Initial Nursing Assessment

for Spiritual / Religious

Needs
 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.
 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.
 FACT
• 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.
 Spirituality and Health
Positive and Negative Religious Coping
• Positive Coping: Patients showed less psychological
distress
- seeking control through a partnership with God
or Higher Power in problem-solving
- asking God’s forgiveness and trying to forgive
others
- finding strength and comfort from one’s spiritual
beliefs
- finding support from spiritual / religious
community
 Positive and Negative Religious Coping
• Negative Coping: Patients have more depression,
poorer quality of life and callousness towards
others
- seeing the crisis as punishment from God
- excessive guilt
- absolute belief in prayer and cure; inability to
resolve anger when cure does not occur
- refusal of indicated medical treatment
 Spiritual Coping
• Hope: for cure, for healing, for finishing
important goals, for a peaceful death
• Sense of control
• Acceptance of situation
• Strength to deal with situation
• Meaning and Purpose: in life in midst of
suffering
 Spiritual Care
• Practice of compassionate presence
• Listening to patient’s fears, hopes, pain, dreams
• Obtaining a spiritual history
• Attentiveness to all dimensions of the patient and
patient’s family: body, mind and spirit
• Incorporation of spiritual practices as appropriate
• Chaplains as members of the interdisciplinary
healthcare team
 Spiritual History

F Faith, Belief, Meaning

I Importance and Influence
C Community
A Address