Validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department (NSCAIP-ED) instrument

Aim To report the development and validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department instrument, shortened NSCAIP-ED. Methods: A mixed-methods design was used to develop the instrument. It was used to conduct a survey where ED nurses self-evaluated their skills to care for acutely ill alcohol-intoxicated patients (N = 1220, n = 252). The data were utilised to perform instrument validation using confirmatory factor analysis (CFA) and Cronbach's alpha. Results: The construct validity was tested statistically. The CFA model fit indicators showed mostly acceptable fit (chi-square test p < 0.001; RMSEA 0.079; CFI 0.923; TLI 0.918; SRMR 0.084) and instruments' scales had well acceptable Cronbach's alpha values (all alphas were in the range of 0.866-0.912). Conclusions: The NSCAIP-ED is a feasible and reliable instrument that can be used when measuring nurses' skills to care for alcohol-intoxicated patients in the ED. This instrument could be useful for nursing managers in EDs for evaluating their nursing staff's skills in the care area in question, but also for designing continuing education based on the results.

Mental Health Nurses' Attitudes on Consumers with Dual Diagnosis: A Thematic Analysis

BACKGROUND

The issue of dual diagnosis continues to be a global health concern. There is a lack of empirical research on mental health nurses' attitudes toward consumers with dual diagnosis.

OBJECTIVE

This study aimed to answer the following research question: How do mental health nurses describe their attitude toward consumers with co-existing mental health and drug and alcohol problems?

DESIGN

This qualitative study employed purposive sampling to recruit participants. Semi-structured interviews were conducted to explore mental health nurses' attitudes toward consumers with dual diagnosis.

SETTING

This study focused on mental health nurses employed in mental health settings. It placed a particular emphasis on mental health nurses who had experience in caring for consumers with dual diagnosis. Seventeen mental health nurses participated in the interview.

METHODS

Interviews were transcribed verbatim and coded using NVivo™ 12 Plus software. Thematic analysis was used to generate codes and themes inductively.

RESULTS

Three major themes with a total of eight sub-themes were identified: (1) satisfaction and connection, with three subthemes; (2) combating negativity in others, with two subthemes; and (3) working to improve outcomes, with three subthemes.

CONCLUSIONS

Participants were concerned about their peers' sense of fear and frustration, stigmatized language, and lack of consistency in providing dual diagnosis training for mental health nurses. There is a need to investigate effective strategies to address mental health nurses' stigmatized attitudes, fear, and frustration toward consumers with dual diagnosis.

Nurses' Perception of Caring for Patients With Substance Use Disorder

ABSTRACT

The objective of this research was to explore the perceptions of nurses regarding patients with substance use disorder (SUD), healthcare provided, and desired resources to care for this population properly. This study used a cross-sectional, descriptive design. Data were collected via an anonymous 12-item survey and three open-ended questions. Data were analyzed using descriptive statistics and conventional content analysis. Nurses with less than 1 year of experience reported more significant challenges when caring for patients with SUD. These challenges included difficulties in managing pain, implementing alternative pain management techniques, and knowing who to contact when problems occur. The study revealed many needs of nurses to provide compassionate care for patients with SUD. Findings indicate a need for education for nurses, especially novice nurses, who care for patients with SUD.

The Complexity of Educating Acute Care Nurses on Opioid Use Disorder: A Quality Improvement Project

BACKGROUND

Opioid use disorder (OUD) is a public health crisis, yet most acute care nurses are not educated to deliver evidence-based OUD care. Hospitalization provides a unique opportunity to initiate and coordinate OUD care in people presenting for other medical-surgical reasons. The aim of this quality improvement project was to determine the impact of an educational program on self-reported competencies of medical-surgical nurses caring for people with OUD at a large academic medical center in the Midwestern United States.

METHOD

Data were collected from two time points using a quality survey examining self-reported nurse competencies related to (a) assessment, (b) intervention, (c) treatment recommendation, (d) resource use, (e) beliefs, and (f) attitudes toward caring for people with OUD.

RESULTS

Nurses surveyed before education (T1G1, N = 123) and, after education, those who received the intervention (T2G2, N = 17) and those who did not (T2G3, N = 65) were included. Resource use subscores increased over time (T1G1: x = 3.83, T2G3: x = 4.07, p = .006). Results from the two measurement points found no difference in mean total scores (T1G1: x = 3.53, T2G3: x = 3.63, p = .09). Comparison of mean total scores of nurses who directly received the educational program with those who did not during the second time point showed no improvement (T2G2: x = 3.52, T2G3: x = 3.63, p = .30).

CONCLUSIONS

Education alone was insufficient in improving self-reported competencies of medical-surgical nurses caring for people with OUD. Findings can be used to inform efforts to increase nurse knowledge and understanding of OUD and to decrease negative attitudes, stigma, and discriminatory behaviors perpetuating care.

