Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-11-2019

Graduate Advisor

Allison Brauch

Committee

Sheila Grigsby

Wendy Orson

Abstract

Problem. The rising rates of opioid overdose deaths continue to be a significant public health concern. Innovative programs utilizing a Recovery Coach in the Emergency Department (ED) have demonstrated initial success. However, there is limited evidence to support their effectiveness for improving treatment or recovery outcomes for people living with opioid use disorder. The purpose of this study was to evaluate whether the method of arrival to the ED for an opioid overdose affects engagement and retention in an opioid overdose project in a midwestern metropolitan area, which utilizes a Recovery Coach in the ED. Methods: Utilizing the Plan-Do-Study-Act framework, this study evaluated the Engaging Patient’s in Care Coordination (EPICC) program. The primary investigator conducted a retrospective chart review for individuals referred to the program between December 2016 and October 2018. The study compared clients who arrived at the ED via EMS and clients who came to the ED another mode of transportation and its effect on program engagement and retention rates. Results. During this period, 1,769 referrals (N =1,769) met project inclusion criteria. Within the sample, 31.7% of individuals arrived at the ED via EMS (n=560) and 68.3% arrived another mode of transportation (n=1,209). Results from χ2 found a statistically significant relationship between arrival to the ED and early engagement and retention in the EPICC program. Implications for Practice. Clients who arrive at the ED without EMS are more likely to initially engage and remain in the EPICC project versus those who arrive with EMS. Differences may be affected by treatment-seeking behavior, in terms of levels of OPIOID OVERDOSE PROGRAM AND EMS INVOLVEMENT 3 motivation. Individuals who arrive at the ED via EMS my present involuntarily and have less motivation than individuals who voluntarily present to the ED. Implications of this project should consider how to reduce the number of individuals who arrive by EMS and decline or drop out of the program and how to support them in recovery effectively.

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