Increasing Nurse's Knowledge for Management of Nurses with Substance Use Disorders
The main purpose of this research was to demonstrate improved nurse leader’s knowledge about substance use disorders (SUD) in nurses. The aims were;1) to increase confidence and to take action for nurses with employee performance problems and 2) to reduced stigmatized attitudes toward nurses with SUD.
Rationale/Background:
Nurses are the center of hospital care teams and it is their responsibility to assure safe and
effective nursing care in the health care system. This function has profound influence on the
quality of patient outcomes and there is a serious problem when nurses use substances that
impair their performance and may result in patient harm.
Patient safety may be jeopardized when nurses have SUD which can impact performance via
slower reaction times, diversion of prescription drugs, patient neglect, and medication errors.
SUD is defined as the “persistent usage of alcohol or drugs and functional impacts caused by this usage.” (Cadiz, Truxillo & O’Neill 2014). The performance of nurses with SUD is not only a threat to patient safety, but also a threat to their own health. Thus, it is the ethical and legal responsibility of nurse leaders and co-workers to have the knowledge and skills to recognize and report the problem so that the nurse can obtain effective help for his or her SUD.
Yet, there are powerful barriers to nurse leaders gaining the necessary knowledge and skills for recommending SUD intervention. In the workplace, many nurses choose to remain silent about a co-worker who may have an SUD because of “loyalty, fear of being a hypocrite, guilt, or fear of jeopardizing a colleague’s license to practice.” Nurses and the American public view SUD as a “moral failure of lack of will power” (Trossman, S. 2003). Furthermore, the persistence of negative stereotypes and ongoing stigma towards SUDs (Cadiz, D., Truxillo, D., O’Neill, C. 2012) make nurses even more reluctant to take action.
Methods:
This was an IRB approved research that used RedCap to randomized the University of New Mexico Hospital (UNMH) nurse leaders for the consent and pre- and post-tests. The intervention was a 4 hour CEU approved class. The measurement was the mean changes in knowledge, self-efficacy, and substance abuse stigma.
Outcomes achieved/documented:
There were 116 UNMH nurse leaders who participated in the class and over the majority being a supervisor over 5 years with 66% in areas of adult care. Only 9% of the nurse leaders had supervised someone in the monitoring program. Results indicated that participants’ knowledge, self-efficacy and perceived utility was higher after training than just before training
Conclusions: The results suggest that supervisor classroom training, of "Fit to Perform" positively affects knowledge, self-efficacy, and reduces stigma and adds another effective training resource for supervisors managing nurses with substance use disorders.