Interprofessional Evidence-Based Solution for Alcohol Screening Using Technology

Puskar, Kathryn

Purpose: Communication and coordination between clinical providers across all disciplines is needed to deliver efficient and effective care for patients with risky substance use, misuse, or substance use disorders. Universal screening identifies patients who may be at risk for problems related to substance misuse. Nurses receive limited content in nursing school curricula or continuing education about interprofessional education and evidence-based substance use screening or brief interventions. The purpose is to share results of an interprofessional evidence based practice solution for Alcohol Screening in rural areas using technology.

Methods: A mixed method design employing both quantitative pre-to post-survey and qualitative focus group and key informant interview methods was used. Measures: The Alcohol and Alcohol Problems Perceptions Questionnaire (AAPPQ), drug (DDPPQ), and the Interdisciplinary Education Perception Scale (IEPS) questionnaires were administered.

Results: Data demonstrates statistically significant improvement in confidence and competence. [Piper1] Two products resulted: online training module offering Continuing Education Units (CEU’s) and a training manual titled Substance Use Education Manual for Nurses, both available online for distribution.

AAPPQ:

Scores on both subscales of the AAPP questionnaire increased over time. The average score for role security, a measure on a 2 to 10 scale of self-perceived skill and legitimacy in working with problem drinkers, increased significantly from the pre-training period (M=7.5, SD=1.4) to the post-training period (M=8, SD=1) and to the follow up period (M=8.3, SD=1.7), F(2,65)=6.24, p<.01. The average score for Therapeutic Commitment to working with problem drinkers, measured on a 3 to 15 scale, increased significantly from the pre-training period (M=10.7, SD=1.8) to the post-training period (M=11.1, SD=1.7) and to the follow up period (M=11.2, SD=2.4), F(2,64)=1.8, p=.17.

DDPPQ:

Scores on both subscales of the DDPP questionnaire increased over time. The average score for role security increased non-significantly from the pre-training period (M=7.5, SD=1.3) to the post-training period (M=7.8, SD=1.1) and to the follow up period (M=8, SD=1.7), F(2,64)=2.36, p=.1. The average score for therapeutic commitment also increased non-significantly from the pre-training period (M=10.7, SD=2.2) to the post-training period (M=11, SD=2.1) and to the follow up period (M=11.45, SD=3), F(2,65)=1.77, p=.18.

IEPS:

The average score for perceived autonomy of one’s profession measured on a 1 to 6 scale increased significantly from baseline (M=4.7, SD=.81) to the post-training period (M=4.9, SD=.8) and to the follow up period (M=5.1, SD=.82), F(2,139)=4.08, p=.02. The average increase (0.36) in Autonomy between pre training and follow up was statistically significant (p<0.01).

Average Actual Cooperation scores increased from baseline (M=4.9, SD=.7) to post-training (M=5.1, SD=.75) and to the follow-up assessment (M=5.3, SD=.7), F(2,143)=6.21, p<.01 . The average increase (0.39) in Actual Cooperation between pre training and follow up was statistically significant (p<0.01).

Conclusions: Our findings have implications for nursing and healthcare systems and policy. Integration of substance misuse screening throughout the lifespan of patients into all nursing curricula is essential to address substance use as a domestic and global public health issue using interprofessional and technology focus.

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