June 2023 Newsletter
The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) provides mental health and substance use evidence-based training, customized technical assistance, and resources to certified Medicare and Medicaid nursing facilities who care for residents with a variety of behavioral health conditions at absolutely no cost. To submit a request for assistance, complete the online request form at https://nursinghomebehavioralhealth.org/.
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In This Issue
This month’s newsletter focuses on establishing and monitoring a Naloxone program for your nursing facility. Become informed about regulatory guidance and share new COE-NF resources that will assist your facility in implementing an effective Naloxone program.
- What is Naloxone?
- Naloxone and Nursing Facility Regulatory Guidance
- COE-NF Resources for Naloxone Use in Nursing Facilities
- Naloxone in Nursing Facilities: HOW IT SAVES LIVES
- Naloxone in Nursing Facilities: A Checklist for Process Review
- Using Naloxone to Respond to an Overdose in a Nursing Facility
- June 27th is Post Traumatic Stress Disorder Awareness Day
- Did You Know?
- Register for Upcoming COE-NF Training Sessions
- You Matter – Caring for Yourself in the Face of Challenging Work
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What is Naloxone?
Naloxone, sometimes called by its brand name, Narcan, is a drug that reverses respiratory depression caused by an opioid overdose. Having Naloxone readily available in nursing facilities is an opioid harm-reduction best practice that can save lives. The COE-NF has developed resources to support nursing facilities in developing effective Naloxone programs.
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Naloxone and Nursing Facility Regulatory Guidance
Guidance related to Naloxone can be found in the CMS Appendix PP State Operations Manual in F689 Accidents (Pg. 338). The guidance notes that it can be common for residents with a history of Substance Use Disorder (SUD) to have a relapse that may result in a drug overdose. Not all relapses or overdoses are preventable, however facilities are expected to be prepared to respond to an emergency such as an overdose. This includes having Naloxone available in the facility, and maintaining staff who are knowledgeable about the warning signs of a potential overdose and how to respond and administer opioid reversal agents such as Naloxone.
Additional guidance in F697 Pain Management (Pg. 413) notes that facilities should have a written policy to address opioid overdoses.
To summarize the Naloxone related regulatory guidance:
Additional guidance in F697 Pain Management (Pg. 413) notes that facilities should have a written policy to address opioid overdoses.
To summarize the Naloxone related regulatory guidance:
- Have Naloxone available in the facility.
- Have a written policy that addresses opioid overdoses.
- Ensure staff are knowledgeable about:
- Warning signs of an opioid overdose
- Steps to take in emergency response to an opioid overdose
- How to administer opioid reversal agents such as Naloxone
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COE-NF Resources for Naloxone Use in Nursing Facilities
The COE-NF developed three resources related to Naloxone in nursing facilities. Whether you have already established a Naloxone program, or are just getting started, these resources can help you and the nursing facility staff become more knowledgeable about Naloxone, successfully implement a Naloxone program in your facility, and be ready to respond in the event of an emergency.
Naloxone in Nursing Facilities: How it Saves Lives
This two-page flyer highlights the following information:
- Facts about Naloxone
- Why you should have it available in your facility
- How to establish a Naloxone program,
- How to respond to signs of an opioid overdose.
Naloxone in Nursing Facilities: A Checklist for Process Review
The COE-NF developed a one-page checklist to assist nursing facilities when using Naloxone or evaluating existing Naloxone policies and procedures.
Whether you have already established a Naloxone program, or are just getting started, this checklist will help ensure you are addressing all appropriate policy and procedure areas.
Click HEREto view and download the flyer.
Using Naloxone to Respond to an Overdose in a Nursing Facility
This double-sided flyer summarizes warning signs of an overdose and the 5 steps to respond to an overdose and administer Naloxone.
Consider keeping copies of this flyer in multiple areas accessible to all staff for reference in case of an overdose.
Click HERE to view and download the flyer.
Are you interested in accessing additional resources for your facility?
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June 27th is Post Traumatic Stress Disorder (PTSD) Awareness Day
Post Traumatic Stress Disorder Awareness Day is dedicated to creating awareness regarding PTSD. Take this day to reflect on your facility’s care for residents who have experienced a traumatic event.
