Friday, 3 August 2012: 10:55 AM
Ann M. Mitchell, PhD, RN, FAAN1
Irene Kane, PhD, MSN, RN, CNAA, HFI1
Holly Hagle, MA2
Kimberly Owens, MSN, BSN, CS3
Laurie Christie, RN3
Dawn Lindsay, PhD2
Lynn Owens Boucek, RN1
Kathryn Puskar, DrPH, MN, MPH, FAAN1
Lauren Terhorst, PhD1
Kimberly Talcott, MPA1
Gail R. Woomer, RN, MN, IBCLC1
(1)School of Nursing, University of Pittsburgh, Pittsburgh, PA
(2)Institute for Research, Education, and Training in Addictions, Pittsburgh, PA
(3)Western Psychiatric Institute and Clinic, Pittsburgh, PA
Learning Objective 1: Describe the evidence-based practice of Screening, Brief Intervention, and Referral to Treatment (SBIRT)
Learning Objective 2: List three implications for Emergency Department Registered Nurses (EDRNs) when implementing SBIRT into an Emergency Department procedure.
Background: Substance use is a worldwide public-health priority. Annually, 2.5 million die from the harmful use of alcohol (World Health Organization (WHO) 2011 Global Status Report). In 2008, WHO reported 155 to 250 million people (~5% worldwide population) used psychoactive substances. Risks associated with use of alcohol and other drugs can lead to accidents, violent behavior, and societal/developmental issues. To address substance use risks, an interprofessional (academic-community-health provider) partnership trained Emergency Department Registered Nurses (EDRNs) to utilize an evidence-based practice (Screening, Brief Intervention and Referral to Treatment, SBIRT) to screen patients for substance misuse. Screening provides patients timely brief interventions enhancing motivation to reduce use or follow-up on assessment referral. This project is significant because an opportunity exists in the ED to identify, address, and reduce the risks of an otherwise under-identified cause of ED admissions.
Methods: The Nursing School partnered with the Medical Center and an additions-training nonprofit to train four hospitals located in urban, rural, and low-income areas. EDRNs were trained in primary prevention of substance abuse by improving the quality of care via SBIRT intervention. Objectives include providing 1) a two-hour training teaching EDRNs the evidence-based practice and 2) a skill-building component to teach EDRNs to reduce health risks of substance use through clinical practice opportunities.
Results: EDRNs were surveyed on perceptions-of and confidence-in assisting patients who use substances pre, post, and 30-days after training. Results suggest a linking of evidence-based innovation with practice change.
Conclusions of Significance: A significant opportunity exists in the ED to identify, address, and reduce risks of patient substance use. As a result of ED education, patients’ need for intervention is identified earlier along the continuum of use, abuse, and dependence. Implementing this evidence-based practice in the ED increases patient exposure to intervention and community-specific referrals.