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Gerolamo AM, Delaney KR, Phoenix B, Black P, Rushton A, Stallings J. Psychiatric Nursing Workforce Survey: Results and Implications. J Am Psychiatr Nurses Assoc 2024; 30:690-696. [PMID: 36582042 DOI: 10.1177/10783903221146190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The last national survey of psychiatric-mental health (PMH) nurses was conducted in 2016 and was limited to advanced practice registered nurses (APRNs). Data on the demographic and employment characteristics of the PMH workforce could inform how to optimize the PMH nursing workforce to address increasing demands for mental health services. The objective was to conduct a national survey of PMH registered nurses (RNs) and PMH-APRNs to gather data on their demographic, educational, and practice characteristics. METHODS An email survey was administered between October 2020 and February 2021 to all members of the American Psychiatric Nurses Association and to all PMH-APRNs certified by the American Nurses Credentialing Center. Separate surveys included 51 questions (RN) and 52 questions (APRN). Survey questions were informed by several sources including the Minimum Data Set for the Behavioral Health Workforce. RESULTS Surveys were completed by 4,088 PMH-RNs and 5,158 PMH-APRNs, with a combined response rate of 12.1%. Findings suggest that the workforce is aging but has increased slightly in diversity. In all, 62.4% of RNs reported a hospital as their primary employment setting, while the majority of APRNs (70.4%) practice in outpatient settings. Forty-four percent of the PMH-APRN respondents indicated that most of their patients receive federal insurance. CONCLUSIONS Nursing must plan for significant retirements in the PMH workforce in next 5 years. Hospital-based practice continues to dominate PMH-RN roles but might be expanded to community-based settings teaming with PMH-APRNs in outpatient sites. Increasing the diversity of the workforce should be prioritized.
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Affiliation(s)
- Angela M Gerolamo
- Angela M. Gerolamo, PhD, CRNP, PMHNP-BC, Jefferson College of Nursing, Philadelphia, PA, USA
| | - Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMHNP-BC, FAAN, Rush College of Nursing, Chicago, IL, USA
| | - Bethany Phoenix
- Bethany Phoenix, PhD, RN, FAAN, UCSF School of Nursing, San Francisco, CA, USA
| | - Patricia Black
- Patricia Black, PhD, RN, FAAN, APNA, Falls Church, VA, USA
| | - Amy Rushton
- Amy Rushton, DNP, PMHCNS-BC, HCA Healthcare, Nashville, TN, USA
| | - Janette Stallings
- Janette Stallings, MA, MSN, APRN, PMHNP-BC, Thrive Mental Health, LLC, Bellevue, NE, USA
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2
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Incze MA, Azari S, Finnell DS. Amplifying the Strength and Leadership of Nurses in Opioid Use Disorder Care-Loud and PROUD. JAMA Intern Med 2023; 183:1354-1356. [PMID: 37902745 DOI: 10.1001/jamainternmed.2023.5712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Affiliation(s)
- Michael A Incze
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah, Salt Lake City
| | - Soraya Azari
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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Tierney M, Castillo E, Leonard A, Huang E. Closing the Opioid Treatment Gap Through Advance Practice Nursing Activation: Curricular Design and Initial Outcomes. J Addict Nurs 2023; 34:240-250. [PMID: 38015575 DOI: 10.1097/jan.0000000000000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Buprenorphine, an effective medication for opioid use disorder (MOUD), reduces opioid-related harms including overdose, but a significant gap exists between MOUD need and treatment, especially for marginalized populations. Historically, low MOUD treatment capacity is rising, driven by advanced practice registered nurses (APRNs). A graduate nursing course was designed to increase equitable buprenorphine treatment delivery by APRNs. We report on baseline findings of a curriculum evaluation study with a pretest-posttest design. DESIGN Computerized surveys assessed trainee satisfaction with the course, trainee knowledge for providing MOUD, and trainee satisfaction in working with people who use drugs. METHODS Quantitative survey results utilizing Likert scales are presented. RESULTS Baseline precourse surveys revealed less than half (44%) of APRN students agreed/strongly agreed that they had a working knowledge of drugs and drug-related problems and 37% agreed/strongly agreed that they knew enough about the causes of drug problems to carry out their roles when working with people who use drugs. Approximately two thirds of APRN students agreed/strongly agreed that they want to work with people who use drugs (63%), that it is satisfying to work with people who use drugs (66%), and that it is rewarding to work with people who use drugs (63%). Nearly all students reported high satisfaction with the course. CONCLUSION APRN students reported high satisfaction with a novel course grounded in health equity that has potential to reduce health disparities and accelerate the closure of the MOUD treatment gap, particularly for racial/ethnic minorities, rural populations, and transition-age youth.
