AHD-CLINICAL-002 — Nursing Curriculum v0.1
Avina Home Detox Academy Status: DRAFT v0.1 (Avina version, recreated from scratch in our voice; replaces the Mallory consulting baseline) Date: 24/04/2026 Owner: Medical Director (Elizabeth Mortazavi MD) + Director of Nursing (TBA)
Preamble
The Avina Home Detox Academy is the in-house training programme through which every nurse contracted by the Company is validated before a first deployment. The curriculum is twelve modules, approximately forty hours, delivered through a combination of self-paced study, live virtual sessions with the Medical Director, simulated case scenarios, and supervised first-deployment ride-alongs.
The Curriculum is reviewed quarterly. Modules update as the protocol library evolves and as the Medical Director identifies field gaps from M&M reviews.
No nurse deploys to a principal’s residence without successful completion of all twelve modules and a validated first deployment with the Director of Nursing.
Curriculum Architecture
| Module | Topic | Hours | Format |
|---|---|---|---|
| 01 | Avina Home Detox: model, mission, brand standards | 2 | Self-paced + live Q&A |
| 02 | Intake and case approval workflow | 2 | Self-paced + live |
| 03 | The principal’s residence as a clinical setting | 3 | Self-paced + simulation |
| 04 | Alcohol withdrawal: pathophysiology, scoring, protocol | 4 | Self-paced + live + simulation |
| 05 | Opioid withdrawal: pathophysiology, scoring, protocol | 4 | Self-paced + live + simulation |
| 06 | Benzodiazepine and polysubstance protocols | 3 | Self-paced + live |
| 07 | IV therapy: NAD, glutathione, B-complex, hydration | 4 | Self-paced + live + simulation |
| 08 | Emergency management: stroke, chest pain, DT, naloxone, falls | 4 | Self-paced + live + simulation |
| 09 | Communications: principal, family, family office, MD, non-clinical staff | 3 | Self-paced + role-play |
| 10 | Documentation: EMR, MAR, group thread reporting | 3 | Hands-on |
| 11 | Discretion and HIPAA: NDAs, encryption, residence behaviour | 3 | Live + scenario |
| 12 | Supervised first deployment with Director of Nursing | 4 | In residence with active case |
Total: ~39 hours delivered over 4-6 weeks before a nurse is approved for solo deployment.
Module Detail
Module 01 — Avina Home Detox: Model, Mission, Brand Standards
Objectives: - Understand the Avina business model: in-residence medical detox + IV therapy at the UHNW tier, family-office buyer - Understand brand standards: discretion, voice, dress, communication - Understand the difference between a private wellness firm and a residential treatment facility, and how that shapes our work
Topics: - Avina Wellness umbrella + Avina Home Detox practice - The four practices and how they interlock - The principal as the central relationship - The Chief of Staff orchestration layer (when applicable) - Brand standards for nurses in residence
Validation: Written quiz + verbal commitment to brand standards
Module 02 — Intake and Case Approval Workflow
Objectives: - Understand how cases enter the firm - Understand the Medical Director’s case approval criteria - Understand the nurse’s role in pre-deployment readiness
Topics: - Inbound channels and triage - Pre-deployment briefing - The case file: what to read, what to clarify - Day-0 logistics: pharmacy, equipment, residence walk-through
Validation: Walk through a sample case file and identify the protocol, contraindications, and safety considerations
Module 03 — The Principal’s Residence as a Clinical Setting
Objectives: - Adapt clinical workflow to a non-clinical setting - Maintain clinical standards while respecting residence and household - Manage the unique safety profile of in-residence care
Topics: - Residence walk-through and clinical setup - Sharps, medications, equipment storage - Household staff coordination - Family member presence and boundaries - Discrete clinical workflow
Validation: Conduct a simulated residence walk-through with the Director of Nursing; identify and resolve at least 5 clinical-environment risks
