University of Wisconsin, School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin.
University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin.
West J Emerg Med. 2024 Jul;25(4):444-448. doi: 10.5811/westjem.18020.
As opioid overdose deaths continue to rise, the emergency department (ED) remains an important point of contact for many at risk for overdose. In this study our purpose was to better understand the attitudes, beliefs, and knowledge of ED nurses in caring for patients with opioid use disorder (OUD). We hypothesized a difference in training received and attitudes toward caring for patients with OUD between nurses with <5 years and ≥6 years of clinical experience.
We conducted a survey among ED nurses in a large academic medical center from May-July 2022. All ED staff nurses were surveyed. Data entry instruments for the nursing surveys were programmed in Qualtrics, and we analyzed results R using a chi-square test or Fisher exact test to compare nurses with <5 years and ≥6 years of clinical experience. A -value of < 0.05 was considered statistically significant.
We distributed 74 surveys, and 69 were completed (93%). Attitudes toward naloxone distribution from the ED were positive, with 72% of respondents reporting they were "very" or "extremely" supportive of distributing naloxone kits to individuals at risk of overdose. While attitudes were positive, barriers included limited time, lack of system support, and cost. Level of comfort in caring for patients with OUD was high, with 78% of respondents "very" or "extremely" comfortable. More education is needed on overdose education and naloxone distribution (OEND) with respondents 38% and 45% "a little" or "somewhat" comfortable, respectively. Nurses with <5 years of experience reported receiving more training on OEND in nursing school compared to those with ≥6 years of experience ( = 0.03). There were no significant differences in reported attitudes, knowledge, or comfort in caring for patients with OUD.
In this single-center survey, we found ED nurses were supportive of overdose education and naloxone distribution. There are opportunities for targeted education and addressing systemic barriers to OEND. All interventions should be evaluated to gauge impact on knowledge, attitudes, and behaviors.
随着阿片类药物过量死亡人数持续上升，急诊科（ED）仍然是许多有过量风险的人的重要接触点。在这项研究中，我们的目的是更好地了解 ED 护士在照顾阿片类药物使用障碍（OUD）患者方面的态度、信念和知识。我们假设，在接受过的培训和对照顾 OUD 患者的态度方面，临床经验不足 5 年和≥6 年的护士之间存在差异。
我们于 2022 年 5 月至 7 月期间在一家大型学术医疗中心对 ED 护士进行了一项调查。所有 ED 在职护士都接受了调查。护理调查的数据输入工具是在 Qualtrics 中编程的，我们使用卡方检验或 Fisher 精确检验分析结果 R，以比较临床经验不足 5 年和≥6 年的护士。值<0.05 被认为具有统计学意义。
我们发放了 74 份问卷，有 69 份完成（93%）。ED 分发纳洛酮的态度是积极的，72%的受访者表示他们“非常”或“极其”支持向有过量风险的个人分发纳洛酮试剂盒。虽然态度是积极的，但障碍包括时间有限、缺乏系统支持和成本。护理 OUD 患者的舒适度较高，78%的受访者“非常”或“极其”舒适。更多的教育是需要的，包括关于过量教育和纳洛酮分发（OEND）的教育，受访者中有 38%和 45%分别“有点”或“有些”舒适。与≥6 年经验的护士相比，临床经验不足 5 年的护士在护理学校接受的 OEND 培训更多（ = 0.03）。在对 OUD 患者的态度、知识或护理的舒适度方面，没有显著差异。
在这项单中心调查中，我们发现 ED 护士支持过量教育和纳洛酮分发。有机会进行有针对性的教育，并解决 OEND 的系统障碍。所有干预措施都应进行评估，以衡量其对知识、态度和行为的影响。