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de Vargas D, Ramírez EGL, Pereira CF, de Oliveira SR. Telenursing in mental health: effect on anxiety symptoms and alcohol consumption during the COVID-19 pandemic. Rev Lat Am Enfermagem 2023; 31:e3932. [PMID: 37283418 PMCID: PMC10243443 DOI: 10.1590/1518-8345.6172.3932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 02/26/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE (1) A remote intervention with a positive impact on reducing anxiety and alcohol use. (2) Nursing as a protagonist of preventive care in mental health (3) A low-cost intervention that covers several population groups. (4) Telenursing in mental health as a care strategy during COVID-19. to investigate the effect of a remote intervention on anxiety symptoms and alcohol use in users of the Primary Health Care service. METHOD a quasi-experimental study conducted with 1,270 participants who answered the Alcohol Use Disorders Identification Test and the State-Trait Anxiety Inventory-6. Of these, 1,033 interviewees scored for moderate/severe anxiety symptoms (STAI-6 > 3) and moderate/severe risk alcohol use (AUDIT-C > 3), and received the interventions via telephone calls with follow-up periods lasting seven and 180 days. For data analysis, a mixed-effects regression model was used. RESULTS the effect of the intervention performed was positive in reducing anxiety symptoms between T0 and T1 (µ=1.6, p<0.001) and in reducing the alcohol use pattern between T1 and T3 (µ=1.57, p<0.001). CONCLUSION the follow-up results suggest a positive effect of the intervention in reducing anxiety and the alcohol use pattern, which tends to be maintained over time. There is diverse evidence that the intervention proposed can be an alternative for preventive care in mental health, in situations where accessibility of the user or the professional is compromised.
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Affiliation(s)
- Divane de Vargas
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Erika Gisseth León Ramírez
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Universidade de Guarulhos, Guarulhos, SP, Brasil
- Becaria de la Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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5
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Phoenix BJ, Tierney M, Chapman SA, Spetz J. Influences on advance practice nursing education to prescribe medications for opioid use disorder. Nurs Outlook 2023; 71:101963. [PMID: 37003088 PMCID: PMC11060844 DOI: 10.1016/j.outlook.2023.101963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Opioid misuse is a major public health concern in the United States. Opioid agonist medications are evidence-based treatments for opioid use disorders (OUD) that can be prescribed by advance practice registered nurses (APRNs) with prescriptive authority and appropriate training. PURPOSE Article examines factors influencing preparation to provide medications for opioid use disorder (MOUD) in APRN education. METHODS Data from semi-structured interviews addressing the role of education in preparing APRNs to provide MOUD were grouped into key themes using thematic analysis. Data were collected in a mixed methods study in four states with high opioid overdose deaths whose main findings were previously published. FINDINGS Two overarching themes emerged: "addressing attitudes" and "curriculum change." Sub-themes include affective barriers to providing OUD treatment; motivation to respond to the OUD crisis; and attitude change through experience with MOUD. DISCUSSION AND CONCLUSION APRNs can play a key role in reducing the harms caused by OUD. Attention to attitudinal issues, such as stigma, toward people using opioids is important in educating APRNs about providing MOUD.
