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Kobelt EF JDC 4 24 17 ohiolinkfinal.pdf (1.3 MB)

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Nasal Spray Can Save Lives: Engaging Emergency Department Nurses in the Provision of Naloxone Nasal Spray to High Risk Patients

Kobelt, Paula Anne
http://orcid.org/0000-0002-1807-3553
http://rave.ohiolink.edu/etdc/view?acc_num=otbn1493059037547445

Abstract Details

2017, DNP, Otterbein University, Nursing.
The opioid overdose epidemic continues to escalate in the United States. Some of the morbidity and mortality associated with opioid overdose can be prevented with the timely administration of naloxone, an opioid reversal agent. The literature emphasized that the emergency department (ED) venue and registered nurses are well positioned to screen and identify high risk individuals whether they present as a result of an overdose or for other medical reasons. The literature also pointed to the importance of providing naloxone to high risk individuals and those who would be most likely to be at the scene of an overdose. This is critical because most overdoses occur at home. Additionally, negative attitudes and stigmatization towards individuals with substance use disorders (SUD) can result in provision of suboptimal patient care for this population. The literature demonstrated that education can improve knowledge gaps and negative attitudes towards patients with SUD. The purpose of this evidence-based practice improvement project (EBPI) was to address the knowledge gaps and attitudes of Emergency Department Registered Nurses (EDRNs) about the scope of the opioid overdose epidemic, SUDs as a disease, pathways from prescription opioids to heroin, treatment, recovery, harm reduction education, and nasal naloxone spray. The goal of the EBPI was to use evidence to increase the EDRNs’ knowledge and improve attitudes to facilitate delivery of evidence-based care. The clinical question guiding the EBPI was “In EDRNs caring for patients at high risk for opioid overdose, how does providing a standardized education intervention about harm reduction education and naloxone nasal spray (HRENNS), compared to not providing standardized education, affect the EDRNs’ knowledge and attitudes about providing HRENNS to patients at high risk for opioid overdose, measured immediately and 30 days following completion of the education intervention.” The project framework included Plan, Do, Study, Act cycles and Appreciative Inquiry. A 60 minute evidence-based education intervention was developed and co-presented by the DNP student and the Attorney General’s Office’s Director of Drug Abuse Outreach Initiatives and Community Outreach Specialist to four EDs in one hospital system. A survey was developed using items from the Opioid Overdose Knowledge Survey and the Opioid Overdose Attitude Survey to measure change following the education intervention. The Substance Abuse Attitudes Survey was used to design a follow up interview for participants. Fifty seven EDRNs attended the 11 education intervention sessions. Thirty-five surveys were completed of which 27 met criteria for analysis. Findings included improved EDRNs’ knowledge related to naloxone and managing an opioid overdose following the intervention. EDRNs’ paired t-test mean scores significantly improved in rating of having enough information to manage an overdose (p = 0.137). Survey items did not capture negative attitudes and frequently asked questions that were demonstrated during the education intervention pertaining to whether providing naloxone would encourage drug use, or give false reassurance to patients and families. This underscores the importance of providing opportunities for informal stakeholder feedback. Follow up phone interviews revealed EDRNs’ willingness to provide evidence-based care. Outcomes of the project were used to inform a system-wide project and revise the education intervention that was posted electronically for ongoing staff education to provide naloxone nasal spray for home use to ED patients at high risk for opioid overdose.
Eva Fried, DNP, WHNP (Committee Chair)
John Chovan, PhD, DNP, RN, CNP, CNS (Committee Member)
Jennifer Biddinger, Mpsy (Committee Member)
109 p.
Health Care; Mental Health; Nursing
Opioid Overdose, Naloxone, Substance Use Disorder, Addiction, Overdose Reversal, Emergency Department, Registered Nurse, Attitude, Stigma

Recommended Citations

Citations

  • Kobelt, P. A. (2017). Nasal Spray Can Save Lives: Engaging Emergency Department Nurses in the Provision of Naloxone Nasal Spray to High Risk Patients [Doctoral dissertation, Otterbein University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1493059037547445

    APA Style (7th edition)

  • Kobelt, Paula. Nasal Spray Can Save Lives: Engaging Emergency Department Nurses in the Provision of Naloxone Nasal Spray to High Risk Patients. 2017. Otterbein University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=otbn1493059037547445.

    MLA Style (8th edition)

  • Kobelt, Paula. "Nasal Spray Can Save Lives: Engaging Emergency Department Nurses in the Provision of Naloxone Nasal Spray to High Risk Patients." Doctoral dissertation, Otterbein University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1493059037547445

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Otterbein University and OhioLINK.