Patient-centered medical homes: presenting a role for the advanced practice mental health nurse

Pediatric Refugee Health Care Delivery in the Community Setting: An Educational Workshop for Multidisciplinary Family-Centered Care During Resettlement

INTRODUCTION

With 70.8 million people displaced worldwide, there is an increasing need for medical professionals to provide medical care to refugees. Insufficient training on refugee health poses a barrier to effective care delivery.

METHODS

This workshop addressed common challenges in providing family-centered pediatric refugee care in community settings as well as barriers related to policy changes. Presentations covered prearrival experiences, medical screening, and trauma-based care. In small groups, participants discussed cases that featured medical, behavioral health, social, and cultural factors impacting the provision of family-centered pediatric care that was culturally respectful and included shared decision-making. After the breakout session, each small group informed the larger group of topics discussed. Facilitators identified themes and reinforced key learning points. At the workshop's conclusion, participants were guided to create their own personalized action plan.

RESULTS

This workshop was presented at two international conferences to more than 47 participants, including clinicians, nurse practitioners, pediatric residents, and medical students. Evaluations were completed by 34 individuals. Participants' overall comfort level with taking care of refugee patients increased from 3.3 to 4.0 (on a 5-point scale, p = .24) during the 3-hour version of the workshop and from 3.8 to 4.0 (p = .43) in the 1-hour version of the workshop. Mean overall ratings of the 3- and 1-hour workshop versions on conference-administered evaluations were 4.8 and 4.2, respectively, on a 5-point scale.

DISCUSSIONS

This workshop was well received and equipped participants with knowledge, tools, and strategies regarding pediatric refugee health in a community setting.

Engaging Integrated Health Teams to Decrease the Risk of Controlled Substance Use for Individuals With Serious Mental Illness

The United States is facing an opioid epidemic that is virulent in its lethality and includes morbidity and mortality related to prescription opioids. Overuse of another class of drugs- benzodiazepines-has received less media attention, but also poses the threat of tolerance, dependence, and death, especially in combination with opioids or alcohol. These negative outcomes are not distributed evenly over the population but are especially prevalent in vulnerable populations. One such vulnerable population comprises individuals with serious mental illness. Professionals who serve this population are challenged by an often-fragmented health care system to collaborate with patients and other professionals to reduce risks and improve outcomes. This article examines strategies for addressing risks associated with the use of benzodiazepines and opioids in this population within the context of an integrated interprofessional team. Recommendations include (a) building consensus on the team, (b) providing education for all stakeholders, and (c) enhancing care coordination and patient access to effective treatments. [Journal of Psychosocial Nursing and Mental Health Services, 56(12), 11-15.].