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Affiliation(s)
- Bethany J Phoenix
- Department of Community Health Systems, University of California San Francisco School of Nursing, San Francisco, CA, USA.
| | - Matthew Tierney
- Department of Community Health Systems, University of California San Francisco School of Nursing, San Francisco, CA, USA.
| | - Susan A Chapman
- Department of Social and Behavioral Sciences, University of California San Francisco School of Nursing, San Francisco, CA, USA.
| | - Joanne Spetz
- University of California San Francisco, Philip R. Lee Institute for Health Policy Studies, San Francisco, CA, USA.
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Slater TM, Rodney T, Finnell DS. Promoting the integration of peer support specialists into the healthcare team. Nursing 2023; 53:50-55. [PMID: 36700816 DOI: 10.1097/01.nurse.0000903972.32588.ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
ABSTRACT The 21st Century Cures Act to address the opioid crisis spurred the expansion of the peer support specialist (PSS) workforce. Nurses are in key positions to promote the successful integration of the PSS into the healthcare team. This article describes the role of the PSS, including key functions that overlap with those of nurses and ways they can help mitigate stigma, which remains a significant barrier to patients' access to treatment.
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Affiliation(s)
- Tammy M Slater
- At Johns Hopkins School of Nursing in Baltimore, Md., Tammy Slater is an assistant professor and the Adult-Gerontology Acute Care Nurse Practitioner Track Coordinator, Tamar Rodney is an assistant professor and the Advanced Practice Psychiatric Mental Track Coordinator, and Deborah S. Finnell is a Professor Emerita
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Fox JM, Wason K, Beers D, Faulds M, Lincoln N, Tomanovich M, Gaden NW, Komaromy Md M. The Creation of an Addiction Nursing Fellowship Program for Registered Nurses: A Unique Approach to Enhancing the Addiction-Treatment Workforce. Subst Abus 2023; 44:24-31. [PMID: 37226903 DOI: 10.1177/08897077231169566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In 2020, Boston Medical Center and the Grayken Center for Addiction launched an addiction nursing fellowship to enhance registered nurses' knowledge and skills related to the care of patients with substance use disorders and to improve patient experience and outcomes. This paper describes the development and essential components of this innovative fellowship, to our knowledge the first of its kind in the United States, with the goal of facilitating replication in other hospital settings.
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Affiliation(s)
- Jason M Fox
- Addiction Consult Service, Boston Medical Center, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Kristin Wason
- Boston University School of Medicine, Boston, MA, USA
- Grayken Center for Addiction Training and Technical Assistance, Boston Medical Center, Boston, MA, USA
| | - Donna Beers
- HEALing Communities-Massachusetts Study, Boston Medical Center, Boston, Massachusetts, USA
| | | | | | - Mary Tomanovich
- Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA
| | | | - Miriam Komaromy Md
- Boston University School of Medicine, Boston, MA, USA
- Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA
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Landis RK, Opper I, Saloner B, Gordon AJ, Leslie DL, Sorbero M, Stein BD. Buprenorphine treatment episode duration, dosage, and concurrent prescribing of benzodiazepines and opioid analgesics: The effects of Medicaid prior authorization policies. Drug Alcohol Depend 2022; 241:109669. [PMID: 36332589 PMCID: PMC10695272 DOI: 10.1016/j.drugalcdep.2022.109669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/29/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Buprenorphine is an effective medication for the treatment of opioid use disorder (OUD), but the association between prior authorization policies and quality of care for individuals receiving buprenorphine treatment is not well-understood. METHODS Using 2006-2013 Medicaid Analytic eXtract (MAX) data from 34 states and the District of Columbia, we identified 294,031 episodes of buprenorphine treatment for OUD among individuals aged 14-64 years. We estimated generalized difference-in-differences models to examine the association between buprenorphine prior authorization policies and changes in buprenorphine treatment quality along four dimensions: (1) duration of at least 180 days, (2) dosage of at least 8 milligrams, and concurrent prescribing of (3) opioid analgesics and (4) benzodiazepines. RESULTS Buprenorphine prior authorization policies were associated with an 11-percentage point reduction (p < 0.01) in the likelihood of episodes with a duration of at least 180 days in the first four years after policy implementation. The policy was not associated with changes in effective dosage or concurrent prescribing of opioid analgesics or benzodiazepines. CONCLUSIONS Buprenorphine prior authorization policies were associated with a sizeable and significant reduction in episodes of at least 180 days duration, underscoring the importance of identifying and removing barriers to effective and appropriate OUD care.
