Methods: In the Family Nurse Practitioner (FNP) and Psychiatric Mental Health Nurse Practitioner (PMHNP) programs, students are required to complete a module for “Opioid Harm Reduction”. Through a multimethod educational approach students receive the fundamentals in opioid overdose prevention, recognition and response, and harm reduction strategies. In the 2016 fall semester, at the beginning and after completion of the module, students were surveyed regarding confidence, understanding, and relevance of opioid harm reduction in preparing for their specialties.
Results: The results of the module survey included a total of 27 participants in the FNP and PMHNP programs. Five areas were looked at and the percentages of the essential components of harm reduction were compiled. Results showed a significant difference before and after the module in knowledge of overdose symptoms, confidence of teaching harm reduction, confidence in providing emergency care, relevance of topic to practice, and confidence in ability to reduce opioid use while treating pain in patients.
Prior to the activity, the majority of students (96%) agreed or strongly agreed that opioid harm reduction was relevant to their practice prior to the activity. In addition, 41% expressed a lack of confidence in their ability to teach opioid harm reduction to patients and 48% expressed a lack of confidence in their ability to provide emergency treatment to patients experiencing overdose.
Following the activity, the increase in opioid harm reduction knowledge and confidence increased for all knowledge and skill areas. The greatest areas for growth were a 14-fold increase in the number of students who strongly agreed that they would be able to reduce opioid use among patients with chronic pain, a 5-fold increase in the number of students who strongly agreed that they would be able to teach harm reduction to patients with opioid use disorders, and a 4-fold increase in the number of students who strongly agreed that they would be able to provide emergency treatment to patients with opioid overdose. All of the students indicated that they would recommend use of the module in the future.
Conclusion: The module is an innovative strategy to address the opioid epidemic by educating nurse practitioner students in harm reduction strategies. Post-graduate NP students found the online harm reduction module helpful for gaining competency in recognizing opioid overdose and administering intranasal naloxone to prevent harm. Students indicated an intent to utilize harm reduction strategies in their own NP practices and an interest in further discussion. The module was low cost and easy to develop with the help of an online instructional designer. The built in pre-post surveys were useful in planning future learning modules.
The educational initiative is generalizable to other advanced practice and generalist nurses. This type of online harm reduction education may have a community impact that can be strengthened by state and county initiatives, public service announcements, local trainings and easy access to naloxone.