Mary R. Habashy

Committee Chair Name & Credentials:
Sandra Halbruner, DNP, FNP-BC

Universal Screening for Opioid Use Disorder on a Labor and Delivery Unit: A Program Evaluation

Abstract Background: Universal screening to identify pregnant individuals with substance use concerns and opioid use disorder (OUD) is recommended to improve maternal-child outcomes. A health system in rural Pennsylvania began universal screening with the NIDA Quick Screen/ASSIST tool on a labor and delivery (L&D) unit with intentions to expand to the outpatient setting.

Local problem: The project site county had 32.5 pregnant individuals per 1,000 whose hospital stays involved opioid use.

Methods: A program evaluation based on the CDC Framework for Program Evaluation in Public Health was utilized to assess the NIDA Quick Screen/ASSIST universal screening process on a L&D unit. Descriptive statistics were used to present data relating to screening utilization rates, provider follow up, and staff feedback. Qualitative data from open-ended survey questions were reviewed for thematic analysis.

Interventions: A nursing and provider feedback survey analyzed the acceptability, appropriateness, and feasibility of the NIDA Quick Screen/ASSIST as a screening tool. Emerging feedback themes were analyzed in conjunction with key stakeholder perspectives to inform lessons learned and follow up recommendations.

Results: The screening utilization rate on L&D over a 13-month period was 89%. Providers ordered the appropriate follow up orders on “at risk” screens 87% of the time. Nurses and providers found the NIDA Quick Screen/ASSIST to be an acceptable screening tool.

Conclusions: The screening utilization rates and provider follow up rates on L&D were above the health system goal of 80%. Qualitative feedback identified areas of future focus as Streamlining the Screening Process, Nurse and Provider Education, Patient Education, and Patient Follow Up.

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