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Affiliation(s)
- Rachel K Landis
- RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202, USA.
| | - Isaac Opper
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA.
| | - Brendan Saloner
- Department of Health Policy and Management, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, USA; Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
| | - Douglas L Leslie
- Department of Public Health Sciences and Center for Applied Studies in Health Economics, Penn State College of Medicine, Hershey, PA 17033, USA.
| | - Mark Sorbero
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Bradley D Stein
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
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Finnell DS, Soltis-Jarrett V, Bratberg J, Muzyk A, Liu Y, Edens E, Seale JP, Mattingly J, Schnurman K, Osborne-Leute V, Zweben A, Cary A, Moore BA. Substance use-related continuing education course objectives: Alignment with professional competencies. Subst Abus 2022; 43:1363-1369. [PMID: 36094441 DOI: 10.1080/08897077.2022.2112365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Background: Novel educational efforts are needed to prepare the current and future interprofessional health care workforce to address the range of substance use-related health problems. A 6-module massive open online course (MOOC) was developed to provide education to health professionals of various disciplines on the fundamentals of substance use-related treatment. The purpose of this project was to match course objectives to substance use-related competencies for 5 disciplines: nurses, pharmacists, physicians, physician assistants (PA), and social workers. Methods: Content expert raters within each discipline determined what Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) core competencies were matched to each objective for the 6 modules of the MOOC. The number of objectives across the 6 modules was summated. Results: All nursing and social work competencies were mapped to the course objectives. For physicians, PAs, and pharmacists, the proportions of knowledge-based competencies that mapped to the course objective were 58%, 76%, and 80%, respectively, and proportions of skill-based competencies that mapped to the course objective were 88%, 83%, and 75%, respectively. For those 3 groups, 100% of attitude-based competencies mapped to the course objective. Conclusions: The competency-based mapping with the MOOC objectives supports the interprofessional design of the course and discipline-specific competencies needed to promote the best outcomes for patients.
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Affiliation(s)
- Deborah S Finnell
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Victoria Soltis-Jarrett
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffrey Bratberg
- College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
| | - Andrew Muzyk
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Yifei Liu
- Division of Pharmacy Practice and Administration, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Ellen Edens
- Yale School of Medicine, New Haven, Connecticut, USA
| | - J Paul Seale
- Departments of Psychiatry and Family Medicine and Institute of Public and Preventive Health, Augusta University, Augusta, Georgia, USA
| | - Jill Mattingly
- College of Health Professions, Mercer University, Atlanta, Georgia, USA
| | - Kristen Schnurman
- Department of Physician Assistant Studies, South University, Richmond, Virginia, USA
| | | | - Allen Zweben
- School of Social Work, Columbia University, New York, New York, USA
| | - Ann Cary
- Marieb College of Health and Human Services and The Water School, Florida Gulf Coast University, Fort Myers, Florida, USA
| | - Brent A Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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10
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Finnell DS. Letter to the Editor: Commentary on "Exploring Substance Use Disorder Nursing Competency in the Italian Context" by J. Acquaro, S. Scalzo, and A. Procacci (2022). J Am Psychiatr Nurses Assoc 2022; 28:269-270. [PMID: 35708456 DOI: 10.1177/10783903221104044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Roles and Perceptions of Nurses During Implementation of a Medication Treatment for Opioid Use Disorder National Initiative. J Addict Nurs 2022; 33:70-79. [PMID: 35640210 DOI: 10.1097/jan.0000000000000455] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND In the United States, a national priority exists to improve access to medication treatment for opioid use disorder (MOUD). Nurses can be an essential component of that care. We examined the perceptions and evolving roles of nurses in a national Veterans Health Administration (VHA) initiative designed to improve MOUD access within general medical settings. METHODS From April 15, 2021, to June 16, 2021, we