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Advancing the Implementation of Medication-Assisted Treatment in Residential Treatment

Description

Abstract
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.

Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude…

Abstract
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.

Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study.

Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.

Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).

Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.

Keywords: Naloxone, opioid overdose, overdose education, overdose response program

ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor)

Created2021-04-12

Mindfulness Intervention Reduces Substance Cravings and Increases Psychological Flexibility

Description

Objective: Substance use disorder (SUD) is an epidemic in the United States. Current standard of care for SUD continues to produce a 40-60% relapse rate. Treatment for SUD is costly and is not obtainable for many individuals. The purpose of this project is to implement mindfulness as an adjunct treatment…

Objective: Substance use disorder (SUD) is an epidemic in the United States. Current standard of care for SUD continues to produce a 40-60% relapse rate. Treatment for SUD is costly and is not obtainable for many individuals. The purpose of this project is to implement mindfulness as an adjunct treatment for SUD to reduce relapse. Methods: Voluntary program offered at a residential treatment center designed as a team-based project. The combined project includes exercise, wellness, and mindfulness. Adults over the age of 18, male or female with a diagnosis of SUD were eligible. Program consisted of three hourly sessions a week, for a total of three weeks. Sessions included one session of exercise and wellness, one session of mindfulness training, and a combined session. Mindfulness sessions included learning the seven pillars of mindfulness followed by guided meditation. Participants were given a mindfulness journal for daily exercises. Five Facet Mindfulness Questionnaire (FFMQ) was completed before program and on completion. Results: 11 of 22 participants completed the program. FFMQ total scores were analyzed with paired t-test with Wilcoxon signed rank to account for small sample size. Statistical significance was based on an alpha of 0.05, V=10.50, z=2.00 and p=0.45. Conclusion: This project has the potential to decrease relapse rates by increasing mindfulness in individuals with SUD. Mindfulness training reduces cravings and negative thought processes. Implementing mindfulness training with current standard of care can be cost effective and recommended for all individuals with SUD.

ContributorsRouston, K. Courtney (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-05-01

Decreasing Burnout in Psychiatric Nursing

Description

Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as…

Burnout has become an increasingly popular topic among registered nurses, but unfortunately burnout among psychiatric nursing is less understood than other nursing specialties such as the Intensive Care Unit, Emergency Room, or Oncology. Psychiatry is unique and psychiatric nurses, in particular, are often subjected to physical and verbal violence as well as exposure to patient’s trauma. The aim of this project was to decrease burnout among psychiatric nurses in a private practice out-patient family psychiatric facility using Rossworm and Larabee’s change model (Appendix D). The MBI-HSS was completed by 1 participant (n=1) at pre-intervention and post-intervention. Between the pre/post MBI-HSS questionnaire the participant was asked to partake in a mindfulness-based intervention utilizing the smartphone application Headspace to complete a 10-session meditation course over one week. The results conclude the participant’s burnout decreased overall from pre-intervention to post-intervention. Internal Review Board (IRB) was granted in September 2021, and the project was completed in November 2021. The impact of the project was projected to have a more thorough statistical influence, but due to the participant size, there is minimal impact of system or polices in the psychiatric facility.

ContributorsSteward, M. Shannon (Author) / Guthrey, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2022-04-30

Opioid Overdose: How to Spot the Signs and Act

Description

Background and Aims: Due to the significant rise in opioid use and fatal opioid overdoses, an opioid reversal agent naloxone has been made available to the public through standing orders at Arizona pharmacies. The aim of this project is to implement a virtual naloxone education program to increase community knowledge…

