Screening for Drug and Alcohol Dependence in a Safety Net Clinic
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Authors
Tierney, Kenneth McCord
Issue Date
2018-05-12
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Abstract
Substance abuse and dependency is a negative health state currently associated with increased mortality, morbidity, and overall healthcare costs (Healthy People 2020, 2016; National Institute on Drug Abuse, 2015). Healthy People 2020 (2016) aims at overall reduction in both adolescent and adult consumption of alcohol and illicit substances, ultimately reducing associated healthcare disparities. Current best-practice guidelines recommend annual screening of substance abuse and dependency. In addition, increased coverage mandated by the Affordable Care Act places emphasis on accurate and consistent screening by primary care providers as a means of achieving the goals set by government healthcare organizations (Saitz, 2017; Substance Abuse and Mental Health Services Administration, 2014). But still barriers exist which prevent the efficient and comprehensive screening of patients in primary care settings. The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to increase provider compliance in screening adult patients for drug and alcohol abuse and dependence in a primary care, safety net clinic. The aim of this study was fourfold, including assessment of both provider compliance and barriers to compliance, as well as increase provision of education and resources to at-need patients. Results from the study indicated that the CAGE-AID questionnaire could be successfully integrated into the routine assessment of patients in a safety net clinic. Barriers to screening included time restraints, which parallels findings established in previous research, as well as language barriers and patient refusal. It was also found that despite referral to a Psychiatric Nurse Practitioner, often patients declined or did not seek further treatment. This is a potential area for future research.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University