On July 1st 2017 three new screeners were made available to NADAbase users that have the potential to not only enhance client care but to also increase our evidence base of clients experiencing these issues. The screeners are attached to each client episode and form part of the initial assessment to inform care planning around issues related to:
- suicide risk
- domestic and family violence
- blood borne virus and sexual health
As a result of NADA member and stakeholder consultation and informed by strategic imperatives at a sector level – these screeners are designed to support holistic and client-centred care while appreciating the time pressures on busy workers. As with any new initiative there is allowance for user feedback as part of a quality improvement and evaluation process – if you have any feedback simple email ITsupport@nada.or.au. Each screener is supported by current NADA capacity building resources and/or training and can be found on the NADA website.
Use and Storage of the Data
Data will be stored securely as with all other NADAbase data, and only used by NADA for the purposes of advocating for increased support for member organisations around the provision of holistic client treatment. NADAbase reports will also reflect data related to these screeners and be available for member organisational use.
It should be noted that this is a NADA initiative and is not mandated by the Ministry of Health or other funding bodies at this time.
Guidance for Screener Data Collection Items
|Screener Data collection has highly sensitive components and should only be completed by a clinician of the organisation, not by a member of the administrative or support staff or the client themselves.||The data set in all screeners is sensitive and pertains largely to clinical information and should therefore be completed by a clinician.|
|Include all clients who are assessed and/or accepted for one or more types of specialised drug and alcohol service for a new episode created after 1 July 2017.||This can be for their own, or another person’s problem and includes people who seek advice for information only.|
|Where there is options for a multiple response, select based on the most significant response/s.||At least one response will need to be selected for each question in order for progression through NADAbase.|
|Base all items on the client’s response||The clinician should not guess or assume the client’s response. Wherever possible, direct all questions to the client.|
|Lead in statements at the top of each screener are a guide to assist clinicians in asking the screener questions.||It should be made clear to clients that any response they provide is for the purposes of their care and will not impact their entry to treatment or the quality of their care.|
|Alert boxes are prompts to alert the clinician of a high risk response to a sensitive question.||The information and suggested resources are there to provide support to the clinician in managing the high risk situation and to assist in care planning. Where an alert is identified some action needs to be taken by the clinician and recorded where appropriate.|
|“Action Taken” data collection item allows for multiple selections and requires a response to what action was taken as a result of the screener questions, including if there was nil response.||This item allows for the clinician and organisation to view what action has occurred as a result of asking the screener. Detailed actions should be included in the client progress notes and care plan.|
|“NO” or “DID NOT ASK” responses for question 1 in each screener will require follow up with the client at a later time.||NADAbase has been set up with a prompt whereby the respective screener is highlighted in red to encourage the clinician to re-ask the set of questions with the client. It provides the organisation with the ability to see if the questions are being asked, provided through the organisation report in NADAbase.|
NADA recognises the unique opportunity AOD services have to reduce the very serious risk of suicide, and where appropriate assist in linking clients with medical treatment providers. The integration of suicide screening questions into NADAbase will help ensure all people accessing AOD treatment are screened as part of standard practice.
The questions within the suicide screener have been drawn from the Suicide Assessment Kit (SAK) developed by NDARC in partnership with NADA. This screener provides specific questions around current suicide risk and advice on assessing risk, AOD worker approach and care planning based on client responses embedded in NADAbase.
How to use the SAK
It is recommended that organisations review their policies and procedures in relation to suicide and self harm. In the absence of a specific policy, refer to NADA’s Suicide & Self Harm Prevention Policy template . This will ensure appropriate policies are in place to support staff using the Suicide Screener and supporting documents.
There are also three videos available to you via NDARC’s website. They provide you with an introduction to the Suicide Assessment Kit, including role-plays demonstrating the use of the Suicide Risk Screener.
The form, along with support resources referred to throughout the screener can also be downloaded here:
- Suicide Screener Form
- The Suicide Assessment Kit – developed by the National Drug and Alcohol Research Centre (NDARC) in partnership with NADA in response to a need identified as a result of surveying staff and managers working within residential rehabilitation settings. The SAK provides guidance to treatment providers in assessing a client’s response and rating of the client on a risk scale of low, moderate or high. The resource should be used in conjunction with asking the questions from the screener.
- Suicide & Self Harm Prevention Policy Template – available for organisations that do not have a policy in place to manage suicide and self-harm.
