Alcohol, Tobacco and Other Drugs: Clinical Guidelines for Nurses and Midwives Version 3, 2012 Endorsed by the South Australian Alcohol and Drug Nursing and Midwifery Statewide Action Group This work is copyright. It may be reproduced in whole or in part for educational or training purposes subject to the inclusion of an acknowledgement of the source. Commercial usage or sale is not permissible without negotiation with the authors. Electronic Index: This publication is available as a down-loadable PDF with fully searchable text. To access PDF copies go to: www.dassa.sa.gov.au www.health.adelaide.edu.au/nursing For further information contact: The University of Adelaide School of Nursing Phone (08) 8303 3595 Email: [email protected] This work may be cited as: de Crespigny, C & Talmet, J. 2012. (Eds). Alcohol, Tobacco and Other Drugs: Clinical Guidelines for Nurses and Midwives. Version 3. The University of Adelaide School of Nursing, Drug and Alcohol Services, South Australia. Subject Keywords: Alcohol, Tobacco, Other Drugs, Drug and Alcohol, Substances, Clinical Guidelines, Nurses, Midwives. For Cataloguing-in-Publication data please contact National Library of Australia: [email protected] ISBN 978-0-9803130-8-6 First printing Version 1 2003 Second printing Version 2 2003 Third printing Version 3 2012 © University of Adelaide and Drug & Alcohol Services, South Australia 2012 Foreword The use of alcohol, tobacco and other drugs (ATOD) is prevalent in our society. Nurses, midwives and other health care professionals are faced with a diverse group of consumers many of whom are affected either temporarily or in the longer term by ATOD related health challenges. These challenges include intoxication, withdrawal, trauma, medical and mental health conditions, and social issues. The complexities of providing safe care to consumers affected by ATOD are unmistakable and challenging. The provision of safe care is at the core of good nursing and midwifery practice. For nurses and midwives to do this they require reliable evidence based clinical guidelines that are accessible and easy to use. These guidelines aim to support and provide a benchmark for quality assessment, intervention and referral by nurses and midwives in their daily practice. Clinicians should aim to use these guidelines within the context of their roles and scopes of practice and, to update their knowledge base by accessing current research and clinical guidelines as they emerge. To this end I draw your attention to the information, links to key resources and websites listed at the back of this publication. Ms Lydia Dennett Chief Nurse and Midwifery Officer Nursing and Midwifery Office Department for Health and Ageing i Contents FOREWORD................................................................................................................................................. I CONTENTS ................................................................................................................................................. II LIST OF FIGURES ........................................................................................................................................ VII LIST OF TABLES ......................................................................................................................................... VIII PURPOSE AND PRINCIPLES ............................................................................................................................IX Statement of purpose ....................................................................................................................... ix Principles for practice ....................................................................................................................... ix ACKNOWLEDGEMENTS ................................................................................................................................. X GLOSSARY ................................................................................................................................................ XII USEFUL RESOURCES AND INFORMATION ........................................................................................................ XIX Blood Borne Viruses ....................................................................................................................... xxii Useful Websites .............................................................................................................................. xxii Peer reviewed journals ................................................................................................................... xxii Professional Resources .................................................................................................................. xxiii Relevant services and community groups ..................................................................................... xxiv LIST YOUR OWN CONTACT NUMBERS ........................................................................................................... XXVI SECTION 1 BASIS FOR PRACTICE ........................................................................................................... 1 1.1 ALCOHOL, TOBACCO AND OTHER DRUG USE ........................................................................................... 2 Introduction ....................................................................................................................................... 2 Poly drug use ..................................................................................................................................... 2 Patterns of ATOD use ........................................................................................................................ 3 Myths ................................................................................................................................................ 4 1.2 HARM MINIMISATION ......................................................................................................................... 5 Introduction ....................................................................................................................................... 5 Harm reduction ................................................................................................................................. 5 Demand reduction ............................................................................................................................. 6 Supply reduction ................................................................................................................................ 7 1.3 NON-JUDGEMENTAL CARE ................................................................................................................... 8 Barriers to people seeking help ......................................................................................................... 8 Engaging people in treatment and care ............................................................................................ 9 1.4 UNDERSTANDING ATOD PROBLEMS ................................................................................................... 10 Theories ........................................................................................................................................... 10 Integrating the models in practice .................................................................................................. 16 ii SECTION 2 CLIENT CARE ...................................................................................................................... 17 2.1 COMMUNICATION AND CULTURAL ISSUES ............................................................................................. 18 Introduction ..................................................................................................................................... 18 General principles of communication .............................................................................................. 18 Working effectively with Indigenous People ................................................................................... 21 Working with young people and children ....................................................................................... 28 2.2 ASSESSMENT .................................................................................................................................. 30 Introduction ..................................................................................................................................... 30 Rationale for assessment ................................................................................................................ 30 Using a person-centred approach ................................................................................................... 32 Issues for assessment ...................................................................................................................... 33 Nursing guidelines—general assessment ........................................................................................ 37 Pattern and recent history of ATOD use .......................................................................................... 37 Physical assessment ........................................................................................................................ 41 Planning care ..................................................................................................................................