Module 04 — Alcohol Withdrawal: Pathophysiology, Scoring, Protocol
Objectives: - Master the pathophysiology of alcohol withdrawal - Master CIWA scoring - Master the Avina alcohol withdrawal protocol - Recognise progression from withdrawal to delirium tremens
Topics: - GABA / glutamate imbalance - Stages of withdrawal: Stage 1 (6-12 hr) through Stage 4 (DT, 48-96 hr) - CIWA-Ar scoring: every item, every threshold - Benzodiazepine taper protocol (Ativan-based standard) - Adjunct medications: clonidine, gabapentin, ondansetron, trazodone - Repletion: thiamine, folic acid, multivitamin - Wernicke-Korsakoff prevention: thiamine BEFORE glucose, every time - Escalation triggers
Validation: Pass the CIWA-Ar scoring test (8 cases, 100% accuracy required); complete a full protocol walk-through with the Medical Director
Module 05 — Opioid Withdrawal: Pathophysiology, Scoring, Protocol
Objectives: - Master the pathophysiology of opioid withdrawal - Master COWS scoring - Master the Avina opioid withdrawal protocol - Recognise the unique safety profile of opioid detox in residence
Topics: - Mu-opioid receptor adaptation - Subutex (buprenorphine) microinduction and standard induction - Subutex 8-day standard taper - Adjunct medications: clonidine, gabapentin, ondansetron, loperamide - Naloxone: indication, dosing, post-administration management - Care continuity to outpatient buprenorphine prescribing where appropriate
Validation: Pass the COWS scoring test (8 cases, 100% accuracy required); complete a Subutex induction walk-through with the Medical Director
Module 06 — Benzodiazepine and Polysubstance Protocols
Objectives: - Understand the long-taper protocol for benzodiazepine dependence - Understand sequenced protocols for polysubstance presentations - Recognise stimulant withdrawal and supportive care
Topics: - Benzodiazepine cross-titration to long-acting agents - The 21-day minimum taper - Polysubstance: which substance to address first - Stimulant withdrawal: supportive care, sleep restoration, nutritional support
Validation: Walk through a benzodiazepine taper case and a polysubstance case with the Medical Director
Module 07 — IV Therapy: NAD, Glutathione, B-Complex, Hydration
Objectives: - Master IV starts in a non-clinical setting - Master the Avina IV protocol library - Recognise infusion-related adverse events and respond
Topics: - IV start technique in residence (peripheral, no central line) - Vital sign monitoring during infusion - Hydration protocols: balanced electrolytes, banana bag composition - Thiamine 500mg IV: indication, dosing, Wernicke prevention - NAD IV: BR+ NAD 250-500mg over 4-6 hours, slow administration, common adverse reactions (chest pressure → slow rate, niacin flush, GI discomfort) - Glutathione push: 1-2g, hepatic support indication - Methylated B-complex: dosing, neurological repletion - Pause-and-call protocol for any adverse reaction
Validation: Demonstrate competent IV starts (3 successful attempts under DON observation); pass written test on IV protocol library
Module 08 — Emergency Management
Objectives: - Recognise and manage clinical emergencies in a residence - Coordinate with EMS and the Medical Director - Manage the principal’s residence and family during an emergency
Topics: - Stroke recognition and FAST exam - Chest pain protocol: aspirin if appropriate, EKG-12 lead via portable, EMS - Delirium tremens: sedation, EMS transport - Naloxone administration and post-administration management - Fall risk assessment and management - Calling 9-1-1: when, how, what to say, what to coordinate - Post-emergency documentation
Validation: Pass the simulated emergency scenarios (stroke, chest pain, naloxone, fall, DT) with the Director of Nursing
Module 09 — Communications
Objectives: - Communicate effectively with the principal - Communicate effectively with family members - Communicate effectively with family-office contacts - Communicate effectively with the Medical Director and the Director of Nursing - Communicate effectively with non-clinical household staff