Domestic and Family Violence Screener: Female Client focus
The domestic and family violence screener in its current form has been developed with the gendered-nature of domestic and family violence in mind. NADA acknowledges that this screener is not suitable for a broader audience and that there is further work that is needed in regard to male clients and clients from LGBTIQ communities. Furthermore, NADA intends investing in future capacity building work regarding violence, respectful relationships and working effectively with perpetrators of violence.
The domestic and family violence screener is available to those organisations who work specifically with women and who have engaged in the NADA domestic violence training. This screener has embedded script prompts about supporting women who are/have in the past, experience domestic violence and provides links to resources for case planning purposes.
NADA recognises the unique opportunity AOD services have to reduce the very serious risks posed by domestic and family violence. Evidence suggests the use of direct questions can help prevent violence and improve victim safety. The integration of DFV screening questions into the NADAbase will help ensure all women accessing AOD treatment will be screened as part of standard practice.
The form and support resources referred to throughout the screener can also be downloaded here:
- DFV Screener Form
- Policy Template – available for organisations that do not have a policy in place to manage domestic and family violence.
- Domestic Violence Safety Assessment Tool – available for use by non-government service providers and government agencies, the DVSAT has primarily been designed for use in intimate partner violence situations. Clinicians should use their professional judgement about the appropriateness of individual questions. This assessment can be used in conjunction with the DFV screener in the instance that the client would like to provide further information.
- Identifying and responding to Domestic Violence Policy Template for guidance – available for organisations that do not have a policy in place to manage domestic and family violence.
- Charmed and Dangerous Resource – an initiative of the Tweed Shire Women’s Services Inc, this booklet has been developed for women by women. A resource that can be provided to the client that offers information on reclaiming a healthy relationship.
Blood Borne Virus and Sexual Health Screener
Blood borne virus (BBV) and sexual health screener is designed to identify whether clients attending AOD specialist services have had access to testing for BBVs and sexually transmitted infections (STIs) and/or access to treatment. The screener is accompanied by information links to support testing services, further information around BBVs and STIs, and are included to serve as prompts for workers to consider testing and treatment as part of a client’s care plan.
The form, support resources and information referred to throughout the screener can also be downloaded here:
- BBV & Sexual Health Screener Form
- Hepatitis Factsheet – developed by Hepatitis NSW, this resource provides clients with easy to understand information on hepatitis A, B & C, detailing what it is, treatment available, vaccine and prevention.
- HIV Factsheet – developed by NSW Health, this resource provides information on HIV – what HIV is, the risks, prevention, and treatment, including hotlines for further information.
- STIs and Safe Sex – a link to the NSW Health Play Safe website that provides an interactive site for clients to easily navigate to receive information on STIs and safe sex practices. The site also includes online community chats and Q&As.
Client and Organisation Reports
Once a screener has been filled out in NADAbase a print icon in the top right hand corner of each screener will allow clinicians to print out the filled in forms for each client. This can either be placed on the client’s file along with their case notes or alternatively used to provide to the referred clinician for further treatment.
Through your Organisation Summary Report located in NADAbase under the drop down menu Reports, managers will have the ability to see if your organisation is asking these questions. This will be displayed as three numbers: Green = figure of respondents saying YES, Orange = figure of respondents saying NO, Red = figure of respondents who were not asked the question. As we move further along the NADAbase expansion project, these figures, including further details, will be visible via dashboards and client summary reports.
Privacy and Confidentiality
NADA members and users of NADAbase are required to comply with the National Privacy Act 2008 (amended 2016), and the Health Records and Information Privacy Act 2002 (NSW). These Acts outline the responsibilities the organisation has with regard to collection, use and security of data.
Prior to administering any of the screeners, it is important to inform clients that steps will be taken to protect the privacy of their personal information. The following are appropriate steps to ensure this. A sample Privacy and Consent Form is provided.
- Inform the client why you are collecting this information.
- Assure the client that their personal health information will be protected in accordance with the relevant Acts.
- Inform the client that they are entitled to access their own records according to your organisation’s policies and are entitled to make a complaint about handling of personal information and privacy.
- Explain to the client that their personal information will be given to another person only if this is important for their health care or can be otherwise legally and ethically justified.
- Explain that de-identified information may be used in service or sector wide planning, reporting or research activities.
NADA has invested in screeners that have been informed by research literature and treatment-based expertise and welcomes feedback throughout their implementation in NADAbase on ITsupport@nada.org.au. The current screeners are also well supported by NADA capacity building projects to ensure that workers have the tools they need to respond to clients who identify as having personal experiences of any or all of these important issues.