Nurse Practitioners' Role in Preparing Community Members for Opioid-Associated Overdose Rescue:

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1 Nurse Practitioners' Role in Preparing Community Members for Opioid-Associated Overdose Rescue: Using a Computer-Based Module to Train Laypersons and Advocating for Naloxone Legislation International Nurses Society on Addictions 38th Annual Educational Conference - Washington, D.C. October 17, 2014 Caroline Baptista, BSN, RN, CCRN, Presenter Magdalena Del Angel, BSN, RN, Presenter ACKNOWLEDGEMENTS Funding to develop prototypes of the training modules was provided by NIH/NIDA through grant #1R43D to Dr. Janie Simmons, PI, at Social Sciences Innovations Corporation, Inc. (SSIC). The Hillman Foundation, the Hillman Alumni Nursing Network, and Aaron Mishan provided funding for the Nurse Practitioner manual accompanying the Bystander module and a pilot test of a training system for nurses and social workers initiating a naloxone program.

2 Overview of Presentation Introduction to epidemiology of overdose in the U.S. and the ways the epidemic is being addressed. Presentation of a computer-based training module and its availability via the internet - handouts with link to module and other resources will be provided. Emphasis on the critical need for nursing involvement and advocacy in addressing the national overdose epidemic. The Current Overdose Epidemic

3 Hard Facts: The Statistics

4 INCREASING DEATHS FROM OVERDOSE Drug overdose death rates have been rising steadily since 1992 with a 118% increase from 1999 to 2011, alone (CDC) According to 2011 data, there are 113 deaths from overdose daily in the US (DAWN report)

5

6 Current Approaches to the Epidemic

7 Harm Reduction Movement: History and Overview Came to existence with the idea of needle exchange program, composed of advocates and drug users A subsequent movement addressed overdose prevention: Reduction of stigma Good Samaritan laws Naloxone access Standing orders

8 Community-based Overdose Prevention Training and Naloxone Distribution The Naloxone Kit

9 Community-based Naloxone Programs Community based naloxone programs created to prevent overdose deaths with naloxone use by non-medical persons Non-medical persons include non-medical first responders -police officers; persons who use drugs and their family and friends; drug treatment providers Early Prescription Naloxone Programs

10 Success Stories

11 A Need for Nurses: You! Utilizing Prescriptive Authority

12 Aiding Nurses in Preparing Community Members: A New Computer-Based Training System

13 Expertise Behind the Bystander Training Module Janie Simmons, Ed.D. Principal Investigator. National Development and Research Institutes, Inc. and Social Sciences Innovations Corporation, New York, NY. Sharon Stancliff, MD, Co-Investigator. Medical Director, Harm Reduction Coalition, New York, NY. Alexander Walley, MD, MSc, Co-Investigator. Assistant Professor of Medicine, Boston University School of Medicine, Boston Medical Center; Medical Director, Massachusetts Department of Public Health, Opioid Overdose Prevention Pilot Program and Boston Public Health Commission Opioid Treatment Program, Boston, MA. Joseph Lunievicz, Co-Investigator. Director, Training Institute, National Development and Research Institutes, Inc., New York, NY. Hilary Liberty,Co-Investigator. Director, Social Science Innovations, Inc. New York, NY. Sonali Rajan, Ed.D. Evaluator. Assistant Professor of Health Education, Teachers College, Columbia University, New York, NY. Caroline Baptista, RN, Research Fellow. Hillman Nursing Scholar, NYU School of Nursing, New York, NY Magdalena Del Angel, RN, Research Fellow. Hillman Nursing Scholar, NYU School of Nursing, New York, NY. Michael Grabinksi, Graphic Design. President, Red 5, LLC, New York, NY.

14 The Training Module: Clips

15 GiveNalxone.org flyer for patients, families, community members GiveNaloxone.org

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19 Pilot Program Evaluation Results

20 Pre-Test and Post-Test Statistical Analysis: Outpatient Pilot The majority of participants were social workers with some nurses and CASAC counselors. 100% of people gained competency after the pilot program, defined as an increase in test scores above the 80% threshold. The mean score before was 55% and the mean score after the training was 97%.

21 Statistical Analysis: Inpatient Pilot Demographics: 52% were nurses, the rest were social workers and counselors 82% had no prior overdose training despite working in an inpatient drug rehabilition center Only 57% of those who had witnessed an overdose before had then intervened For the 43% who had previously witnessed overdoses but not intervened, 100% rated on a Likert scale either 4 or 5 /5 that they felt after the training they were confident to administer naloxone if they were to witness an overdose emergency again. Statistical Analysis: Inpatient Pilot 90% of attendees were competent by completion of the module. The mean gain in scores was 33.5% with pretest mean of 58% and posttest mean of 91.5%. Most common errors included believing the most common overdoses are caused by heroin, naloxone treats benzodiazepine overdose, narcan will make the OD victim feel better, naloxone works because it is long-acting, and that naloxone is not given by trained bystanders (all the other answers were repesented).

22 Nurses Role in Naloxone Legislation Advocacy and Promoting Access

23 Nurses in Washington Institute OSNN

24 Ask for Standing Orders in Your Institution Start a Naloxone Program

25 The GiveNaloxone NP Manual Get in touch! Stay in touch!

26 Demonstration and Questions

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