Initial Nursing Assessment for Spiritual / Religious Needs Tedford J. Taylor, MDiv, BCCC Director of Pastoral Care & Training ttaylor@rwjuhh.edu DO NOT DUPLICATE WITHOUT AUTHOR’S PERMISSION © 2012

Why A Spiritual Assessment? Faith is already a factor affecting the lives and healthcare choices of many of our patients. Most patients and their families already use faith-based / religious practices (like prayer, diet, ritual, etc.) to complement treatment modalities. Healthcare practitioners need to assess how faith impacts individual treatment choices. A spiritual assessment is less about WHAT a person believes and more about HOW their faith / belief system functions as a source of support.

Joint Commission Guidelines for Spiritual Assessments Spiritual assessments are required by the Joint Commission. A spiritual assessment should, at a minimum, determine the patient’s religious beliefs (if any), as well as any values or practices important to the patient. The main goal of a spiritual assessment should be to identify the patient’s needs, hopes, resources, and possible outcomes regarding their spirituality. Joint Commission: “The Source”, February 2005, Vol. 3, Iss. 2

Other Benefits of A Spiritual Assessment Acknowledging spirituality can positively affect the clinician-patient relationship. Addressing spiritual concerns with your patient and their family can provide comfort and increase trust-building. In itself the assessment becomes a therapeutic intervention.

Important Considerations Respect the privacy of patients with regard to their unique spirituality. Do not impose your own beliefs and practices on others.

The FACT Initial Spiritual Assessment Tool The FACT Tool is a hybrid of history and assessment. A Spiritual History collects information on spirituality and religious practice that may help them cope with their present health crisis. A Spiritual Assessment involves an informed judgment concerning treatment options – including referral to a chaplain for a more in-depth assessment.

F A C T FAITH ACTIVE ACCESS CONFLICT / CONCERNS TREATMENT PLAN SPIRITUAL HISTORY FAITH ACTIVE ACCESS CONFLICT / CONCERNS SPIRITUAL ASSESSMENT TREATMENT PLAN

Nursing Intake Spiritual Assessment Questions The following questions are part of a new spiritual assessment process. Positive answers trigger instant referrals for follow-up pastoral care, such as: Communion requests Communication with the patient’s religious congregation Consultation on issues of religious / cultural sensitivity In-depth spiritual assessment by a chaplain General emotional or spiritual support by a chaplain

Faith Can you confirm your religious affiliation that I have recorded from your admission documents? (Check patient's ID band for religious affiliation). I see you are (religious affiliation). Is this correct? Contact admissions office to update / correct this information.

Faith If patient is Catholic, would he/she like to receive communion? SCRIPT: “Eucharistic Ministry volunteers are available daily to distribute communion to Catholic patients and their families.” Generates an automatic referral to pastoral care.

Active Access Do you participate in a religious congregation? SCRIPT: “Our pastoral care team will help you contact them. I’ll let the team know of this request.” Generates an automatic referral to pastoral care.

Active Access Pastoral care is offered to all patients. Would you like me to expedite a visit from one of the pastoral care team members? Call chaplain on duty (*072) if there is an emergent need for pastoral support. “Yes” generates an automatic referral to pastoral care.

Conflict / Concerns What cultural, spiritual, or religious practices / values are important for us to know? SCRIPT: “I’ll work with my colleagues to make sure we work with you on these concerns.” Free-text assessed needs. Consult with Pastoral Care as appropriate.

Conflict / Concerns Do any of your religious practices conflict with or affect how we will need to treat you while you are here? (Example: diet, medication, visitors, privacy, rituals.) SCRIPT: “I’ll work with my colleagues to make sure we work with you on these concerns.” Free-text assessed needs. Update plan of care as appropriate. Dietary or Pastoral Care Departments are automatically referred.

Conflict / Concerns Do you have any particular concerns or fears about your stay in the hospital? Address those fears / concerns that you are able to. SCRIPT: “Our chaplains are also here to help address many of these concerns. Would you like me to expedite a visit from one of the chaplains?” Generates an automatic referral to pastoral care.

Treatment Plan Does the patient appear to be coping well and have adequate social / emotional / spiritual support? Free-text assessed needs. Call chaplain on duty (*072) if there is an emergent need for pastoral support. Non-emergent needs (“no” answers) generate an automatic referral to pastoral care.

Final Thoughts If questioned on the role of pastoral care and chaplains refer the patient / family to facility guides. Or, contact pastoral care for assistance.

Final Thoughts Referrals to pastoral care generated by the FACT assessment will be completed in 24 hours. A chaplain will visit to further assess ongoing issues and pastoral care needs. Urgent pastoral care needs (emergency sacraments, family crises, death / dying issues) should be referred to the chaplain on duty for immediate response.