Addressing Adolescent Substance Use through the Integration of SBIRT in a Primary Care Clinic: A Quality Improvement Project

This quality improvement project fulfills the requirements for the DNP degree at The Pennsylvania State University.

Background: Adolescent substance use is a serious public health problem. Negative consequences may include risky sexual behaviors, violence, mental health risks, and lifelong consequences including substance use disorder, unemployment, and lower life satisfaction.

Local problem: Outpatient clinical providers may not consistently utilize evidence-based screening tools such as the CRAFFT for adolescent substance use. Providers identify barriers to implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT).

Methods: This quality improvement project used a mixed-methods design. Quantitative statistics included CRAFFT completion rates and pre- and post-provider readiness, comfort, and knowledge constructs of SBIRT. Qualitative data included provider comments about the DNP project.

Interventions: Following provider SBIRT educational training, the project occurred over an eight-week period. Intervention instruments included the CRAFFT 2.1 screening tool and provider questionnaires. CRAFFT screening completion rates were obtained biweekly. Anonymous provider questionnaires were completed pre- and post- project assessing provider readiness, comfort, and knowledge using a Readiness Ruler of 0-10 scale.

Results: Quarterly CRAFFT screening completion rates fluctuated but trended upward during the last quarter toward the goal of 75%. P-value of >0.05 indicated no statistical significance between baseline and completion for provider readiness, comfort, and knowledge of SBIRT.

Conclusions: While there was not statistical significance with seven providers, there was clinical significance with screening 80 adolescents and no negative outcomes. Despite challenging circumstances during the Coronavirus-19 pandemic, providers successfully engaged in SBIRT.

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Work Title Addressing Adolescent Substance Use through the Integration of SBIRT in a Primary Care Clinic: A Quality Improvement Project
Access
Open Access
Creators
  1. Brandi Peachey
Keyword
  1. Doctor of Nursing Practice
License No Copyright - U.S.
Work Type Project
Acknowledgments
  1. Dr. Kristen Bransby
  2. Dr. Lisa Kitko
  3. Dr. Rachel Allen
Publication Date 2022
Deposited April 07, 2022

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    Acknowledgments
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    Acknowledgments
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    • Dr. Kristen Bransby, Dr. Lisa Kitko, Dr. Rachel Allen
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  • Updated Description, Publication Date, License Show Changes
    Description
    • This quality improvement project fulfills the requirements for the DNP degree at The Pennsylvania State University.
    Publication Date
    • 2022
    License
    • https://rightsstatements.org/page/NoC-US/1.0/
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  • Added Peachey_B_FINAL DNP PAPER_040622.docx
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  • Updated Keyword, Description Show Changes
    Keyword
    • Doctor of Nursing Practice
    Description
    • This quality improvement project fulfills the requirements for the DNP degree at The Pennsylvania State University.
    • This quality improvement project fulfills the requirements for the DNP degree at The Pennsylvania State University.
    • Background: Adolescent substance use is a serious public health problem. Negative consequences may include risky sexual behaviors, violence, mental health risks, and lifelong consequences including substance use disorder, unemployment, and lower life satisfaction.
    • Local problem: Outpatient clinical providers may not consistently utilize evidence-based screening tools such as the CRAFFT for adolescent substance use. Providers identify barriers to implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT).
    • Methods: This quality improvement project used a mixed-methods design. Quantitative statistics included CRAFFT completion rates and pre- and post-provider readiness, comfort, and knowledge constructs of SBIRT. Qualitative data included provider comments about the DNP project.
    • Interventions: Following provider SBIRT educational training, the project occurred over an eight-week period. Intervention instruments included the CRAFFT 2.1 screening tool and provider questionnaires. CRAFFT screening completion rates were obtained biweekly. Anonymous provider questionnaires were completed pre- and post- project assessing provider readiness, comfort, and knowledge using a Readiness Ruler of 0-10 scale.
    • Results: Quarterly CRAFFT screening completion rates fluctuated but trended upward during the last quarter toward the goal of 75%. P-value of >0.05 indicated no statistical significance between baseline and completion for provider readiness, comfort, and knowledge of SBIRT.
    • Conclusions: While there was not statistical significance with seven providers, there was clinical significance with screening 80 adolescents and no negative outcomes. Despite challenging circumstances during the Coronavirus-19 pandemic, providers successfully engaged in SBIRT.