https://padlet.com/takafumiy/us8zrrwcwvyw7lrg NUR513 Padlet Oral Presentation en-us 2022-02-10 16:16:26 UTC 2022-04-20 16:57:07 UTC hello@padlet.com emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114558554 Substance Abuse is defined as "The use of illegal drugs or the use of prescription or over-the-counter drugs or alcohol for purposes other than those for which they are meant to be used, or in excessive amounts" (NCI Dictionary of Cancer terms, 2022). Substance abuse may lead to many physical, mental, emotional, and social issues as well as job-related problems. It can affect anyone in the country, but jobs with high stress, easy access to controlled substances, and variable work hours are at increased risk for substance abuse (Ivey, 2015). As this can affect the ability to make proper judgment calls, substance abuse among nurses can create patient safety issues among other safety issues.]]> 2022-03-26 03:53:55 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114558554 emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114558741  Globally, some 535 million people are estimated to suffer from drug use disorders and who require treatment services, according to the United Nations Office on Drugs and Crime (2019). 

The United Nations office on Drugs and Crime (2019) reported that in 2017, an estimated 271 million people, or 5.5 percent of the global population aged 15-64, had used drugs in the previous year compared to 2016.

Nurses are on par with the rates of substance abuse in the general population (Foli et al., 2021). ]]> 2022-03-26 03:54:22 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114558741 emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114558904

3.1 million nurses in the U.S.  (U.S. Bureau of Labor Statistics, 2021) 

Approximately 10% of nurses have substance abuse  (Strobbe & Crowley, 2017) 

High heritability: 40-60%  (Yu & McClellan, 2016) 

Risk factors for Nurses: Family history, Stress (Patients death, shortage), experiencing past emotional or physical trauma  (Epstein et al., 2010) 

The annual cost of substance abuse: $510.8 billion in 1999 (Scholze et al., 2017)

• Alcohol abuse cost: $191.6 billion
• Tobacco use cost: $167.8 billion
• Drug abuse cost: $151.4 billion

]]> 2022-03-26 03:54:46 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114558904 emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559038
Per Ivey (2015), it was estimated that 20% of nurses [had] a substance misuse, abuse, and or addiction problem in 2015. This issue has been recognized as a prevalent problem since 1980, so much so that a task force called the Peer Assistance Program was created to help combat the substance abuse problem among nurses.

In a recent study by Trinkoff et. al. (2022), it is found that in the past year nurses working in nursing homes, home health care, and home hospice have the highest rates of substance abuse with illicit drug use at 5.7% and prescription drug abuse at 9.9%. 

Not only does substance abuse make nurses susceptible to physical, emotional, and social issues, but it also makes them susceptible to indirect risks such as car accidents and violence. Psychoactive substance abuse also interferes with working ability due to the reduction in brain activity leading to slow response and lack of reasoning. This can lead to work related accidents, safety issues, and adverse events (Rolim Scholze, 2017).

Nurses who have substance abuse problems prior to becoming nurses struggle to maintain sobriety due to easy access to substances at work. "Interestingly, six out of the ten participants in the study indicated that they had problems with substance abuse prior to becoming nurses. However, they relapsed after entering the nursing profession" (Mumba, 2018). 

Mumba et. al. (2019), discusses that "the focus for the future should be on improving outcomes of peer assistance programs (PAPs), educating the nursing community on recognition of SUDs, supporting nurses with impaired practice in recovery, and reducing the impact on patient safety".]]> 2022-03-26 03:55:08 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559038 emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559099 According to the National Library of Medicine (NIL) (2021) the healthcare system has newly integrated roles to deliver diverse care to patients that have substance abuse issues including:

• Screening for substance misuse and substance use disorders
  • Primary Care
  • Clinics
• Delivering prevention interventions to prevent substance misuse and related health consequences
• Early intervention to prevent escalation of misuse to a substance use disorder
• Engaging patients with substance use disorders into treatment
  • Counseling
  • Programs
  • Facilities
• Treating substance use disorders of all levels of severity
  • In patient
  • Out patient
  • Private vs. Public Facilities
• Coordinating care across both health care systems and social services systems
  • Criminal justice
  • Housing
  • Employment support
  • Child welfare
• Linking patients to Recovery Support Services
  • Peer Support Specialists
• Long-term monitoring and follow-up
  • Case Workers

]]> 2022-03-26 03:55:18 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559099 emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559424 An alternative to discipline (ATD) program would be recommended where a CASAC (credentialed alcoholism and substance abuse counselor) trained provider who would report directly to board of nursing (BON) to make recommendations and oversee the treatment of a nurse with substance abuse disorder.  The nurse will not be identified to the BON unless the treatment plan is not followed.  Treatment could be counseling, drug treatment program, random drug screening and work restrictions (Worley, 2019).  In addition to the ATD, nursing education will provide education to nursing staff regarding signs and symptoms of  substance use disorder and what impaired nursing practice may look like.  In addition to this, nursing education will provide education on what to do if a nurse is suspected of SUD.  Studies show that the longer it takes to get treatment the higher the chance of relapse so this treatment program should be in effect immediately (Mumba & Kraemer, 2019).]]> 2022-03-26 03:55:53 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559424 emily2042 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559647 Utilizing an alternate to discipline (ATD) approach more nurses with substance use disorder will be more likely to self report and supports a Just Culture. A mental health professional who is CASAC (Credentialed Alcoholism and Substance Abuse Counselor) will reduce costs when compared to someone that is doctorate prepared. The American Nurses Association supports ATD programs for nurses and nursing students (Worley, 2019).]]> 2022-03-26 03:56:30 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2114559647 tamara400 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2135169384 Substance abuse is a problem world wide. It is documented that nurses are on par with the rest of the population as far as numbers per capita of substance abuse, but nurses are at a higher risk simply due circumstance and proximity too high stress situations, access to controlled substances, and variable work hours (Foli et al., 2021). 


We found that heredity, mental illness, stress, and trauma all play a role in risk factors for substance abuse. Nurses are exposed to a multitude of variables that increase their risk. The cost of substance abuse is on the rise, and these numbers only reflect the people that admit to having a substance abuse issue. 

The QI intervention that we found to be most effective is the alternative to discipline program. ATD programs are self reported and sustain a supportive culture where there is no punitive damage to one's career for seeking help. This program also provides education for coworkers to help identify issues earlier in hopes of helping individuals with SUD sooner. We also found this model to be more sustainable by the hospitals because you can reduce costs by employing a counselor rather than a physician or doctorate prepared psychologist to help nurses with this disease. ]]> 2022-04-07 18:54:37 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2135169384 tamara400 https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2135274180 2022-04-07 20:16:50 UTC https://padlet.com/takafumiy/us8zrrwcwvyw7lrg/wish/2135274180