recruited nurses participating in VHA's Stepped Care for Opioid Use Disorder Train the Trainer Initiative-a national program intending to implement MOUD in general medical settings-to participate in an interview about their roles, perceptions, and experiences. The respondents answered our inquiries through an interview or responded to an email solicitation with written responses, which were then recorded, transcribed, and independently coded to identify themes. RESULTS Nurses from 10 VHA facilities participated in an interview (n = 7) or completed the questionnaire (n = 4). Inadequate staffing, high patient-to-provider ratios, and time constraints were identified as barriers to MOUD care. Mentorship activities, existing VHA informational resources, and patients' willingness to accept treatment were identified as facilitators of MOUD care. The Stepped Care for Opioid Use Disorder Train the Trainer Initiative processes were acknowledged to promote role confidence, which in turn increased job satisfaction and empowered nurses to become content experts. Respondents often identified nurses as local lead facilitators in MOUD care. CONCLUSIONS In a national initiative to implement MOUD within general medical settings, nurses identified several barriers and facilitators to MOUD implementation. Nurses play vital collaborative care roles in enhancing access to MOUD.
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Diaz Heredia LP, de Vargas D, Ramírez EGL, Naegle M. Nursing students' attitudes towards alcohol use disorders and related issues: A comparative study in four American countries. Int J Ment Health Nurs 2021; 30:1564-1574. [PMID: 34231303 DOI: 10.1111/inm.12906] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 11/30/2022]
Abstract
The present study identified and compared the attitudes of nursing students from North and South American countries towards alcohol, alcohol use disorders and persons with alcohol use disorders (AUDs). A cross-sectional design and survey approach were used. The sample consisted of 327 nursing students recruited from four nursing schools in metropolitan regions of North and South America. The questionnaire contained questions about sex, age, marital status, home country and other questions about training in substance use disorders during nursing education and previous experiences with substance use disorder patients. To identify nursing students' attitudes, validated English, Spanish and Portuguese versions of the attitudes scale for alcohol, alcoholism and persons with AUDs (EAFAA) were applied. Comparison of the four groups suggested that nursing students in the United States demonstrated more positive attitudes than students from Colombia, Mexico and Brazil. Similar positive attitudes were observed towards individuals with AUDs. Results of the attitudes towards the aetiology of AUDs showed positive attitudes in all samples, suggesting a contemporary understanding of AUDs. Nursing students' attitudes were associated with home country and training in substance use disorders during nursing education. Nursing students' attitudes were generally positive across countries. Idiosyncratic cultural and educational aspects in these countries and world regions likely significantly influenced the attitudes of nursing students towards alcohol and associated issues.
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Affiliation(s)
| | - Divane de Vargas
- Nursing College of University of São Paulo, São Paulo, SP, Brazil
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Belintxon M, Calatrava M, Osorio A, Balaguer Á, Vidaurreta M. Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study. J Adv Nurs 2021; 78:1990-2003. [PMID: 34821407 DOI: 10.1111/jan.15100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/24/2021] [Accepted: 11/04/2021] [Indexed: 12/30/2022]
Abstract
AIMS To determine the associations between internal assets (planning and decision-making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs). DESIGN A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru). METHODS Adolescents aged 12-18 self-completed a multi-purpose questionnaire between 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision-making, interpersonal competence, and commitment to learning) and substance use. RESULTS The results indicate that planning and decision-making and commitment to learning are conducive to the prevention of substance use. On the contrary, interpersonal competence was not associated with substance use. CONCLUSION The present study shows that planning and decision-making and commitment to learning can be relevant factors in explaining substance use during adolescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These findings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adolescents. Furthermore, the Developmental Assets framework has been proved as a suitable frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use.
