Nurse led models of care for outpatient substance use disorder treatment: A scoping review.

AIM: To map key characteristics and describe nurse led models of care for the treatment of persons with substance use disorders (SUDs) in the outpatient setting. DESIGN: A scoping review. METHODS: Conducted in accordance with the JBI methodology. The PRISMA-ScR checklist was used. DATA SOURCES: Pubmed, CINAHL Complete (EBSCOhost), Cochrane Library, APA PsycNet and Scopus were searched from 1999 to May 2022 and updated on 28 November 2023. A handsearch and a grey literature search was conducted. RESULTS: Title and abstract screening was performed on 774 articles resulting in 88 articles for full text screening. Full text screening yielded 13 articles that met inclusion criteria. CONCLUSION: Existing nurse-led models of care for SUDS are scarce and limited in scope, with the majority focused on treating opioid use disorder. Additional research is needed to develop, test, and implement efficacious nurse-led models of care for the treatment and management of SUDs. IMPLICATIONS TO CLINICAL PRACTICE: Nurse led models of care have demonstrated their efficacy and quality in the management of other chronic diseases. As we move forward with innovative solutions for individuals with addiction, nurse led models of care can be a mechanism to deliver high quality, evidence-based care for SUDs. IMPACT: SUDs are chronic diseases that impact individuals, families, and communities. SUDs require a biopsychosocial approach to treatment. Globally, nurses are well positioned to provide high quality care to mitigate the impact of SUDs. This scoping review mapped the extant literature on nurse led models of care for substance use disorder treatment in the outpatient setting finding that additional research is needed to develop, test and implement evidence-based interventions to care for individuals, families, and communities experiencing SUDs. REPORTING METHOD: PRISMA checklist for scoping reviews. No patient or public contribution were part of this study. PROTOCOL REGISTRATION: Open Science Framework accessible at: https://doi.org/10.17605/OSF.IO/NSW7V.

Nurse-led models of care for metabolic syndrome in primary care: A scoping review.

AIM: To identify and map out existing nurse-led models of care for treatment and prevention of metabolic syndrome in primary care settings. DESIGN: A scoping review. METHODS: Conducted in accordance with the JBI methodology. DATA SOURCES: A search of the databases PubMed, CINAHL Complete, Cochrane Library, Scopus, handsearch and a grey literature search was conducted in June 2022 and updated in March 2023. RESULTS: Title and abstract screening was performed on 926 articles resulting in 40 articles for full text screening. Full text screening yielded seven articles that met inclusion criteria. CONCLUSION: Additional research is needed on nursing models of care to prevent and treat metabolic syndrome. Future studies should concentrate on rigour with clearly defined objective inclusion criteria. IMPLICATIONS TO CLINICAL PRACTICE: This review contributes a synthesis of the evidence on nurse-led models for metabolic syndrome in primary care. IMPACT: This scoping review addresses metabolic syndrome, the precursor to non-communicable disease. The review mapped the evidence for nurse-led models of care for metabolic syndrome in the primary care setting. These findings promote the development and evaluation of novel nurse-led models of care which can mitigate the effect of the current epidemic. REPORTING METHOD: PRISMA checklist for scoping reviews. No patient or public contribution was part of this study. PROTOCOL REGISTRATION: Open Science Framework accessible at: https://osf.io/jfpw7/.

Enhancing Racial Justice and Equity Through Simulation.

ABSTRACT: Diversity, equity, inclusion, and antiracism (DEI-A) are critical to providing adequate health care to all populations. High-fidelity simulations and role-play scenarios allow students to experience caring for clients from diverse backgrounds. This article discusses the project development and implementation of a DEI-A simulation day placed in a community health clinical course.

Resilience and burnout in healthcare students and inpatient psychiatric nurses: A between-groups study of two populations.

