SIBRT Flashcards
What does SIBRT stand for?
Screening, Brief Intervention, and referral to treatment
What is the AUDIT screening used for?
Adults
what is the Craft screening used for?
children
What is SIBRT?
approach to deliver early intervention and treatment services for persons with potential high risk substance misuse
what is the goal of SIBRT?
reduce and prevent related consequences, disease, accidents and injuries
SBIRT process-screening
assess use and severity of alcohol, illicit drugs, and prescription drug use, misuse, or abuse
SIBRT process- Brief intervention
motivational and awareness
takes 5-10 min
given to risky or problematic substance users
SIBRT process- Referral to treatment
refer to specialty care for patient with substance disorders
what is the outcome of SIBRT
prevents disease, accidents, and injuries
improves patient outcomes
reduces cost and healthcare utilization
The joint commission and SAMSHA
screen all patients 18 and older
offer brief interventions for positive screens
provide alcohol and drug use disorder treatment at discharge
Brief negotiated interview (BNI)
build rapport and ask permission to do screening
patient discusses pro’s and con’s and nurse summarizes (Pro’s- what do you get out of drinking, Con’s- how does it negatively effect you?)
discuss and interpret the score from screening Audit/Craft
determine patients motivation to change using readiness, confidence, and important rules (1- not ready, 10- ready)
negotiate action plan, strengths, supports and barriers, write down steps offer education, resources, give referrals, thank patients
AUDIT screening
adults
annual screening
10 item screening tool developed to assess consumption and drinking behaviors
8 or more = hazardous drinking
show what 1 drink looks like
AUDIT scoring
0- abstainers
1-7- low risk drinkers
8-19- high risk drinkers
20+- probable alcohol dependence
CRAFFT screening
adolescents
developed by SADD, commitment to health and safety
ask pt 1st three questions about last 12 m period, if 0 go to part B and ask car safety questions, if anything other than zero ask RAFFT questions
if yes to two or more = serious problem
provide score and provide brief counseling
brief counseling for CRAFFT
review
recommend
riding/driving
response
reinforce
Contract for life
Risky drinking
use when pregnant, driving, taking certain medications, having certain medical conditions, in recovery from addiction, or if you cannot control drinking
hazardous drinking
pattern that increases risk for adverse consequences
harmful drinking
negative consequences have already occured
positive scores for risky drinking
3 or more drinks for women and over the age of 65
4 or more drinks for men
how much is 1 drink?
standard drink: 0..6oz of alcohol
determines the patients motivation to change
assess importance, confidence, and readiness to change
assess on scale 1-10
assess how important it is for them to change
reinforce positives and hope
ask about a lower number ( I see you said a 7, why not a 5?)
OARS
open ended questions
affirmation
reflective listening
summarizing
used during brief interview
high risk alcohol consumption
healthy med more than 4 drinks in 1 night, more than 14 drinks in 1 week
healthy women and nonpregnant- more than 3 drinks a night and more than 7 drinks in 1 week
strategies for cutting down drinking
count and measure your drinks
set a goal (Im only gonna have 2 drinks tonight)
eat if your gonna drink
plan to say no and be confident in your answer
sip and drink slow and alternate non alcoholic drinks
outpatient counseling
individual or group meetings
provided weekly
includes motivational and cognitive behavioral methods
acute treatment services
medical detoxification
medical intervention to withdraw from alcohol and drugs
length of stay usually 4-7 days followed by outpatient counseling
clinical stabilization services
medical detox is complete and no medical supervision is required
residential counseling 7-10 days
peer support groups
AA meetings
NA meetings
Al-anon groups
nursing actions for SIBRT
encourage- no judgement
listen to what they are saying
express caring
hold individual responsible for behaviors
communicate the treatment plan to patient and treatment team
prioritize care needs