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Affiliation(s)
- Maider Belintxon
- School of Nursing, Department of Community, Maternity and Pediatric Nursing, Universidad de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - María Calatrava
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,Institute for Culture and Society, Universidad de Navarra, Pamplona, Spain
| | - Alfonso Osorio
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,Institute for Culture and Society, Universidad de Navarra, Pamplona, Spain.,School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
| | - Álvaro Balaguer
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
| | - Marta Vidaurreta
- School of Nursing, Department of Community, Maternity and Pediatric Nursing, Universidad de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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14
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Changes in Nursing Students' Attitudes and Perceptions After Receipt of Enhanced Substance Use-Related Curricular Content. J Addict Nurs 2021; 33:62-69. [PMID: 34839300 DOI: 10.1097/jan.0000000000000427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Negative attitudes toward persons who use alcohol and other drugs contribute to suboptimal care. Nurses are in key roles to address the needs of this population, yet they lack the education needed to identify persons who may be at risk because of substance use and intervene accordingly. The purpose of this study was to evaluate the impact of a substance-use-related curriculum on nursing students' attitudes and therapeutic commitment for working with patients with alcohol- and drug-use-related problems. METHODS Data were collected for four cohorts of 169 nursing students enrolled in a Master's Entry into Nursing program. Questionnaires included the Person-Centered Alcohol and Alcohol Problems Perception Questionnaire and the Drug and Drug Problems Perception Questionnaire, completed before and after completing the curriculum. Paired samples t test were used to examine pre/post differences for each measure's subscale. RESULTS Four of the seven Person-Centered Alcohol and Alcohol Problems Perception Questionnaire subscales showing significant increases were role adequacy, role support, role legitimacy, and general perceptions. Four of the five Drug and Drug Problems Perception Questionnaire subscales showing significant increases were role adequacy, role support, job satisfaction, and role legitimacy; there was a significant change in role-related self-esteem, however, in a negative direction. CONCLUSIONS This study adds to the growing evidence of the positive impact of providing evidence-based information and skill development, which enhance alcohol- and drug-related knowledge and competence for nurses entering professional practice.
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R-E-S-P-E-C-T: Psychosocial Factors Outdo Employment Conditions in Predicting Job Satisfaction and Turnover Intentions for AOD Nurses and Counsellors. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00676-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Magel J, Kietrys D, Kruger ES, Fritz JM, Gordon AJ. Physical therapists should play a greater role in managing patients with opioid use and opioid misuse. Subst Abus 2021; 42:255-260. [PMID: 34524070 DOI: 10.1080/08897077.2021.1971818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The U.S. opioid crisis necessitates that health care providers of all types work collaboratively to manage patients taking prescription opioid medications and manage those who may be misusing prescription opioids. Musculoskeletal conditions are the most common diagnoses associated with an opioid prescription. Physical therapists commonly manage patients with musculoskeletal conditions and chronic pain. Some patients who attend physical therapy for pain management take prescription opioid medications for pain and some of these patients may be misusing prescription opioids. Physical therapists who manage patients with musculoskeletal conditions are well-positioned to help address the opioid crisis. Historically, physical therapists have not been adequately engaged in efforts to manage persons with co-occurring musculoskeletal pain and opioid misuse or OUD. The American Physical Therapy Association (APTA) has emphasized physical therapy over the use of prescription opioids for the management of painful conditions. The APTA, however, does not highlight the important role that physical therapists could play in monitoring opioid use among patients receiving treatment for pain, nor the role that physical therapists should play in screening for opioid misuse. Such screening could facilitate referral of patients suspected misuse to an appropriate provider for formal assessment and treatment. This commentary presents simulated musculoskeletal patient presentations depicting 2 common opioid use states; chronic opioid use and opioid misuse. The cases highlight and interactions that physical therapists could have with these patients and actions that the physical therapist could take when working inter-disciplinarily. Recommendations are provided that aim to increase physical therapists' knowledge and skills related to managing patients taking prescription opioid medications for pain.
