Respond to your colleagues by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

Response Discussion

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Response Discussion

Substance use and overdoses among individuals, as you stated, is on the rise and requires an urgent address. Addressing the issue can be achieved through preventive initiatives and intervention strategies such as dissemination of evidence-based practices. I agree with you that evidence-based treatments and information has strong and positive effects in addressing the issue, as they provide proven strategies and effective policies that maximize the quality of patient care (Melnyk, 2018). The evidence-reviewed articles you have shared in your post confirm this theory. When disseminating information, as stated, you use teaching and direct contact with your target audiences, which can be classified as oral and poster presentations. These strategies are effective and efficient to apply; however, I believe you are susceptible to barriers such as limited time, audience impediment, and lack of adequate time to prepare well-structured posters.

Addressing these barriers requires effective mitigation strategies. For instance, when disseminating information prepare a summary that highlights summarized topics and communicates information only needed, to ensure you cover everything. From your post, information that you disseminate is extensive and equally important; hence, no information should be left out. You have visuals and videos that should be viewed to facilitate effective dissemination process  (McClung, 2012). Therefore, organizing your work into topics and bulleting most essential points will ensure you cover everything and time does not catch up with your presentation.

Ensure that the presentation is culturally responsive by determining a cultural value perception strategy to address audience impediment-oriented barriers. Inadequate preparation can be solved by always preparing for the performance weeks before the actual presentation date. Overly, one requires adequate preparation on all public speaking elements to be prepared to overcome any barrier that may be presented  (Brownson, 2018).

References

Brownson, R. C. (2018). Getting the Word Out: New Approaches for Disseminating Public Health Science. Journal of Public HealthManagement and Practice, Vol 24(2), pp; 102-111.

McClung, S. J. (2012). Potential Effects of Institutional Repositories on Nursing Research Dissemination. Master’s Thesis, University of Tennessee.

Melnyk, b. m.-o. (2018). Evidence-based practice in nursing & healthcare: a guide to best practice (4th ed.). Philadelphia: Wolters Kluwer Publishers.

This year, the California Department of Corrections and Rehabilitation (CDCR) rolled out an unprecedented substance use program for the inmates throughout the state. It consists of medication-assisted treatment (MAT) with Suboxone and Naltrexone as well as counseling to increase the chances of abstinence. This program is an expensive initiative from the governor and is aimed at decreasing the number of opiate overdose deaths as well as reduce the number of people paroling to the streets with active substance use disorders.  The vast majority of these people return to prison.

Drug use and overdoses are a huge problem in the California prison system. Drugs are routinely smuggled into the prison during inmate family visits. This is how most of them get into the prison with corrupt staff also bringing some in. These staff members are eventually caught and arrested. I have experienced the impact of opiate overdoses firsthand responding to countless patients who are found unconscious and in some cases, deceased.

Medication-assisted treatment is an evidenced-based treatment modality that has shown great success. Barglow (2018) highlighted the power of harm reduction, which is the backbone of medication-assisted treatment. Expecting long time substance users to go cold turkey and completely abstain from drugs has not been shown to work. Drugs are able to make their way into maximum-security prisons which shows how powerful the demand is.

Elarabi et al. (2019) reviewed the STAR-T trial which showed the powerful potential of using Suboxone for medication-assisted treatment, including a staggering 10-fold increase in heroin abstinence. The article discussed the importance of drug testing and follow-ups to ensure success and reduce diversion. This is a big component of the new program in CDCR. Participants who fail the drug tests for other substances or those that do not have the MAT drug in their system are removed from the program.

Wickramatilake et al (2017) demonstrated how the states have responded to the opiate epidemic. The article showed how the states had pursued evidence-based initiatives to combat the program as well as reminding the reader about the 33,000 people who died of opiate overdoses. It was reassuring to read that the states were aggressive in their response.

As the prison’s nurse instructor, I play a very important role in disseminating the information. The first dissemination strategy is teaching the staff about the manifestations of substance abuse. This includes monthly nursing meetings were I present on diseases such as bacterial endocarditis, skin abscesses, and osteomyelitis which are directly linked to IV drug use. I show symptoms, high definition pictures, videos of echocardiograms, as well as go over the fatal consequences if these drug-related diseases. These presentations have been very well received. I am also the prison’s lead emergency medical response trainer and teach the staff how to respond to opiate overdoses and what they are expected to do. Real-world stories and experiences are shared to help the newer staff who have never handled Narcan let alone administered it in a medical emergency.

The second way I am involved in the dissemination of information is by working with our substance abuse resource RN in hanging up posters regarding the new program. I also am involved in teaching the correctional staff about the new substance abuse program and this can include the warden. This is to ensure all staff is on the same page and to increase the chance of success.

References

Barglow, P. (2018). Commentary: The opioid overdose epidemic: Evidence-based interventions. American Journal on Addictions, 27(8), 605–607. https://doi-org.ezp.waldenulibrary.org/10.1111/ajad.12823

Elarabi, H., Elrasheed, A., Ali, A., Shawky, M., Hasan, N., Gawad, T. A., Adem, A., & Marsden, J. (2019). Suboxone Treatment and Recovery Trial (STAR-T): Study Protocol for a Randomised Controlled Trial of Opioid Medication Assisted Treatment with Adjunctive Medication Management Using Therapeutic Drug Monitoring and Contingency Management. Journal of Addiction, 2019, 2491063. https://doi-org.ezp.waldenulibrary.org/10.1155/2019/2491063

Wickramatilake, S., Zur, J., Mulvaney-Day, N., Klimo, M. C. von, Selmi, E., & Harwood, H. (2017). How States are tackling the “opioid crisis.” Public Health Reports, 2, 171.