Making the case for harm reduction programs for injection drug users

Hepatitis B immunity among undergraduate nursing students: A brief report

BACKGROUND

Health sciences students who report low/equivocal hepatitis B titers may be required to repeat the immunization series, even though the result may not indicate non-immunity.

METHOD

To describe hepatitis B immunity patterns, this retrospective, descriptive study utilized de-identified vaccination records and anti-HBs titers of three cohorts of sophomore nursing students entering clinical rotations in 2018-2019.

RESULTS

Only 33% of students had initial anti-HBs quantitative serum titer ≥10 mIU/ml, demonstrating immunity. After students with low/equivocal titers (n = 191, 64%) were re-immunized per institution protocol, only 2% (n = 7) were identified as non-responders. Cumulative costs incurred by students for revaccination and repeat titer exceeded $20,000, with a process time of up to 8 months.

CONCLUSION

While rates of exposure to hepatitis B in acute care settings have steadily declined in the United States, students who go on to practice in community and public health settings have increased risk of exposure. Following best practices in demonstrating hepatitis B immunity, which include a single challenge dose followed by titer 4 weeks later, would decrease per student costs, wait time, and administrative burden associated with documentation and student counseling.

Exploring Substance Use Disorder Nursing Competency in the Italian Context

BACKGROUND

In Italy, the majority of people treated in Addiction Treatment Service are heroin users. Nurses represent a strategic position in the multiprofessional and multidisciplinary Addiction Treatment Service team.

AIMS

To describe the addiction nurses' competency in the Italian context.

METHOD

This research uses the qualitative approach to describes the addiction nurses' competency. The research was divided into two steps: ethnographic, to identify activities, habits, settings, critical issues and other distinctive features characterizing addiction nursing specific competencies, and a subsequent phenomenological semistructured interview to understand the lived and the meanings of the experience.

RESULTS

The meaning units identified could be organized as follows: ability to manage unexpected events, work organization, and teamwork relationships, professional responsibility.

CONCLUSIONS

Many of these described competencies, if considered in general terms, relate to any area of the profession. It is possible to understand their specificity by investigating the meanings and the values attributed to the personal experience This study attempts to develop and define an Italian addiction nursing competency framework.

Opportunities to Offer Harm Reduction to People who Inject Drugs During Infectious Disease Encounters: Narrative Review

Increased rates of overdose (OD) and blood-borne infections have been associated with injection drug use (IDU). This increasing overlap between IDU-related infectious diseases (ID) is a byproduct of the opioid OD crisis, especially with the transition to synthetic opioids with faster onset and shorter duration leading to potentially more frequent injections. ID specialists are uniquely positioned to positively impact the opioid OD crisis by capitalizing on opportunistic moments of engagement during clinical encounters with people who inject drugs (PWID). Harm reduction services should therefore be expanded and offered to PWID in ID settings to reduce rates of OD, infection, and hospitalization. Major target areas include (1) teaching and distribution of materials related to safer injection practice such as sterile injection supplies, fentanyl test strips, and naloxone; (2) increased screening and access to pre-exposure prophylaxis and postexposure prophylaxis; and (3) initiation of medications for opioid use disorder. Incorporating these strategies in various treatment settings can expand treatment access, improve patient outcomes, and reduce stigma associated with IDU.