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Affiliation(s)
- John Magel
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - David Kietrys
- Department of Rehabilitation and Movement Sciences, Rutgers School of Health Professions, Newark, NJ, USA
| | - Eric S Kruger
- School of Medicine, Department of Orthopaedics and Rehabiliation, Division of Physical Therapy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Julie M Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
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Wason K, Potter A, Alves J, Loukas VL, Lastimoso C, Sodder S, Caputo A, LaBelle CT. Addiction Nursing Competencies: A Comprehensive Toolkit for the Addictions Nurse. J Nurs Adm 2021; 51:424-429. [PMID: 34411061 DOI: 10.1097/nna.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
With the increased role of nurses in caring for patients with substance addiction, there was a clear need to develop the Addiction Nursing Competencies to guide and support the nursing workforce. A literature search revealed a lack of formal instruments to assess and guide nurses in caring for persons with substance use disorders. The Addiction Nursing Competencies were created using existing nursing education frameworks and addiction nurse care manager clinical guidelines.
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Affiliation(s)
- Kristin Wason
- Author Affiliations: Clinical Nurse Educator (Mss Wason, Potter, and Lastimoso; Mr Alves; and Dr Caputo), Project Coordinator (Ms Sodder), and Director (Ms LaBelle), Office-Based Addiction Treatment Training and Technical Assistance, Boston Medical Center; Assistant Professor of Medicine (Mss Wason, Potter, and Lastimoso), School of Medicine, Boston University; and Administrative Director (Ms Loukas), Addiction Services Department, East Boston Neighborhood Health Center, Boston, Massachusetts
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Jones KF, Ho JJ, Sager Z, Childers J, Merlin J. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness. Am J Hosp Palliat Care 2021; 39:101-107. [PMID: 33685244 DOI: 10.1177/1049909121999783] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The majority of Palliative Care (PC) clinicians report recently caring for a person with a Substance Use Disorder (SUD). The impact of an untreated SUD is associated with significant suffering but many PC clinicians report a lack of confidence in managing this population. OBJECTIVE This paper aims to demonstrate existing PC skills that can be adapted to provide primary SUD treatment. METHODS A comprehensive literature review was conducted on quality PC domains and core SUD treatment principles. To demonstrate the shared philosophy and skills of PC clinicians and SUD treatment, the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care and resources outlining core Addiction Medicine and Nursing Competencies were used. RESULTS There is an abundance of overlapping domains in PC and SUD treatment. This paper focuses on the domains of communication, team-based care, quality of life considerations, addressing social determinants of health, and adherence to ethical principles. In each section, the shared domain in PC and SUD treatment is discussed and steps to expand PC clinician's skills are provided. CONCLUSION PC clinicians may be among the last healthcare touchpoint for persons with SUD, by naming the shared skills required in PC and evidenced-based SUD treatment, we challenge the field to undertake primary SUD treatment as part of its constant pursuit to better serve people living with serious illness.
