversed?
• Association with other diagnoses (depression/ADHD)

Life Threatening Challenges

• Is it reasonable to expect a patient to just stop?
• Withdrawal signs/symptoms
• Initial interventions when you don’t know what your patient has taken
• Ethics of supplying clean needles
• Interpretation of drug test results
• Safe drug disposal

Treatment Options

• Inpatient vs. outpatient benefits
• Medication assisted
  • Buprenorphine – what you MUST know
  • Methadone
  • Mitigating medications
  • Quickly recognize symptoms of precipitated withdrawal
  • Process of induction
  • Maintenance
• Lucemyra
• Therapy and group counseling
• Assessment of true pain vs. drug-seeking behavior
• Your safety in a potentially dangerous situation
• Provider requirements – X waiver

Narcan

• What can go wrong with this life-saving treatment
• Quick overdose assessment
• Why Narcan will not work on non-opiate overdoses
• Administration perils
• Critical assessment AFTER Narcan administration

Marijuana: Medical…or Otherwise

• Conditions benefited by medical marijuana
• Long-term implications of recreational use
• Ramifications of legalization
• Side effects can be life threatening

The New Hot Topic of Vaping

• What we know and what we don’t know yet
• The risks of various vaping devices
• Patient education based upon the latest injury/death statistics

Patients in Addiction Crisis

• Early intervention more effective than treating at “rock bottom”
• Expecting quitting “cold turkey” is just unrealistic
• Relapse IS predictable
• MAT is NOT trading one drug for another
• Addiction is not just “1 gene”
• Opioids change the brain

Copyright : 06/15/2020

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