Introduction
The awareness of Recovery Orientated Care (ROC) keeps increasing. Different from the traditional psychiatric nursing care which emphasizes on symptom management and relapse avoidance, ROC suggests supporting the sufferers to better identify their strengths and to set goals under the restrictions imposed by their illness, in order to enhance their life satisfaction. Numbers of evidence have proven its advantages, such as facilitating the sufferers’ sense of hope, autonomy, empowerment and decision making. A successful service transformation contained the elements of changing staff's attitude and enhancing staff's knowledge. Pioneers and scholars suggested that a favorable organization culture had positive influence on staff's attitude in transformation. Meanwhile, providing sufficient training helped enhancing staff's knowledge, which could facilitate its promotion in department. Therefore, the transformation has gone through the journey of organization culture exploration, knowledge equipment and clinical application.
Objectives
(1)To transform the traditional psychiatric care to ROC in Department of Psychiatric in PYNEH; (2)To enhance staff’s confidence in promoting ROC in Department of Psychiatry in PYNEH; (3)To change staff’s attitude towards the ROC implementation in Department of Psychiatry in PYNEH.
Methodology
Initially, organization culture was explored by conducting a pre-recovery self-assessment survey developed by Yale University. The acceptance and concern of implementation of ROC among different stakeholders were explored. A 3-tier training program was formulated based on the result, preparing the ROC implementation in moving forward to the next stage, “knowledge equipment”. At the 1st tier stage, representatives from each unit were nominated as a Recovery Promoter to participate into an intensive training. They helped their unit’s members to equip ROC related knowledge. At the 2nd tier, a series of ROC related training elements were provided to all the front-line nurses in the department. At the 3rd tier training, selected patients were recruited to join the intensive training programs. They were then employed as a peer support worker with on-the-job coaching provided. After the knowledge was well equipped, it came to the clinical practice stage. Recovery log book in two versions were distributed to facilitate the patient care practice. Moreover, different tools were established including Camberwell assessment, Need-Strength-Risk assessment and relapse management plan for guiding the implementation of ROC. Regular peer newsletters with different topics were published to share the experience of patient recovery journey.
Results & Outcome
A post-test survey was completed by staff. Result showed that approximate 80% of staff rated they were confident of promoting ROC. Moreover, from the post-recovery self-assessment survey, staff had significant improvement in the following practices, including: (1)Staff encourage program participants to have hope and high expectations for their recovery; (2)Staff listen to and respect the decisions that program participants make about their treatment and care; (3)Staff regularly ask program participants about their interests and the things they would like to do in the community. The results indicated that staff is positive to ROC and is trying to adopt it into their health care practices.
Co-location with:
