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STOP SMOKING PRACTITIONER PROGRAMME(Unit standards 27504, 27505, 27506, 27507 22 credits)

(Towards New Zealand Certificate in Health and Wellbeing (Level 3) Support Work, 70 Credits)

Task Two: Working with your complex needs clientIn this task you need to work with a client who has complex needs.

A complex needs client might be one who is: Pregnant Diabetic Being treated for smoking related illness (e.g. lung disease, heart or blood

vessel disease, cancer) Diagnosed with mental health illness (e.g. depression, schizophrenia) Suffering drug, alcohol, or gambling addiction

Check with [email protected] if you are not sure if you are having trouble identifying the complex needs client.

You need to start compiling a portfolio of evidence for your client.In the portfolio you will provide evidence of work you have done with your client. This is broken in to three parts:

PRE QUIT – Building a good relationship and setting them up for their quit day.

QUIT DAY – Helping your client make a strong start in their quit attempt. AFTER QUIT DAY – Supporting your client to remain smokefree.

You also need to get some verification forms completed. Verification/observation from your supervisor or manager. Verification from your client.

Contact [email protected] if you have questions about the verification process. The form is included in your documents that follow.

SSPP 4 Unit Programme for Experienced Health Care Providers v1 Aug16© Inspiring Limited 2016

mailto:[email protected]

mailto:[email protected]



Read through the information below about what is needed before you get started so you can plan which documents you need to collect and how you will collect them.

The documents you need to collect require you to provide lots of details. You MUST provide the information that is requested.

If your organisation does not have a document that includes the information required, you are welcome to include the details in these pages for your complex needs client portfolio. Call this client CLIENT CX

Your referral document.

Note: If you do not have a referral document write a sentence in the space provided to explain why.

If you did not have the client come to you from a referral – explain how they knew to see you:

If you did have a referral - you need to provide a copy of the referral information you received. This document must show how you followed your workplace policies and procedures to:

Accept the referral. Process the referral. Record the referral.

Include a copy of the referral documents in your portfolio that show all these steps.Clearly label the document/s Task Three Referral of Complex needs clientGet your manager to sign these to show that he or she has reviewed them and they follow your company’s policy and procedures.To keep things private and confidential black out the name and address and other identifiable information. Call this client- CLIENT CX. (27505 1.1)

Your client assessment document.

You will need to submit to NTS, along with your assessment task, a copy of any assessment form/s (or screen shots) you have used to record your client’s history, personal details and other information.The forms must be completed in accordance with your organisation’s policies and procedures.The assessment form/s you submit to NTS must include all of the information listed below:The client’s:

Age Culture




Gender Goals (including what brought the client here today and their

past quit attempt history.) Needs (these are often in follow up documents). Strengths (these are often in follow up documents). Resources. Level of tobacco dependence. Background factors which include three of the following:

o Cultural implications.o History of the client.o Social factors.o Economic factors.o Risk and resiliency factors.

Note: Your workplace forms might not: Record all of these things in one document. Cover all of the things listed above. Include some things listed above because they are usually

covered and recorded in a later session.However, for the purposes of this assessment you must provide all of this detail.You can use the template provided by NTS in your folder if you wish, but you must cover all the required details. (27504 1.1, 27505 1.2, 2.1)

Your client’s quit plan

Develop a stop-smoking plan for your client.

The important thing is to make sure the stop-smoking plan matches your client’s needs and covers all of the items listed below.

You can use the stop smoking / follow-up forms you usually use in your workplace or a template from your training module or screenshots from your computer.

(27505 2.2, 2.3 , 2.4, 2.5, 27504 3.2, 27506 1.1, 1.2)

REMEMBER – your plan must cover all of these things:

A quit date. Coping strategies. Stop smoking medicines. Dates for support sessions and the forms you have for each

session. Identification by the client of the personal relapse risk

factors. Strategies to reduce relapse risk. Access to ongoing support – generally and in case of risk. Referral to a medical practitioner for prescription

medications (if needed).




Referral to other interventions and services if needed at this point.

Proof of NRT Medicines given

You need to show how you supported your client to use nicotine replacement therapy (NRT) or other stop smoking medicines (if these were part of his or her stop smoking plan) and that the instructions for this medicine aligned with the person’s care plan.

Provide the following information:

Attach a copy of evidence of the medicines this client was given. This might be a copy of the record book in which you record the medicines, or it might be client notes to say you gave the medicines to the client, or it might be in your database of medicines used. (27505 2.6)

Your client’s progress notes

You need to provide evidence that you have observed changes with your client and documented and reported the changes and the client’s progress correctly – the way your organisation requires you to. This means the progress and change notes must be typed or written in pen and easy to read. They must also have the date and time correctly noted and you have to remember to sign them.

