Universal Screening for Opioid Use Disorder on a Labor and Delivery Unit: A Program Evaluation

Abstract Background: Universal screening to identify pregnant individuals with substance use concerns and opioid use disorder (OUD) is recommended to improve maternal-child outcomes. A health system in rural Pennsylvania began universal screening with the NIDA Quick Screen/ASSIST tool on a labor and delivery (L&D) unit with intentions to expand to the outpatient setting.

Local problem: The project site county had 32.5 pregnant individuals per 1,000 whose hospital stays involved opioid use.

Methods: A program evaluation based on the CDC Framework for Program Evaluation in Public Health was utilized to assess the NIDA Quick Screen/ASSIST universal screening process on a L&D unit. Descriptive statistics were used to present data relating to screening utilization rates, provider follow up, and staff feedback. Qualitative data from open-ended survey questions were reviewed for thematic analysis.

Interventions: A nursing and provider feedback survey analyzed the acceptability, appropriateness, and feasibility of the NIDA Quick Screen/ASSIST as a screening tool. Emerging feedback themes were analyzed in conjunction with key stakeholder perspectives to inform lessons learned and follow up recommendations.

Results: The screening utilization rate on L&D over a 13-month period was 89%. Providers ordered the appropriate follow up orders on “at risk” screens 87% of the time. Nurses and providers found the NIDA Quick Screen/ASSIST to be an acceptable screening tool.

Conclusions: The screening utilization rates and provider follow up rates on L&D were above the health system goal of 80%. Qualitative feedback identified areas of future focus as Streamlining the Screening Process, Nurse and Provider Education, Patient Education, and Patient Follow Up.

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Work Title Universal Screening for Opioid Use Disorder on a Labor and Delivery Unit: A Program Evaluation
Access
Penn State
Creators
  1. Mary Habashy
Keyword
  1. Doctor of Nursing Practice (DNP)
  2. Opioid use disorder (OUD)
  3. Universal Screening in pregnancy
  4. NIDA Quick Screen/ASSIST
  5. CDC Framework for program evaluation in public health
  6. Substance Use Disorder (SUD)
License In Copyright (Rights Reserved)
Work Type Project
Acknowledgments
  1. Sandra Halbruner, DNP
  2. Kelly Gallagher, PhD
  3. Susan Maynard, DNP
Publication Date March 17, 2023
Language
  1. English
Geographic Area
  1. Central Pennsylvania
Deposited March 17, 2023

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Version 1
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  • Created
  • Updated
  • Updated Acknowledgments Show Changes
    Acknowledgments
    • Sandra Halbruner, DNP, Kelly Gallagher, PhD, Susan Maynard, DNP, Karena Moran, PhD
  • Added Creator Mary Habashy
  • Updated Geographic Area Show Changes
    Geographic Area
    • Central Pennsylvania
  • Updated License Show Changes
    License
    • https://rightsstatements.org/page/InC/1.0/
  • Updated Description Show Changes
    Description
    • Abstract
    • Background: Universal screening to identify pregnant individuals with substance use concerns and opioid use disorder (OUD) is recommended to improve maternal-child outcomes. A health system in rural Pennsylvania began universal screening with the NIDA Quick Screen/ASSIST tool on a labor and delivery (L&D) unit with intentions to expand to the outpatient setting.
    • Local problem: The project site county had 32.5 pregnant individuals per 1,000 whose hospital stays involved opioid use.
    • Methods: A program evaluation based on the CDC Framework for Program Evaluation in Public Health was utilized to assess the NIDA Quick Screen/ASSIST universal screening process on a L&D unit. Descriptive statistics were used to present data relating to screening utilization rates, provider follow up, and staff feedback. Qualitative data from open-ended survey questions were reviewed for thematic analysis.
    • Interventions: A nursing and provider feedback survey analyzed the acceptability, appropriateness, and feasibility of the NIDA Quick Screen/ASSIST as a screening tool. Emerging feedback themes were analyzed in conjunction with key stakeholder perspectives to inform lessons learned and follow up recommendations.
    • Results: The screening utilization rate on L&D over a 13-month period was 89%. Providers ordered the appropriate follow up orders on “at risk” screens 87% of the time. Nurses and providers found the NIDA Quick Screen/ASSIST to be an acceptable screening tool.
    • Conclusions: The screening utilization rates and provider follow up rates on L&D were above the health system goal of 80%. Qualitative feedback identified areas of future focus as Streamlining the Screening Process, Nurse and Provider Education, Patient Education, and Patient Follow Up.
  • Updated Acknowledgments Show Changes
    Acknowledgments
    • Sandra Halbruner, DNP, Kelly Gallagher, PhD, Susan Maynard, DNP, Karena Moran, PhD
    • Sandra Halbruner, DNP, Kelly Gallagher, PhD, Susan Maynard, DNP
  • Added Habashy_Mary_ScholarSphere.pdf
  • Published
  • Updated Work Title Show Changes
    Work Title
    • Universal Screening for Opioid Use Disorder on a Labor and Delivery Unit: A Program Evaluation
    • Universal Screening for Opioid Use Disorder on a Labor and Delivery Unit: A Program Evaluation

Version 2
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  • Deleted Habashy_Mary_ScholarSphere.pdf
  • Added HabashyM_4-19-23-Scholarsphere.pdf
  • Published