Topics: - The principal in withdrawal: tone, pacing, presence - Family communication: what to share, what to defer to the MD - Family-office briefings: who, when, what, what not - Group thread protocol: format, frequency, escalation - MD escalation: when to call vs text vs EMS-then-call - Household staff: scope, professionalism, discretion
Validation: Role-play scenarios with the Director of Nursing; deliver a sample family-office briefing
Module 10 — Documentation
Objectives: - Master DrChrono Pro EMR - Master the paper MAR - Master group thread reporting - Understand the legal and clinical purpose of every documentation requirement
Topics: - DrChrono Pro: SOAP note, MAR, vitals, assessments - Paper MAR reconciliation - Group thread report format - Documentation of refusals - Documentation of adverse events - Co-signature workflow with the Medical Director
Validation: Complete a full case documentation set in DrChrono for a simulated 5-day detox
Module 11 — Discretion and HIPAA
Objectives: - Master Avina’s confidentiality and discretion standards - Master HIPAA and 42 CFR Part 2 in practice - Understand the legal and reputational stakes of any breach
Topics: - HIPAA Privacy Rule: minimum necessary, patient access, disclosure rules - 42 CFR Part 2: enhanced confidentiality for substance use treatment records - The Avina NDA cascade - Encrypted communications: which channels, when, why - Residence behaviour: phones, photographs, social media - Family-office briefings: confidentiality boundaries between principal and family - Breach response
Validation: Pass the HIPAA + 42 CFR Part 2 test; sign the NDA cascade
Module 12 — Supervised First Deployment
Objectives: - Demonstrate competence in a real case under direct supervision - Validate readiness for solo deployment
Process: - The nurse joins the Director of Nursing on an active Avina Home Detox case for at least one full shift (12 hours) - The Director of Nursing observes the nurse’s clinical performance, documentation, communication, and discretion - The Director of Nursing signs off on solo deployment readiness or identifies remediation requirements
Validation: Director of Nursing written sign-off
Continuing Education
Once deployed solo, every Avina nurse completes:
- Quarterly clinical reviews with the Director of Nursing (1 hour each)
- Annual recertification with the Medical Director (4 hours)
- All M&M reviews for cases the nurse worked on (2 hours per quarter)
- Continuing education credits per state law (Avina reimburses up to $1,000/year per nurse)
Recruitment Standards
Every nurse considered for the Avina Home Detox pool must hold:
- Current active RN license in the jurisdiction of intended deployment
- Minimum 5 years clinical nursing experience
- Documented experience in substance use disorder, addiction medicine, or critical care preferred
- Current BLS; ACLS preferred
- Clean professional record (no actions on file with state Board of Nursing)
- Personal references from at least 3 clinical supervisors
- Demonstrated discretion in prior roles
- Ability to commit to the Curriculum and to ongoing CE
Pay Structure
| Activity | Pay (USD) |
|---|---|
| Curriculum modules 01-11 (40 hours self-paced + live) | $1,500 honorarium on completion |
| Module 12 (supervised first deployment) | Standard per-shift rate ($600-900) |
| Solo deployed shift (12 hours) | $900-$1,200 per shift, jurisdiction-dependent |
| On-call (no deployment) | $25/hour |
| Quarterly clinical review participation | $100 honorarium |
| M&M review participation | $50 honorarium per case reviewed |
| Annual recertification | $300 honorarium |
Materials
- Curriculum binder (digital + printed) provided on engagement
- Avina Home Detox Operating Manual (provided on signing the NDA)
- Avina Home Detox Protocol Library (provided on completing Module 04)
- Avina Home Detox IV Library (provided on completing Module 07)
- Quarterly amendments distributed via the encrypted nurse channel
End of v0.1. Refreshed when NEXUS clinical evidence research returns; Module 07 (IV Therapy) and Module 04 (Alcohol Withdrawal) protocols may evolve.