Screening, Brief Intervention, and Referral to Treatment Education for Emergency Nurses in 5 Hospitals: Implementation Steps and Hurdles

Impact of a new specialist alcohol and drug brief intervention service model integrated into the emergency department: An interrupted time series analysis

“…A number of barriers to the successful translation of BIs into routine clinical care have been identified. These include low staff engagement, limited staff training, limited staff AOD knowledge, skills and confidence, time pressures and limited resources 13–18 . Importantly, studies that have trained ED doctors and nurses to screen all ED patients for possible alcohol problems and deliver BIs have failed to demonstrate any advantage over standard care 18 .…”

“…These include low staff engagement, limited staff training, limited staff AOD knowledge, skills and confidence, time pressures and limited resources. [13][14][15][16][17][18] Importantly, studies that have trained ED doctors and nurses to screen all ED patients for possible alcohol problems and deliver BIs have failed to demonstrate any advantage over standard care. 18 A limited number of EDs have on-site AOD/addiction experts, and other common hospital-based models such as consultation-liaison tend to operate with high demand across multiple acute wards, limiting access to specialised AOD BI support.…”

Commentary on Blowet al.(2017): Leveraging technology may boost the effectiveness and adoption of interventions for drug use in emergency departments

“…The limited adoption of interventions for the prevention and treatment of substance use problems in the emergency department (ED) and other non‐specialized clinical settings, despite a multi‐faceted campaign, exemplifies the importance of considering barriers to setting‐specific implementation while studying effect . Among the many cited barriers to the integration of intervention for substance use problems in the ED are (1) clinician skillset inadequacy, (2) time and resource limitations and (3) intervention efficacy concerns . While these barriers may not be unique to the ED, the magnitude of their impact is exacerbated by challenges inherent to this clinical setting.…”

The experiences of registered nurses caring for people with substance use disorders in emergency department settings

“…Nurses in the ED are well situated to assist PWSUDs to access health care services (Kane et al, 2016). This is due to RNs' frequent, and sometimes regular, contact with PWSUDs who access health care through the ED.…”

“…This is due to RNs' frequent, and sometimes regular, contact with PWSUDs who access health care through the ED. With detailed knowledge of navigating the health care system, the availability of resources and the ability to refer clients to appropriate services as necessary, ED RNs could act as facilitators for PWSUD to access immediate and ongoing care (Kane et al, 2016). Discharge planning is firmly in the domain of the RN regardless of the area of practice and RNs must have the knowledge and ability to direct PWSUD to appropriate and timely resources upon discharge, as they would with any other patient (Sexson, Lindauer, & Harvath, 2017).…”