Improving Dual Diagnosis Care in Acute Psychiatric Inpatient Settings Through Education

Sunday, 30 July 2017: 10:15 AM

Kofi Bonnie, DNP, MSc, BSc(Hons), RPN
Yale School of Nursing, Yale University, Orange, CT, USA

Background: Patients with co-existing substance use and mental disorder (dual diagnosis) have complex and challenging care needs. They have an increased risk of homicide, suicide, homelessness, incarceration, multiple admissions and infectious diseases such as hepatitis C and HIV. Acute psychiatric care settings play a vital role in providing services for dual diagnosis patients who often do not voluntarily seek treatment. There is evidence that nurses working in these settings often have unmet learning needs regarding dual diagnosis care, posing a challenge to nursing practice with this clientele. This is significant in that recent data reveals that 57% of the psychiatric inpatients at an inner city hospital in Vancouver, Canada are characterized as dual diagnosis.

Purpose:  To develop and pilot an educational module which will equip nurses with the skills and knowledge required to deliver evidence-based dual diagnosis care in acute psychiatric settings.

Methods: A survey of 74 nurses working in acute psychiatric settings was completed to identify their learning needs and challenges. This was followed by a comprehensive review of evidence from the literature to identify competencies, knowledge, and skills needed to deliver dual diagnosis care. Content for the educational module was then validated by a panel of leading international experts on dual diagnosis. Two focus groups of acute psychiatric nurses were then conducted to discuss content. After this, an 8 hour educational session was developed and piloted using the content that was reviewed and validated. Evaluation from 55 participants' of the educational session was collected and analyzed.

Results:  Thirteen content areas were identified and validated by experts. Evaluations from 55 participants of the educational session suggest improved knowledge, skills and competencies in dual diagnosis care. 

Conclusion: This project translates evidence into practice, contributes to the body of knowledge on dual diagnosis care in acute psychiatric settings and improves nurses’ confidence and competency in delivering evidence-based care which also will improve patient care outcomes and experiences.