Effective Nursing Recovery-Oriented Interventions for Individuals With Substance Use Disorder: A Literature Review

ABSTRACT

Nurses support the recovery of individuals with substance use disorder. How they support individuals, however, may impact the effectiveness of their work. For example, there are various paradigms of recovery that alter interventions. In addition, negative attitudes adopted by clinicians discourage individuals who use substances from accessing healthcare services, experiencing further health deterioration. Alternatively, nurses can enact interventions that promote positive experiences, further supporting the recovery of individuals. Hence, it is beneficial to increase nurses' awareness of effective interventions that promote recovery. The purpose of this literature review is to examine effective nursing interventions that promoted recovery of those with substance use disorders from the perspective of nurses and individuals who received nursing care. The review identified that effective interventions were based on three major themes: person-centered care, empowerment, and maintaining supports and capability enhancement. In addition, literature revealed that some interventions were perceived to be more effective; this depended on whose viewpoint was examined-nurses or individuals with substance use disorders. Finally, there are interventions based on spirituality, culture, advocacy, and self-disclosure that are often disregarded but may be effective. Nurses should utilize the more prominent interventions as they offer the most benefit and integrate interventions that are often overlooked.

Interprofessional Oncology Providers' Experiences and Knowledge of Opioid Use Disorders in Patients With Cancer

OBJECTIVES

To determine oncology providers' experiences and knowledge of opioid use disorders (OUDs) in patients with cancer.

SAMPLE & SETTING

The final sample of 773 participants included 42 physicians, 213 advanced practice providers (APPs), and 518 nurses at a large comprehensive cancer center.

METHODS & VARIABLES

This study used a cross-sectional descriptive survey to describe providers' experiences and knowledge of OUDs.

RESULTS

Nurses and APPs reported personal experiences with addiction and encountering issues with OUDs in patients more often compared to physicians. Knowledge deficits were identified regarding addiction, including evidence-based treatment for OUDs. Overall, OUDs are a topic of concern that the majority of oncology providers are interested in learning more about.

IMPLICATIONS FOR NURSING

The opioid epidemic presents an opportunity to improve the knowledge of interprofessional oncology providers addressing OUDs. Nurses and APPs are ideally positioned for the prevention and early recognition of patients with an OUD and cancer.

Nurses' Practices With Persons Experiencing Opioid Use Disorder: A Narrative Literature Review

ABSTRACT

Millions of persons globally use opioids, and more than two million persons in the United States report having opioid use disorder (OUD). Increases in overdose deaths associated with opioids have led to a declaration of an opioid epidemic in the United States. Many healthcare professionals are involved in the treatment of persons experiencing OUD; several discipline-specific (e.g., medicine and public health) interventions are available. Nurses comprise large portions of the global and national healthcare workforces; therefore, investigating their unique, disciplinary contributions for addressing the opioid epidemic is warranted. This narrative literature review was undertaken to understand nurses' actions, practices, and work with persons with OUD. Using several databases and keywords, 21 research studies met the inclusion criteria. Most studies used qualitative designs; most quantitative studies were nonexperimental. The studies were conducted mostly in Europe and North America. Descriptions of nurses' practices with people with OUD varied in their levels of specificity and aligned well with the scopes of practice outlined by the American Nurses Association and the International Nurses Society on Addictions. The absence of theories (specifically nursing theories) used in the studies was notable. Theoretically informed studies that move beyond descriptions of nurses' practices are needed to advance discipline-specific knowledge and to showcase the unique contributions of nurses who make significant contributions to lessening adverse outcomes associated with OUD.

Odnos medicinskih sester do pacienta, odvisnega od prepovedanih drog

Uvod: Odnos medicinskih sester do pacientov, odvisnih od prepovedanih drog, je dejavnik, ki vpliva tako na izid zdravljenja kot na rehabilitacijo pacientov, odvisnih od prepovedanih drog. Namen raziskave je bil raziskati odnos medicinskih sester do zdravstvene obravnave pacientov, odvisnih od prepovedanih drog.Metode: Uporabili smo analizo in sintezo pregleda dokazov iz zbirk podatkov CINAHL, ProQuest Dissertations & Theses Global, SpringerLink, WILEY in PubMed. Omejitvena kriterija iskanja sta bila: objava članka med letoma 2008 in 2018 ter dostopnost celotnega besedila članka v angleščini. Oblikovan je bil konceptualni model PICOT s ključnimi besedami: »nurses«, »substance use disorders«, »attitudes«. Ocena kakovosti dokazov je prikazana v hierarhiji dokazov. Podatki so bili obdelani s tematsko analizo.Rezultati: V končni pregled je bilo vključenih 18 izbranih ustreznih člankov, identificiranih je bilo 68 kod, ki so združene v pet vsebinskih kategorij: (1) dejavniki vpliva na negativen medosebni odnos; (2) dejavniki vpliva na pozitivnejši medosebni odnos; (3) psihopatološki, vedenjski in drugi dejavniki tveganja na strani pacienta, ki imajo pomen za kakovost medosebnega odnosa; (4) posledice neustreznega odnosa medicinskih sester za zdravstveno obravnavo pacientov; (5) ukrepi za preprečevanje predsodkov in stigmatizacije pacientov, odvisnih od prepovedanih drog.Diskusija in zaključek: Raziskava potrjuje negativni odnos medicinskih sester do pacientov, odvisnih od prepovedanih drog. Določeni dejavniki so povezani tako z negativnim kot s pozitivnim odnosom medicinskih sester do teh pacientov. Njihovo proučevanje in posledice za zdravstveno oskrbo pacientov, odvisnih od prepovedanih drog, pa zahtevajo dodatne raziskave.