It is important that the documents you provide show progress over a period of time for your client – not just one review. It is recommended you include material up to four weeks after the quit date. Remember, in order to keep the client’s details private and confidential, put a black line through his or her name and other private details.

You need to think about at least two different types of changes you have observed with this client. The types of changes will probably fall under the following categories: physical, behavioural, environmental and/or emotional. You have to include examples of two different types of changes. E.g. One might be a physical change like the client is not shaking anymore and another might be behavioural where the client has joined a sports club.

Your evidence must show all of the following details and must be presented in a legible manner based on fact. As you compile this evidence you must adhere to your organisation’s policies and




procedures and adhere to all legislative requirements:

A series of descriptions of:o The changes you observed to your client’s originally

noted condition once they commenced the programme.o The progress you observed the client make as a response

to the care and the programme.o The observations you saw as a result of what was

requested in the progress reports - what did you see resulting from the progress meetings.

o Other changes to conditions that you may not have included earlier, or anticipated.

o How you provided ongoing support to the client so she could monitor his or her own progress and adjust things to stay aligned with his or her stop smoking plan.

o How you provided ongoing support that allowed the client to adjust his or her medication levels as his or her pattern of smoking changed. (27506 2.1, 27505 2.6)

Medication information including:o Where the client kept the smoking cessation medication

they were prescribed.o How you checked the expiration dates and any special

cautionary labels.o How you supported the client to use the medication

correctly and recorded and reported what was used.o When and if you told your client to increase dosage of

NRT due to the severity of withdrawal symptoms they were experiencing.

o What you told your client to do with there was an error in the amount taken.

Attach copies of the notes and progress reports and information from the post-quit meeting including the information about monitoring medicines and side effects and possibly increasing the medicines.

In addition to the documents you must answer all of the following questions related to each stage of the work you do with your complex needs client. The boxes will expand as you type.




PRE QUIT - Building a good relationship with your complex needs client

Your first and last name:Your email address:The date you did this assessment:What ethnicity is your complex needs client? Pacific Island, Māori, European, Indian etc.1. You need to provide information related to your client regarding each of the items listed below. This information may be located in parts of your organisation’s initial assessment form/document. If it is, in the answer box below, please write the location form so your assessor can easily find the details. E.g. “See the XYZ form, question 6 as it is noted there.”Complete the chart below with the answers requested. Your answers must be done in accordance with all related Smoking Cessation Guidelines. (27504 2.1, 2.3, 2.4, 2.5)

Read each of the things or items in the left hand column below. Then, in the right hand column write bullet points, or brief sentences to describe how this thing or item affects your client. A pretend example has been given.Item/issue/effect How does this affect your client?Cues that trigger smoking for this client.

Pretend example:e.g. When she hears a baby crying she gets afraid of being a mum and instantly wants a smoke.

Cues that trigger smoking for this client.Causes of relapse for this client - if there has been a relapse or some relapses in past otherwise write “no relapses”. Remember if your client has tried to quit in the past then they have relapsed.The chronic nature of relapsing for this client – (i.e. they have tried to quit a number of times, but not been successful) if there has been a relapse other wise leave blank.Which withdrawal




symptoms for this client come from nicotine withdrawal?TIP – make sure you have checked this as MANY people include things that are not linked to nicotine.Things the client does to make excuses for smoking.Current impact on this client’s budget.Current impact on this client’s health.Current impact on this client’s social life or circle.Benefits of quitting on this client’s budget.Benefits of quitting on this client’s health.Benefits of quitting on this client’s social life or circle.People in the client’s life affected by them smoking.Why does the smoker crave a cigarette after smoking for so many years? Explain why the person’s brain craves nicotine?TIP – don’t just write that they have got used to nicotine or have become addicted – explain how this has happened.What are the risks to any client’s lungs if they continue to smoke?

What are the risks to any client’s cardio-vascular system if they




continue to smoke?

2. Write a few sentences to describe how you prepared your assessment process to suit the complex needs client’s age, culture and condition. You also need to make sure you follow your workplace policies and procedures for this. (27505 1.3)




QUIT TIME: Working with your complex needs client

After meeting your complex needs client the first time and building rapport you now have to provide information to show how you worked with your complex needs client to help his or her to quit!

Go through each of the questions and provide the answers or the information as requested.

