Concurrent Session Topic: The Role of the Psychiatric-Mental Health - PDF document

APNA 29th Annual Conference Session 3042: October 30, 2015 APNA 29th Annual Conference Disney's Coronado Springs Resort - Lake Buena Vista, Florida October 28-31, 2015 Collaborating in an Evolving Health Care System: Opportunities to Advance Psychiatric-Mental Health Nursing Concurrent Session Topic: The Role of the Psychiatric-Mental Health Advanced Practice Nurse in the Behavioral Intervention Team (BIT) Model of Care Presenters : Jasper L. Tolarba, DNP, MSN, MA, RN, NEA-BC Joanne D. Iennaco, PhD, PMHNP-BC, PMHCNS-BC, APRN Tolarba 1

APNA 29th Annual Conference Session 3042: October 30, 2015 Slide 1 ___________________________________ The Role of the Psychiatric-Mental ___________________________________ Health Advanced Practice Nurse in ___________________________________ the Behavioral Intervention Team (BIT) Model of Care ___________________________________ Presented by Jasper L. Tolarba, DNP, MSN, MA, RN, NEA-BC ___________________________________ Joanne D. Iennaco, PhD, PMHNP-BC, PMHCNS-BC, APRN ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 2 ___________________________________ Background ___________________________________ 1 in every 4 adults suffer from a diagnosable mental disorder ___________________________________ Mild-to-Moderate Depression to 20% to 60% more serious psychotic disorders ___________________________________ like hallucinations or delusions ___________________________________ 68% adults with a mental disorder suffer from at least one general medical disorder ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 3 ___________________________________ Psychiatric Models of Care ___________________________________ Psychiatric Consultation Model - psychiatrist evaluates the patient for any psychological or psychiatric condition after receiving a consult request from the primary medical service. ___________________________________ Consultation-Liaison (CL) Model - psychiatric service with more active collaboration with medical teams to provide care to patients with psychiatric morbidity within the general medical setting. ___________________________________ Integrated Model of Care (IMC)- care delivered by general medical physicians working with psychiatrists and other allied health professionals to provide ___________________________________ complementary services, patient education, and management in order to improve mental health outcomes ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Tolarba 2

APNA 29th Annual Conference Session 3042: October 30, 2015 Slide 4 ___________________________________ Behavior Intervention Team ( BIT ) at YNHH ___________________________________ Evidence-based Practice in Psychological Medicine Service - Using an ABA (basic withdrawal) design with a 33-day intervention ___________________________________ period and 10 similar control periods, the BIT model of care demonstrated significant positiveresults. ___________________________________ ___________________________________ ___________________________________ Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN APNA 29th Annual Conference, October 28-31, 2015 Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 5 ___________________________________ Decreased patient LOS ___________________________________ by 1.2 days Quicker Overall response to ___________________________________ financial gain patient sitter for the evaluation hospital Positive Impact of ___________________________________ BIT Increased ___________________________________ Decreased Outcome of Project staff payer satisfaction Implementation denied days ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing ___________________________________ Slide 6 ___________________________________ Objectives To describe the BIT model of care and focus on the role of the Psychiatric-Mental ___________________________________ Health Advanced Practice Nurse (PMHAPN). More specifically to: ___________________________________ (1.) Describe the overall context and structure of the BIT and the roles and responsibilities of members, ___________________________________ (2.) Describe the PMHAPN’s clinical and operational responsibilities, (3.) Describe the collaborative relationships among stakeholders involved in the care of the client; and ___________________________________ (4.) Validate the overall BIT model of care and the role of the PMHAPN with a group process. ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Tolarba 3

APNA 29th Annual Conference Session 3042: October 30, 2015 Slide 7 ___________________________________ Methods ___________________________________ 1. Writing the initial description of the BIT structure as well as the roles and responsibilities of each member ___________________________________ 2. Describing the concept of the collaborative and integrated nature of the BIT model of care 3. Identifying the multifocal roles of the PMHAPNs as they function within the ___________________________________ BIT model of care. 4. Validation via a group process involving all members of the BIT at YNHH. ___________________________________ 5. Rewriting the paper incorporating the suggestions and feedback by the BIT team members ___________________________________ Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN APNA 29th Annual Conference, October 28-31, 2015 Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 8 ___________________________________ Conceptual Framework ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 9 ___________________________________ ___________________________________ ___________________________________ Results ___________________________________ ___________________________________ ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Tolarba 4

APNA 29th Annual Conference Session 3042: October 30, 2015 Slide 10 ___________________________________ BIT Structure and Roles ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 11 ___________________________________ BIT Daily Clinical Process ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Slide 12 ___________________________________ Integrated and Multidisciplinary Care ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ APNA 29th Annual Conference, October 28-31, 2015 Jasper Tolarba, DNP, RN and Joanne Iennaco, PhD, RN Yale School of Nursing Yale School of Nursing a e Sc oo o u s g ___________________________________ Tolarba 5