Mental Health Nurses' Attitudes towards Consumers with co-Existing Mental Health and Drug and Alcohol Problems: A Scoping Review

Consumers with co-existing mental health and drug/alcohol problems are exposed to more stigma than those with any other health problems. This scoping review aimed to systematically map the available literature regarding mental health nurses' attitudes, empathy, and caring efficacy towards consumers with a dual diagnosis. Twenty studies reported outcomes regarding nurse attitudes; however, none reported nurses' empathy or caring efficacy towards consumers with a dual diagnosis. Further research is required to advance the evidence on the impact of mental health nurses' attitudes, empathy and caring effectiveness, and the outcomes should lead to improved service delivery for consumers with a dual diagnosis.

Opioid use disorder education for acute care nurses: An integrative review

AIMS AND OBJECTIVES

The purpose of this study was to explore opioid use disorder (OUD) education programmes presented to practicing nurses working in medical-surgical settings and identify the methods used to evaluate their effectiveness.

BACKGROUND

Health professionals often express negative attitudes towards patients with OUD which can lead to suboptimal care. Education decreases negative attitudes of healthcare workers. Despite this, few educational programmes are offered to promote knowledge among acute care nurses who work in medical-surgical settings and provide care to patients with OUD.

DESIGN

An integrative review.

METHODS

The framework by Whittemore and Knafl was used to examine empirical literature between 1995-2019 to answer the research questions, (a) What types of education do acute care nurses receive regarding OUD? (b) What methods are used for measuring educational intervention effectiveness? CINAHL, ERIC, PsycINFO and MEDLINE were searched using combinations of search terms and PRISMA guidelines. The initial 394 articles were narrowed to nine from the United States and Australia that met the search criteria and purpose of the review.

RESULTS

Educational programmes used to promote knowledge included interactive workshops, case studies, online modules, simulation sessions, real-time coaching and in-service trainings. Methods used to measure effectiveness of educational interventions were self-assessment tools that measured pre/postknowledge, attitude surveys, alcohol and drug scales and individual researcher-developed instruments.

CONCLUSIONS

Additional research is needed to determine best teaching strategies for increasing knowledge of OUD and OUD patient care. Valid and reliable methods for measuring effectiveness of OUD educational interventions are inadequate.

RELEVANCE TO CLINICAL PRACTICE

Knowledge of OUD has been linked to positive patient outcomes and nurses would benefit from up-to-date educational offerings. Opioid use disorder is a growing global concern. Translation of current OUD nursing science to acute care nurses would promote health equity in practice for individuals with OUD.

Compassionate Care of the Patient Who Uses Substances: Implications for the Infusion Nurse

Given the high rate of infection secondary to substance use, infusion nurses have a unique opportunity to compassionately engage individuals with substance use problems. Compassion is an essential ingredient of nursing practice, yet compassionate care of the individual who uses substances may seem difficult to navigate. This article provides the infusion nurse with the essential principles of compassionate care of the patient who uses substances. A fundamental understanding of how to work with patients who use substances may enhance the infusion nurse's practice.

Systematic Review of Continuing Education Interventions for Licensed Nurses Working in Psychiatry

Continuing education is an important part of nursing practice. These interventions help maintain clinical competence and are mandated by regulatory bodies. Often, continuing education interventions are created ad hoc and implemented without testing or formal evaluation of learning outcomes. In the current health care context, where resources are limited, educators are pressed to do more with less. Having access to a repository of existing continuing education interventions will facilitate the use of evidence-informed learning strategies and save valuable time by reducing duplication of efforts. Therefore, this systematic review aimed to explore continuing education interventions for licensed nurses working in psychiatry. All standard systematic review procedures were followed, including double screening, data extraction, and quality appraisal. This article presents an inventory of existing interventions, including summaries, as well as the reported effectiveness of each for nursing outcomes. Generally, the continuing education interventions result in positive nurse-related outcomes, such as increased knowledge, confidence, and skills, or improved attitudes; however, more rigorous research is needed to advance science in this area. [J Contin Educ Nurs. 2019;50(5):233-240.].