You also need to be observed by your manager with this complex needs client on quit day. The form for your manager to complete is a few pages over and is called. Verification from Your Supervisor or Manager

Your first and last name:

Your email address:

The date you did this assessment:

You need to provide your complex needs client with information and advice to help his or her set a quit date. Complete the chart below with the information requested.

1. Consider the smoking cessation information and advice that would best help this client and complete the information. You must have two or more bits of information you share. Don’t just put one thing. You probably talked about many things with your client!

A pretend example of one thing has been provided. (27505 2.1 27506 1.1, 1.2)

LIST THE INFO AND

ADVICE you gave below.

How does this info’ and advice match his or her

goals and needs?

How does this info’ and advice match his or her

strengths?

How does this info’ and advice

match his or her available resources?

How does this info’ and advice match his or her level of tobacco dependence and

previous experience with

stopping smoking?

Pretend example:

We discussed how she was

She needs to make sure she achieves her goal of vvvvv so it is important she just

When she wants to she can be really strong and committed so these two tasks

No other resources are needed for this so she should be fine.

While she has been a heavy smoker with a high level of dependency this




going to do xxxx and yyyyy this week.

focus on these two things.

should be something she can achieve.

will allow her to do aaaa and bbbb and this will give her the best result.

2. You need to provide some details to explain what you did as you developed the quit plan for the client. Jot down some brief notes in each box provided to answer the questions on the left.

(27505 2.2, 2.3, 2.4, 2.5, , 27506 1.1, 1.2)

2.a. Past quit attempts:

Approximately how many past quit attempts has this client had?




What happened in these past quit attempts?

Describe what you understand from the client about these attempts to quit?

2.b. Treatment programme:

What type of programme is supporting this client?

List the dates of the support sessions.

2.c. Tobacco dependence and withdrawal:

How did you measure your client’s tobacco dependence.

Describe what you said to the client to explain tobacco dependence.

Describe what you said to the client to describe withdrawal symptoms.

Describe how you knew the client understood what you said about dependence and withdrawal.

Describe how you monitored his or her withdrawal




symptoms.

Describe why you monitor withdrawal symptoms.

2.d. Stop smoking medicines

Describe what you said to describe the stop smoking medicines your client could use.

Which stop smoking medicine did this client use?

Describe why this medicine was used for this client.

How does the client get access to this medicine?

Describe what you said to the client about how to use the medicine.

Describe the follow-up monitoring process you use for this medicine and how frequently you do this.

Describe why you monitor the medicine.

2.e. Social Support:




Describe what you said to your client to explain social support.

Describe what you did to put the social support in place for your client.

What sort of social support is identified with this client?

2.f. CO Monitor: If you are in a service that does not see people face-to-face please write what you would say if you were in a face to face service with a CO monitor. Every stop smoking practitioner needs to know and understand the CO monitor.

Describe what you said or would say to the client about the CO monitor.

Explain the importance of the CO monitor for the treatment programme for this client or other clients.

2.g. Quit date:

Describe what you said to the client about the importance of a quit date.

What date did the client choose?

Why did they choose that date?

2.h. Not a Single Puff: (Or whatever you call the concept of committing to NO




cigarettes)

Describe what you said to your client to explain the Not a Single Puff concept.

Describe how you knew the client understood the Not a Single Puff concept.

When will the client begin the Not a Single Puff process?

3. Now consider when people come to your service. They may have been referred to you or they may have just walked in or called directly. Thinking about the three step ABC approach, describe which person or which service did each of those three steps. Fill in the chart below. Refer to NZ Smoking Cessation Guidelines to complete this question. The A and B might have been done by one group and the C by your group. (27504 3.1)

STEP Who or which service did each step?

What did they do in each step?

A

B

C

4. Provide a few sentences to describe how the smoking cessation strategy for your client will improve his or her health. (27507 1.6)

5. The Treaty of Waitangi refers to the 3 P’s: partnership, protection and participation. How did you respect the client’s cultural need for partnership, protection and




participation?

6. Lastly, what did you do to secure a commitment from your client to quit and follow the “not a single puff” rule? (27505 2.3)

When this is complete you then need to provide information about how you worked with the clients after quit day.




AFTER QUIT DAY: Supporting Your Complex needs Client

You need to observe the changes to your complex needs client’s condition since commencing the smoking cessation programme. You need to document the changes in your file notes and complete all of the components below.

Your first and last name:

Your email address:

The date you did this assessment:

1. Provide information about how you collaborated or worked with other professionals and services to support this client to quit according to their stop smoking plan. These might include the GP, Māori or Pacific people’s services, mental health services, Community Corrections, problem gambling services, alcohol and drug services. Note – it may be that there are no others you need to collaborate with for this client – it will depend on the initial quit plan you developed with your client. (27505 2.5, 27506 2.2)

2. Think about the medication your client used and how you supported and advised his or her to use it correctly. Complete the questions below. (27506 2.3)

Describe any adjustments you had to make to the client’s medicines.

