Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
4-11-2023
Degree Program
Doctor of Nursing Practice
Degree Track
Post Master's DNP Completion
Year Degree Awarded
2023
Month Degree Awarded
May
Keywords
: Opioid abuse, Substance dependence; screening; suboxone; emergency department; substance abuse
Advisor
Dr. Terrie Black
DNP Project Chair
Dr. Terrie Black
DNP Project Outside Member Name
Dr. Dawn Williamson
Abstract
Abstract
Background: Opioid use disorder (OUD) is an issue that impacts the healthcare system daily, and has been declared a national public health concern Purpose: The purpose of this DNP Quality Improvement (QI) project was to screen patients aged 16 and older for Opioid Use Disorder (OUD) who presented to the Emergency Department Observation Unit (ED OBS) in a Urban Academic Medical Center regardless of chief complaint. The goal of this project was early identification of OUD and rapid referral to outpatient resources to facilitate recovery compliance. Methods: The QI project utilized a registered nurse led screening intervention for every patient admitted to the ED OBS regardless of admission diagnosis or declaration of opioid use history. The screening process consisted of a two-minute verbal questionnaire which assessed the patient for opioid use disorder risk. If the patient screened positive, they were offered Medication Assisted Treatment (MAT), followed by a rapid follow up appointment in the hospital outpatient clinic within 48 hours upon discharge from the hospital. Results: Out of 650 patients admitted to the ED OBS unit in the month of October 2022, 536 participated in the Quality Improvement Project. No patients screened positive for OUD requiring MAT or referral to Outpatient Recovery Care at discharge. Fourteen women were actively prescribed opiates for a chronic pain condition compared to 4 men prior to arrival to the Observation Unit. Five women were unable to answer the Rapid Opioid Dependence Screen (RODS) questions due to altered mental status/dementia issues compared to 2 men who were unable to answer due to the same reason. Conclusion: Results suggest several theoretical and practical implications for future research into treatment of OUD in the Emergency Department Setting.
Keywords: Opioid abuse, Substance dependence; screening; suboxone; emergency department; substance abuse
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