Substance Abuse: The Quest to Diminish the Disparity

Patrice D. Kiesling, BSN, RN

Bonnie K. Sanderson, PhD, RN

Introduction

Test of Change

Background

Purpose

Mental health and substance use disorders will

surpass all physical disease as a major cause of
disability worldwide, burdening the health care
system.

The purpose of this project was to assess if

specific training or information would create
an environment where the nurse would have a
greater comfort level to address a patient who
suffers from substance use disorder.
To assess the feasibility and acceptability of
providing the education through website.

PICO Question
In adults with identified or suspected substance
abuse, how does enhanced education of
healthcare providers and protocols for appropriate
screening and referral options compare to the
current practice to increase referral rates to
outpatient referral for substance abuse programs,
which may reduce the risk of future hospital
seeking behaviors?

Literature Search
Databases searched included CINAHL,
ProQuest, PubMed, and Medline. Eleven studies
were used, including: 7 Correlational studies, 2
Quasi-experimental, and a Clinical Practice
Guideline. The CPG was from the Michigan
Quality Improvement Consortium (MQIC) on
substance abuse was obtained.
Evidence-based practice recommends the
following at every healthcare visit: Screening,
Diagnosing, Intervening, and Referrals.

Graduate Student, PCNP Program

Faculty Advisor

Methods
Potential participants, nurse colleagues, were
recruited via email with the instruction to share
with other nurses. The email contained
instructions for a pre-survey, an educational
presentation, and a post-survey. The educational
presentation addressed information on the
assessment, diagnosis, and intervention of
persons suffering from Substance Use Disorder
(SUD), as recommended by the CPG of the
MQIC. The presentation was delivered using
Prezi and the surveys were delivered using
esurveycreator.com. Both the presentation and
the surveys were made available using the
Weebly website platform.
The presentation can be viewed by visiting
http://substanceusedisorderebpp.weebly.com/
presentation.html or by scanning this code:

Results
Pre/Post Survey Questions

1. How confident do you feel assessing a person for
substance use disorder (SUD)?

2. How confident do you feel naming an official
assessment tool used to assess persons with SUD?

3. How confident do you feel assessing a patients
willingness to change, regarding SUD?

4. How knowledgeable are you regarding The Joint
Commissions recommendations regarding screening
patients for SUD?

5. How confident do you feel discussing potential
secondary medical complications related to SUD?

6. How knowledgeable are you regarding the idea of
a brief intervention?

7. How confident do you feel your brief intervention
would aid a patient suffering from SUD?

8. How knowledgeable are you regarding official and
unofficial treatment facilities for those suffering
from SUD?

9. As compared to a paper-and-pencil survey, how
satisfied were you with this method of delivery of
this survey?

10. As compared to a face-to-face encounter, how
satisfied were you with this method of delivery of
this survey?

11. As compared to a face-to-face encounter, how
convenient did you find this method of delivery - the
website: http://
substanceusedisorderebpp.weebly.com?

SCALE

Not at all A little Moderately

(0) (1)
(2) (3) (4) (5)

Very
Extremely
(6) (7) (8)(9)(10)

PreSurvey vs PostSurvey
Mean Scores
10
9
8
7

N = 35

N = 28

5
4
3
2
1
0
Q1

Q2

Q3

Q4

Q5

Q6

Q7

Q8

Satisfaction/Ease of
Project Participation
Mean Scores

9.2

PostSurvey
Only

9.18
9.16
9.14
9.12

N = 28

9.1
9.08
9.06
Q9

Q10

Q11

Conclusion
The overall goal is to decrease the disparity among those who
suffer from SUD through patient education.
Educating patients on seeking assistance from Chemical Addiction
Programs should become common practice.
Training healthcare providers to address SUD patients who
demonstrate willingness to change has proven to be beneficial.
Seventy-five percent of participants found the online method of
delivery extremely convenient.

Acknowledgement
Special appreciation to Dr. Bonnie Sanderson, PhD, RN for her
invaluable assistance with this project.