Overall – how well do you feel you were able to assist this client? What were the highs and the lows of the journey for you with this client?




Verification from Your Supervisor or ManagerThis form is to be completed in pen by your supervisor or manager to provide information about the process you used with your complex needs client. Once completed please scan the document and include it in your portfolio with the title YOUR NAME Task Three Manager Verification.First and last name of Stop Smoking Practitioner:First and Last Name of Verifier:

Verifier’s role:

Employer: Date:

Verifier – please note. Your employee is completing the NZQA qualification as a smoking cessation practitioner. Your employee has worked with a complex needs client. You must provide verification of the work the employee has done and confirm it accurately reflects the support your employee has offered the complex needs client and that the support given aligns with all company policies and procedures and legislative requirements. You also attest to the work the practitioner did matched the client’s characteristics, levels of dependence and the practitioner provided support consistent with the smoking cessation worker’s role in the stop smoking plans.Your signature on this form means you stand behind what you are verifying and you will be happy to provide supplemental comments to an assessor should he or she call you.Indicate whether the employee did each of the following by ticking “Yes” or “No”1. If this client was referred to the stop smoking service was the referral handled correctly (use for guideline MOH Smoking Cessation Tier one service specification):

Appropriate response time to clientWas the response back to the referrer conducted in a timely manner?

YES NO

2. Did the stop smoking practitioner display rapport building skills during the session with the client and communicate effectively?

YES NO

3. The paper or online form to assess the client was filled out accurately and reviewed by the stop smoking practitioner.

YES NO

4. The treatment programme was explained to the client giving clear expectations – how many sessions, support and medicines, etc.

YES NO

5. Was tobacco dependence discussed in this session? YES NO

6. Were withdrawal symptoms discussed in this session? YES NO

7. The client’s plans were appropriate for the client. YES NO

8. Was the rationale of Not a Single Puff discussed with the client? YES NO




9. Was the quit date discussed with the client? YES NO

10. Was the CO monitor used with the client? YES NO

11. Did the stop smoking practitioner explain what the CO monitor measures and the purpose of the monitor? YES NO

12. The cultural needs of the complex needs client were addressed during this session’s interactions and advocacy/self advocacy shared with the client aligned with empowerment, was respectful and met the policies and procedures your organisation has.

YES NO

13. The client file notes and progress notes were completed correctly and met your organisation’s requirements.Documented change notes are accurate and effective.

The notes are legible and factual, written in permanent ink, include the date, time and necessary signatures, provide details of condition changes and response to care, and adhere to legislative requirements.

YES NO

14. Referrals made for the client were handled correctly and the appropriate follow-ups were conducted.

YES NO

15. Write a few sentences to describe how well the employee worked with the complex needs client and how you know this.

16. Describe any other services the client was referred to. (27505 2.5)

Signature - Supervisor or Manager:

Date:




Feedback from your Complex needs ClientThis form is to be completed in pen by your complex needs client – remember this person is called CLIENT CX. Once completed please scan the document and include it in your portfolio with the title: YOUR NAME Task Three Client Verification.

First and last name of Stop Smoking Practitioner:

Verification from:CLIENT CX – Complex needs Client

Date:

Please note. The candidate is completing the NZQA qualification as a smoking cessation practitioner. The candidate has worked with you and we would like to get some feedback about what they did.Indicate whether the candidate did each of the following by ticking “Yes” or “No”1. Your Quit Smoking plan was right for you – it was what you needed. (27505 ER 2, 27506 ER1)

YES NO

2. You had meetings and follow-ups as planned.The meetings were handled well and the forms were right. (27506 ER 1, 2)

YES NO

3. Tell us what you think your Stop Smoking Coach did well to help you quit smoking. (27505/6 overall)

Thank you.




SummaryPlease save the document using the following:FIRST NAME LAST NAME Task Three Portfolioe.g. TUI BROWN Task Three Portfolio

For your portfolio please put all the documents into a clear sequence. If they are odd sizes and shapes, please photocopy them and then you will be able to more easily scan them.

Make sure you have written on the documents what each is so your assessor can easily find them.

Put all the pages the same way around and in the right order. Scan the documents as one or a maximum 3 documents.

Save your scanned document/s with

FIRST NAME LAST NAME Task Three Portfolio

Then email the scanned documents and this assessment document to [email protected]


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