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Affiliation(s)
| | - J Janet Ho
- University of California San Francisco, San Francisco, CA, USA
| | - Zachary Sager
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Julie Childers
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jessica Merlin
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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19
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Tierney M, Finnell DS, Naegle M, Mitchell AM, Pace EM. "The Future of Nursing: Accelerating gains made to address the continuum of substance use". Arch Psychiatr Nurs 2020; 34:297-303. [PMID: 33032749 DOI: 10.1016/j.apnu.2020.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/17/2019] [Accepted: 07/02/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE Guided by four key messages from the decade-old Institute of Medicine (IOM) report, "The Future of Nursing," this paper highlights the progress made by the nursing profession in addressing substance use and its related disorders and offers recommendations to sustain and advance efforts to enhance care for persons who use substances, one of the most stigmatized and vulnerable populations. RESULTS Patterns of substance use have shifted over the past 10 years, but the associated harms remain consequential. As awareness of the continuum of substance use has expanded, the care of persons with substance use has also expanded, from the domains of psychiatric-mental health and addictions nursing specialties to the mainstream of nursing. Now, greater efforts are being undertaken to identify and intervene with persons at risk for and experiencing substance use disorders. Nurses have advanced the knowledge and skills necessary for substance-related nursing care including education and training, leadership, care innovations, and workforce expansion and can drive efforts to increase public knowledge about the health risks associated with substance use. Recommendations aligned with each of the four IOM key messages are offered. CONCLUSIONS As a profession, nursing has a responsibility to expand the progress made in addressing substance use - from prevention and early intervention to tertiary care. Nurses at all levels of education and practice are in key positions to carry out the recommendations herein to accelerate the changes needed to provide high quality care for persons impacted by substance use.
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Affiliation(s)
- Matthew Tierney
- University of California San Francisco School of Nursing, 2 Koret Way, San Francisco, CA 94143, United States of America.
| | - Deborah S Finnell
- Professor Emerita, Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, United States of America.
| | - Madeline Naegle
- Professor Emerita, NYU Rory Meyers College of Nursing, 433 First Avenue, New York, NY 10010, United States of America.
| | - Ann M Mitchell
- University of Pittsburgh School of Nursing, 3500 Victoria Street, Pittsburgh, PA 15261, United States of America.
| | - Elizabeth M Pace
- Chief Executive Officer, Peer Assistance Services, Inc., 2170 S. Parker Road, Ste. 229, Denver, CO 80231, United States of America.
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20
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The crucial role of all current and future nurses in addressing the continuum of substance use. Nurs Outlook 2020; 68:682-684. [DOI: 10.1016/j.outlook.2020.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Guilamo-Ramos V, Benzekri A, Thimm-Kaiser M, Abram M, Hagan H. Participation of the nursing workforce to address COVID-19 among people who use alcohol, tobacco, and drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 83:102831. [PMID: 32654929 PMCID: PMC7332926 DOI: 10.1016/j.drugpo.2020.102831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY, USA; Adolescent AIDS Program, Children's Hospital at Montefiore Medical Center, 3514 Wayne Avenue, Bronx, NY, USA; Center for Drug Use and HIV Research, New York University, 665 Broadway, New York, NY, USA; U.S. Presidential Advisory Council on HIV/AIDS, Washington, DC, USA.
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY, USA
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, New York University, 15 Washington Place, New York, NY, USA; City University of New York, School of Public Health and Health Policy, New York, NY, USA
| | - Marissa Abram
- College of Nursing and Public Health, Adelphi University, 1 South Avenue, Garden City, NY, USA; Pulse Center for Patient Safety Education and Advocacy, PO Box 353, Wantagh, NY, USA
| | - Holly Hagan
- Center for Drug Use and HIV Research, New York University, 665 Broadway, New York, NY, USA; College of Global Public Health, New York University, 665 Broadway, New York, NY, USA
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22
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Abstract
BACKGROUND Screening, brief intervention, and referral to treatment (SBIRT) for substance use has an impact on morbidity and mortality and health care cost. LOCAL PROBLEM Nurses in ambulatory care settings may lack knowledge about evidence-based substance use SBIRT. METHODS A comparison of pre- and postintervention data was performed to determine whether knowledge improved and to identify facilitators and barriers to SBIRT implementation. INTERVENTIONS Nurses completed an online self-paced program focusing on alcohol and drug use screening, motivational interviewing used in a brief intervention, and referral to specialty treatment. RESULTS Postintervention knowledge scores increased (P < .001). Facilitator and barrier themes included time, education, resources, receptivity, and interprofessional collaboration. CONCLUSIONS The implementation of the SBIRT online program was feasible for nurses to complete during work hours and resulted in increased SBIRT-related knowledge.
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