Background and Aims: Due to the significant rise in opioid use and fatal opioid overdoses, an opioid reversal agent naloxone has been made available to the public through standing orders at Arizona pharmacies. The aim of this project is to implement a virtual naloxone education program to increase community knowledge of opioid addiction, opioid overdose, and opioid overdose response. Design: Utilized a one group, pretest-posttest design utilizing Brief Opioid Overdose Knowledge (BOOK) screening tool. Participants recruited through Mesa Community College website as an online event open to students, staff, and public. Setting: Online WebEx event through Mesa Community College. Intervention: Presented a 45-minute educational PowerPoint on opioids, opioid overdose, and opioid overdose response with a 15-minute question answer session. Participants: A total of 67 people attended the online event, 38 participated in pre-test and 19 participated in post-test survey. Demographics included 73.7% female, 55.3% between ages 18-30, 86.7% identify as white/Caucasian, and 92% signed up with a community college email address. Findings: Statistically significant results, with alpha value of 0.05, t(13) = -3.99, p = .002, d=1.07. Conclusions: Implementing an online education session is associated with increased knowledge on opioid use, opioid overdose, and opioid overdose response. Implementing community-based education programs may increase knowledge on opioid overdose prevention and community intervention.

ContributorsLeeper, Nicole (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-27

Stress in Healthcare Professionals: Caring for the Carers

Description

Background: Healthcare Professionals commonly experience elevated stress levels, and this issue has only further intensified by the ongoing COVID-19 pandemic. Mindfulness-based intervention have been shown to improve stress levels in diverse populations. Objective: The purpose of this project was to evaluate if an online, multicomponent MBI can reduce stress levels…

Background: Healthcare Professionals commonly experience elevated stress levels, and this issue has only further intensified by the ongoing COVID-19 pandemic. Mindfulness-based intervention have been shown to improve stress levels in diverse populations. Objective: The purpose of this project was to evaluate if an online, multicomponent MBI can reduce stress levels in healthcare professionals enrolled in a graduate health program. Methods: Recruitment was conducted at two different Southwestern institutions via email announcement from university’s program directors. The brief, 12-day intervention involved (1) self-guided online educational modules, (2) one group course via the platform zoom, and (3) at home practice of guided meditation session. The Perceived Stress Scale-10 (PSS-10) was used to measure stress levels pre- and post-intervention. General feedback of experience was also inquired on Postsurvey. Results: Sample comprised of 17 health professionals enrolled in a graduate health program from two different Southwestern Institutions. Scores from PSS-10 in postsurvey (M=20.94, SD=6.04) were statistically significantly lower than scores in pre survey (M=24.24, SD=5.78), t(16) = 3.35, p = .004. A large effect size was detected with findings (d = .81). Conclusions: Mindfulness Based Interventions may be able to reduce stress levels in healthcare professionals. More literature should focus on mindfulness intervention tailored to the needs of healthcare professionals.

ContributorsAfrin, Farhana (Author) / Uriri-Glover, Johannah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-05-03

Advancing the Implementation of Medication-Assisted Treatment in Residential Treatment

Description

Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs) towards opioid overdose management and to assess the effect of online training on opioid overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and respond to opioid overdose situations. Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitude…

Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs) towards opioid overdose management and to assess the effect of online training on opioid overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and respond to opioid overdose situations. Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in 2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study. Interventions: An online training was provided on opioid overdose response (OOR) and naloxone administration and on when to refer patients with opioid use disorder (OUD) for medication-assisted treatment. Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z = 2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5; 95% CI = 2.5 – 18.7; z =2.02, p = 0.043). Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is effective in increasing attitudes and knowledge related to opioid overdose management. opioid overdose reversal in RTCs.

ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-12

Sustaining Depression Remission: Integrating Mindfulness-Based Modalities and Ketamine Infusion Therapy

Description

Major depressive disorder contributes to a growing disease burden globally, with limiting or inadequate treatment options available to patients and healthcare providers. Traditional medications to treat the disorder demonstrate modest efficacy while best outcomes are seen when psychotherapy is implemented adjunctively. Barriers to delivering optimal treatment can lead to relapse, diminished psychosocial functioning, and…

Major depressive disorder contributes to a growing disease burden globally, with limiting or inadequate treatment options available to patients and healthcare providers. Traditional medications to treat the disorder demonstrate modest efficacy while best outcomes are seen when psychotherapy is implemented adjunctively. Barriers to delivering optimal treatment can lead to relapse, diminished psychosocial functioning, and suicide, a leading cause of death in the United States. The purpose of this paper is to examine the rapid antidepressant effects of ketamine combined with nurse-delivered mindfulness-based cognitive therapy to help reduce depression severity and support remission. Research differentiating ketamine’s mechanism of action from traditional anti-depressants and the efficacy of mindfulness-based interventions to reduce depression, have led this evidence-based project integrating these modalities.