In May, the COE-NF offered a 30-minute session called An Introduction to Creating a Trauma-Informed Culture in the Post-Acute and Long-Term Care Facility. Click HERE to view the recording and slides from that session and share it with your staff.
On Thursday, June 22, join us for a second session further exploring trauma-informed care concepts and how they can apply to residents in nursing facilities. Click HERE to register for this session.
In May, the COE-NF offered a 30-minute session called An Introduction to Creating a Trauma-Informed Culture in the Post-Acute and Long-Term Care Facility. Click HERE to view the recording and slides from that session and share it with your staff.
On Thursday, June 22, join us for a second session further exploring trauma-informed care concepts and how they can apply to residents in nursing facilities. Click HERE to register for this session.
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Narcan (brand name of Naloxone) was first made available as a prescription medication in 2015, and the FDA recently announced its approval as an over-the-counter medication.
Naloxone was granted priority review status due to its critical role in preventing opioid overdose deaths. In the last 12 months of available data, the United States recorded over 100,000 fatal drug overdoses.
Source: FDA.GOV
Naloxone was granted priority review status due to its critical role in preventing opioid overdose deaths. In the last 12 months of available data, the United States recorded over 100,000 fatal drug overdoses.
Source: FDA.GOV
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Register for the June COE-NF Training Sessions
This month, the COE-NF monthly training series features six training sessions you won’t want to miss.
There will be two (2) QPR sessions held in June.
Audience: All nursing facility staff
Duration: 90 minutes
Description:This 1.5-hour evidence-based live instructor lead training is held virtually and will provide a comprehensive review of a three-step approach anyone can learn to help save a life from suicide. This session will provide a two-year certification to attendees.
Key components covered in the training:
1. How to Question, Persuade and Refer someone who may be suicidal
2. How to get help for yourself or learn more about preventing suicide
3. The common causes of suicidal behavior
4. The warning signs of suicide
5. How to get help for someone in crisis
Key components covered in the training:
1. How to Question, Persuade and Refer someone who may be suicidal
2. How to get help for yourself or learn more about preventing suicide
3. The common causes of suicidal behavior
4. The warning signs of suicide
5. How to get help for someone in crisis
Certification Details:This session provides a QPR certification for two years.
Registration is limited to 60 participants.
A minimum of five (5) participants are required for the session to occur.
A minimum of five (5) participants are required for the session to occur.
Wednesday, June 21, 2023
2–3:30 p.m.
Audience: All nursing facility staff
Duration: 90 minutes
Description:The Columbia Protocol, also known as the Columbia-Suicide Severity Rating Scale (C-SSRS), supports suicide risk assessment through a series of simple, plain-language questions that anyone can ask. The answers help users identify whether someone is at risk for suicide, assess the severity and immediacy of that risk, and gauge the level of support that the person needs.
Users of the tool ask people:
1. Whether and when they have thought about suicide (ideation)
2. What actions they have taken — and when — to prepare for suicide
3. Whether and when they attempted suicide or began a suicide attempt that was either interrupted by another person or stopped of their own volition
Thursday, June 22, 2023
2-3 p.m. EST
Audience: All nursing facility staff
Duration: 60 minutes
Description:Healthcare staff have a deep intention to care for other human beings and with the principles of trauma-informed care, we can bring that intention to life. In this session, we’ll continue our exploration of TIC concepts including the difference between trauma screening and assessment, the impact of an activated nervous system, and how to integrate that knowledge into daily interactions with residents.
- Discuss trauma-informed principles and how they apply to resident interactions.
- Explain the impact of a nervous system response and the difference between a reaction and a response.
- Differentiate between trauma screening and trauma assessment and why this distinction is critical.
- THIS SESSION IS FULL -
Tuesday, June 27, 2023
11–4:30 p.m. EST
Audience: All nursing facility staff
Duration: 5.5 hours
Description:This training provides skills to provide initial help and support to someone who may be developing a mental health or substance use challenge or experiencing a crisis. This session will provide a three-year certification to attendees.
