Augusta University, 1120 15th Street, Augusta, GA 30912, USA.
Augusta University, 1120 15th Street, Augusta, GA 30912, USA.
Appl Nurs Res. 2018 Feb;39:125-129. doi: 10.1016/j.apnr.2017.11.015. Epub 2017 Nov 6.
Previous research on training health professionals to identify and address unhealthy alcohol and drug use in patients through screening, brief intervention, and referral to treatment (SBIRT) has found that training increases knowledge about substance use and increases students' confidence in addressing substance use in patients. To date, however, there is little information on how health professional students integrate SBIRT into individual practice. Within a U.S. SBIRT training consortium, advanced practice registered nurse (APRN) students were required to practice SBIRT in clinical settings and complete assessment logs for each patient screened. Logs documented results from single item alcohol & drug screening questions; AUDIT or DAST responses; brief intervention (BI)/referral to treatment (RT) steps completed and patients' responses. 113 APRN students completed logs on 538 patients (mean age 44; SD 15.0; 53.5% female). Positive single question alcohol screens were more frequent than positive single question drug screens (55.3% vs. 25.5%). More than one third (36%) of the logs included high-risk AUDIT/DAST scores. The most utilized BI components were discussions regarding consequences of use (76%) and safe levels of use (70%), while the most utilized RT steps included referral to a mutual help group (15%) or a specialty treatment program (8%). Positive screening rates found by APRN students were higher than reported rates in most clinical settings. The logs also demonstrated that APRN students employed many of the SBIRT skills they were taught while also helping identify underutilized SBIRT steps, which may be addressed specifically in future SBIRT trainings.
先前的研究表明，通过筛查、简短干预和转介治疗（SBIRT）培训卫生专业人员识别和处理患者的不健康酒精和药物使用问题，培训可以提高对物质使用的认识，并增强学生在患者中处理物质使用问题的信心。然而，迄今为止，关于卫生专业学生如何将 SBIRT 融入个人实践的信息很少。在美国 SBIRT 培训联盟中，高级执业注册护士（APRN）学生必须在临床环境中进行 SBIRT，并为每个接受筛查的患者完成评估记录。记录文件记录了单项酒精和药物筛查问题的结果；AUDIT 或 DAST 应答；完成的简短干预（BI）/转介治疗（RT）步骤以及患者的反应。113 名 APRN 学生完成了 538 名患者的记录（平均年龄 44；SD 15.0；53.5%为女性）。阳性单项酒精筛查的比例高于阳性单项药物筛查（55.3%比 25.5%）。三分之一以上（36%）的记录包括高风险 AUDIT/DAST 评分。最常用的 BI 部分是讨论使用的后果（76%）和使用的安全水平（70%），而最常用的 RT 步骤包括转介到互助小组（15%）或专科治疗计划（8%）。APRN 学生发现的阳性筛查率高于大多数临床环境中报告的率。记录还表明，APRN 学生运用了他们所学的许多 SBIRT 技能，同时还发现了一些未充分利用的 SBIRT 步骤，这可能在未来的 SBIRT 培训中得到特别关注。