ContributorsYuhas, John V. (Author) / McIntosh, Wayne (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-20

Joy in Work: Addressing Nurse Burnout through Mindfulness

Description

Aim: To investigate the feasibility and efficacy of mindfulness as an intervention in reducing burnout and promoting joy in work for progressive care unit (PCU) nurses and nursing aides. Background: The Institute for Healthcare Improvement (IHI) describes a lack of joy in work and the resultant burnout as a serious threat to healthcare…

Aim: To investigate the feasibility and efficacy of mindfulness as an intervention in reducing burnout and promoting joy in work for progressive care unit (PCU) nurses and nursing aides. Background: The Institute for Healthcare Improvement (IHI) describes a lack of joy in work and the resultant burnout as a serious threat to healthcare workers and organizations. Few studies have examined this phenomenon in PCU nurses and aides. Method: Pre- and post-intervention surveys with established instruments on three variables, mindfulness, burnout, and joy in work, were administered to ten PCU nurses and aides (N = 7) at a city hospital. The intervention was the virtual IHI's mindfulness course and was guided by Martin Seligman's PERMA Model and the Iowa Model for Evidenced Based Practice. A paired sample t-test was used to evaluate changes in the pre-post survey responses. Results: Significant increase in joy in work based on an alpha value of 0.05, p = .041. Slight increase in mindfulness practice based on an alpha value of 0.05, p = .398. Burnout remained the same based on an alpha value of 0.05, p = .766. Conclusion: PCU nurses and aides who practiced mindfulness for 12 weeks scored the same on burnout scales and higher on the joy in work scales. Implications for Nursing Management: Nurse managers can incorporate mindfulness exercises at strategic times during the shift to reduce burnout and promote joy in work for nurses and aides. Future EBP projects should assess the effectiveness of different mindfulness activities in promoting nurses' emotional and psychological well-being in various care settings.

ContributorsImanatue, Loveline (Author) / Sanborn Heidi (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-24

Decreasing and Providing Awareness for Burnout in Mental Health Care Workers

Description

Background: Alarming levels of burnout in mental health care staff is a significant concern not only for the organization but for the individual as well. Identifying and addressing burnout ought to be an essential protocol in a behavioral health organization. Currently, burnout remains an ongoing concern for mental health care…

Background: Alarming levels of burnout in mental health care staff is a significant concern not only for the organization but for the individual as well. Identifying and addressing burnout ought to be an essential protocol in a behavioral health organization. Currently, burnout remains an ongoing concern for mental health care organizations as it is associated with negative impacts for staff, patients, families, and the organization.

Method: The purpose of this project is to utilize the Maslach burnout inventory (MBI) survey tool to measure burnout pre and post intervention. The intervention utilized will be mindfulness-based interventions (MBI) to reduce burnout among mental healthcare workers. Implementing mindfulness interventions has evidence that it reduces burnout rates in mental health care staff. Current literature supports mindfulness-based interventions and have showed a decrease in burnout, stress, and depersonalization.

Results: The pre-intervention results were as followed: emotional exhaustion; 40, depersonalization; 20.4 and personal accomplishment 32. The post-intervention results emotional Exhaustion; 28, depersonalization; 14.90 and personal accomplishment 30. It was found that the category for emotional exhaustion was statistically significant as it had a P value .040, whereas depersonalization was not statistically significant as the P value was .171 and personal accomplishment was not statistically significant as the P value was .577.

Discussion: The use of MBI as an intervention has robust literature supporting the effectiveness in decreasing burnout and stress in mental health care staff.

ContributorsHenao, Cinthya (Author) / McIntosh, Wayne (Thesis advisor)

Created2020-05-01

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