Key components covered in the training:
- Common signs and symptoms of mental health challenges.
- Common signs and symptoms of substance use challenges.
- How to interact with a person in crisis.
- How to connect a person with help.
- Expanded content on trauma, substance use and self-care.
Part 1 starts AFTER initial registration has been APPROVED by the instructor. Approved registrants will be emailed instructions on how to create an on-line profile using MHFA Connect and completing a pre-survey/quiz followed by a 2-hour self-paced online course. Registrants MUST complete Part 1 no less than 48 hours (two business days) prior to the scheduled Part 2 session.
Part 2 is a 5.5-hour live instructor led virtual training. Participants are required to be on camera the entire time.
Part 3 participants will return to MHFA Connect to complete the post test and evaluation, required to receive a certificate of participation.
Certification Details: This session provides a MHFA certification for three years.
Thursday, June 29, 2023
2-2:30 p.m. EST
Audience:All nursing facility staff
Duration: 30 minutes
Description:A distinct increase in the diagnosis of opioid use disorder has been seen across the country in all medical settings such as skilled nursing facilities and other residential rehabilitation settings. Due to an increase in opioid use disorder, there's also been an increase in the number of aging patients with pain who have received opioids as prescribed by their physicians, as well as younger populations being admitted to facilities for rehabilitation. With this prevalence, it is imperative to treat opioid use disorder as any other chronic disease would be treated.
This training will be a series of three (3) 30-minute webinars, designed to:
1. Provide an understanding of the disease and the medicines used to treat opioid use disorder.
2. Explore various models, some of which have been utilized for decades, that have been successfully introduced and sustained.
3. Assist in identifying and collaborating with OUD treat providers within your local area.
Duration: 30 minutes
Description:A distinct increase in the diagnosis of opioid use disorder has been seen across the country in all medical settings such as skilled nursing facilities and other residential rehabilitation settings. Due to an increase in opioid use disorder, there's also been an increase in the number of aging patients with pain who have received opioids as prescribed by their physicians, as well as younger populations being admitted to facilities for rehabilitation. With this prevalence, it is imperative to treat opioid use disorder as any other chronic disease would be treated.
This training will be a series of three (3) 30-minute webinars, designed to:
1. Provide an understanding of the disease and the medicines used to treat opioid use disorder.
2. Explore various models, some of which have been utilized for decades, that have been successfully introduced and sustained.
3. Assist in identifying and collaborating with OUD treat providers within your local area.
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You Matter!
Caring for Yourself in the Face of Challenging Work
Caring for Yourself in the Face of Challenging Work
Caring for residents in a nursing facility can be both rewarding and challenging. When taking care of residents, it is important to be aware of your own triggers. A trigger is a person, place, thing or situation that may cause an unexpected emotional response.
Five things you can do when experiencing your own triggers:
- Be aware of what is happening
- Notice the changes in your bodily responses
- Step away from the situation if possible
- Ask for support
- Practice self-care
It is your empathy for others that helps you do this work. It is vital to take good care of your thoughts and feelings by monitoring how you use them.
Four ways to become better at managing your feelings:
- Managing your feelings is a conscious process. Self-talk can help regulate your emotions.
- Use images that make you feel safe and protected or connected and cared for to help you return to a calm emotional place.
- Find rituals that help you manage your feelings as you start and stop work.
- Breathe slowly and deeply to calm yourself when dealing with a difficult situation.
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Contact us:
For more information, please call 1-844-314-1433 or email coeinfo@allianthealth.org.
To submit a request to inquire about substance use and/or mental health training options for your facility, complete the inquiry form.
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Alliant Health Solutions (AHS) was awarded a three-year cooperative agreement from the Substance Abuse and Mental Health Services Administration (SAMHSA), in collaboration with the Centers for Medicare & Medicaid Services (CMS), to create a COE-NF. AHS has over 50 years of experience working with nursing homes and behavioral health in nursing homes.
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This newsletter was made possible by grant number 1H79SM087155 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Substance Abuse and Mental Health Services Administration.
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