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PN guidelines update

PN guidelines update. SSHA 2012 Justine Mellor, Heather Wilson, Jonathan Roberts, Gill Bell . Background. Why update the SSHA PN guidelines? SSHA Manual 2004 BASHH PN Statement 2012

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PN guidelines update

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  1. PN guidelines update SSHA 2012 Justine Mellor, Heather Wilson, Jonathan Roberts, Gill Bell

  2. Background • Why update the SSHA PN guidelines? • SSHA Manual 2004 • BASHH PN Statement 2012 • Increasing fragmentation of sexual health services- need for guidance for commissioners and practitioners across a range of providers • Electronic PN resources being piloted • Overview of revised sections

  3. PN consultations • Motivational interviewing approach • ‘Dancing rather than wrestling’ • Spirit of MI: collaborative, evocative, respectful • Person – centred counselling skills: open questions, reflections, affirmations and summarising • Managing resistance • Eliciting ‘change talk’ or commitment statements • Building confidence and self efficacy • Planning • Evocative

  4. MI Traps which may create resistance* • Question / answer trap • Expert trap • Premature focus trap • Confrontation / denial trap • If you don’t get your partner in you are just going to keep getting re-infected! • I know, but I’ve told him and now its up to him!

  5. MI approaches to avoid / reduce resistance • Simple reflection • You’ve already told him, and don’t see what else you can do. • Double sided reflection • You are concerned about getting re-infected, but find it difficult to get your partner to attend • Rolling with resistance • You’d prefer not to give any details of your partner. That’s fine. Maybe we can talk again when you have had chance to speak to him / her?

  6. MI approaches to avoid / reduce resistance • Re-framing • Whoever gave you my name is just causing trouble! • The person who asked me to contact you thought you had the right to know. • Shifting focus • I’m not asking for anyone’s name right now, just wondering if any else could be involved.

  7. Provider referral • Aim of all communication methods is to secure a conversation with the contact where possible • Telephone PN • Overcoming barrier of suspicion • Private numbers / cold calling • Examples of dialogue • Text messaging • Use of IT systems • Sample texts

  8. Provider referral • Email • Trust Information Governance policies vary • Illegal to read others’ emails • Good practice guidelines • Social networking • NHS restrictions (IG approval essential) • Site restrictions – facebook • Dating sites and apps • GMFA

  9. HIV PN • NAT seminar: HIV partner notification: a missed opportunity? • BASHH Statement on PN

  10. PN audit • BASHH 2012 auditable outcomes illustrated • 4 PN auditable outcome measures: • PN discussion documented (97%) • Agreed contact action documented (97%) • Attendance reported by index case or by HCW • Chlamydia 0.6 • Gonorrhoea 0.4 London; 0.6 outside London • Attendance verified by HCW • Chlamydia 0.4 • Data collection tools • Action and outcome codes

  11. PN audit example • Reported attendance by index (40) + attendances verified by HCW (40) • Divided by number of index cases (100) • Reported: (40 + 40) / 100 = 0.8 • Verified: 40 / 100 = 0.4

  12. The future • Draft on website by end November 2012 • Consultation period until end January 2013

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