The Healthy Addiction Treatment (HAT) recovery model for addiction nursing services
According to addiction nurses, the current model for nursing services is task orientated and outdated. With nursing caseloads equivalent to client registration lists, there is little time for reflection on client need or innovation. The primary aim of this study was to develop a sustainable addiction nursing model that matched client wider needs and improved outcomes.
Using the opiate treatment index (OTI) with the General Health Questionnaire (GHQ) embedded, for the first time within an Irish drug treatment setting, a cross sectional study supplemented with open ended questions on client nursing needs was implemented.
A total of 131 clients (6.5% of the caseload) from a representative sample of six clinics were interviewed in 2017 in Dublin, Ireland. The mean age of clients was 41 years. On average clients spent 7.8 years in their current treatment. The key finding within the OTI was the lack of psychological adjustment as measured by the GHQ. A cut off score of four is recommended. The mean score among females was 11.07 (95% CI of 8.33, 13.80) and among males was 7.59 (95% CI of 5.56, 9.63). Findings from the open questions highlighted nurses as essential sources of psychological supports including trauma. A review of current nursing models highlighted the benefits of the mental health FRAMES model and a new model, the Healthy Addiction Treatment (HAT) Recovery Model was proposed. A focus on practical implementation and measurable outcomes was stressed.
These results informed a new client mental health, trauma informed and whole clinic response to an addiction nursing framework, underpinned by a logic model. The nursing caseload for the duration of the new model approach is clients with the highest levels of the targeted need but all clients presenting are targeted. The model is currently being implemented across the addiction nursing services and impact and fidelity of implementation of the model are being measured at the client population, family, community and the nursing service level with a view to rolling out the model across all addiction nursing services. This model has the potential to impact EU wide addiction nursing services and client outcomes.