BACKGROUND: Stressful environments can have significant effects on an individual and lead to burnout. Psychological consequences of burnout include trauma reactions, depression, anxiety and substance use disorders. Resilience, a protective mechanism can mitigate the negative impact of burnout. METHOD: This study utilizes an exploratory correlational design to determine whether or not there is 1) a similar correlation between resilience and burnout between psychiatric nurses working in a high stress environment and students who are naive to the high stress academic environment and 2) a higher level of resilience in the psychiatric nurses compared to the healthcare students. RESULTS: A significant inverse relationship was observed with respect to resilience and burnout in both the professional nurse and student groups. However, the inpatient psychiatric nurse group was not found to have a higher level of resilience than the student group, when controlling for age. CONCLUSION: This suggests that resilience to burnout is not related to the work environment but life experience (age) was found to be a factor related resilience in this sample.

Stumbling toward Vulnerability: Recovery from Substance Use Disorders and Co-Occurring Mental Illness.

This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.

High-Fidelity Simulation: An Application to Psychopharmacological Training for the Psychiatric Nurse Practitioner Student.

As the demand for Psychiatric Mental Health Nurse Practitioners (PMHNPs) continues to grow, innovative teaching strategies that can enhance competency learning with skill transfer into the clinical setting is essential. Educational programs must adequately prepare the student for the complexity of the clinical environment. Simulation is an educational approach that replicates aspects of the real world in a safe environment so that learners can engage in an interactive manner. High-fidelity simulation (HFS) has been identified as an effective teaching strategy and mechanism to transfer knowledge and skills learned in the classroom to the clinical setting. HFS uses a human patient simulator to immerse the learner in a contextual learning environment by engaging in a realistic clinical scenario to develop cognitive, affective and psychomotor skills through deliberate practice. This article describes the theoretical foundation, development process, case scenarios, and implementation of HFS, an innovative teaching pedagogy, in a Psychopharmacology didactic course for PMHNP.

The Role of the Registered Nurse Working in Substance Use Disorder Treatment: A Hermeneutic Study.

Substance Use Disorders (SUDs) are a national public health crisis. However, there is minimal existing research literature on the role of the nurse working in SUD treatment. The purpose of this study was to describe the meaning of the professional role of the registered nurse working in the SUD setting. The study utilized a Heideggerian Phenomenological approach with a modified Colaizzi method for analysis and interpretation. The nine study participants, two males and seven females, aged 27-60 had worked in SUD treatment for 1-37 years. Three major themes, with sub-themes, emerged: Defining the Role for Self; Learning the Role; and Navigating with Ease in an Unchangeable Culture. Findings demonstrated that nurses in SUD treatment value their role and the care of patients with SUDs. Patient recovery or relapse influenced job satisfaction. Significantly, the findings highlighted an outdated role with rigid boundaries and no real contemporary identity. Findings can be used to address the need for a contemporary SUD nursing identity and to support ongoing involvement of nurses in health policy related to SUDs.

Stigma towards a nursing specialty: A qualitative analysis of the perceptions of the addiction nursing workforce.

Addiction nurses are highly skilled providers of holistic care and ensuring workforce sustainability is key to providing quality care to a traditionally marginalised group of healthcare consumers. The aim of this study was to explore perceived stigma towards the addiction nursing speciality, addiction nursing (also known as alcohol and other drug nursing) and its impact on workforce sustainability, retention and recruitment. Secondary analysis of qualitative interview data with nurses (n = 50) and survey data (n = 337) was conducted as part of a workforce mapping exercise in 2019. COREQ reporting guidelines were used. After structural coding was applied, three themes emerged: stigma experienced by clients of alcohol and other drug treatment services, stigma experienced by addiction nurses and a lack of awareness of the specialty of addiction nursing itself. Participants overwhelmingly felt that these forms of stigma made addiction nursing less attractive to new entrants, particularly new nurses and posed a threat to the sustainability of the specialty. The findings from this study indicate that urgent attention is required to address stigma towards individuals who use alcohol and other drugs, and the nurses providing care for them. Furthermore, creating awareness of the addiction nursing specialty is paramount to ensure workforce sustainability and to improve care for individuals who use alcohol and other drugs. Beyond addiction nurses, our results indicate that stigma towards other specialties (such as mental health nursing) is a substantive barrier to workforce sustainability.