Harm Reduction in Nursing Practice: Compassionate Care for Persons With Addiction

2.50
Hdl Handle:
http://hdl.handle.net/10755/621571
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Harm Reduction in Nursing Practice: Compassionate Care for Persons With Addiction
Author(s):
Killarney, Audrey Catherine; Neuman, Michelle Esther
Lead Author STTI Affiliation:
Zeta Sigma
Author Details:
Audrey Catherine Killarney, BS, Professional Experience: 2014-2016 -- Research Study Coordinator, Northwestern University, Division of Hospital Medicine, Chicago, IL 2016-present -- Student Intern, Enlace Chicago, Health Promotion & Outreach, Chicago, IL Coauthor of 3 publications related to health promotion interventions for the hospitalized patient. Author Summary: Audrey Catherine Killarney is a Master's in Nursing Student at DePaul University, graduating August 2017. Prior to nursing school, Audrey worked as a Research Study Coordinator under Dr. Kevin J. O'Leary studying health promotion interventions for hospitalized patients. Audrey has a profound interest in how the profession of nursing can be leveraged to yield higher patient engagement and facilitate healthy behaviors, ultimately leading to better care and patient outcomes.
Abstract:

Substance abuse and overdose deaths are increasing at profound rates in the United States. Nurses and clinicians must evaluate their response to this growing epidemic. Harm Reduction is an alternative therapy for rehabilitation and was traditionally used in tobacco cessation, and to control the spread of HIV and HCV. The concept of harm reduction can be described as accepting the possibility that individuals will abuse harmful substances, and the goal of treatment is to reduce the harm associated with the addictive behavior; ultimately, this treatment nurtures a non-judgmental environment that facilitates a therapeutic nurse-patient relationship. Much of the literature regarding harm reduction in nursing is isolated to Canada and parts of Europe. However, the 6-fold increase in heroin overdose deaths in the United States from 2001-2013, has prompted lawmakers, parents, and clinicians to explore alternatives to standard rehabilitation practices (National Institute on Drug Abuse, 2015).

This integrative literature review sought to explore current uses of harm reduction, evaluate their efficacy, and examine harm reduction for inclusion into nursing practice in the United States. The following nursing databases were utilized for provision of literature: CINAHL complete and PubMed. Databases were searched using the following terms and Boolean phrases: “harm reduction & nurs*,” and “harm reduction & addiction,”. Articles were chosen if the language was in English, published within the last 10 years (2006-2016), published in an academic peer-reviewed journal, and were primary sources. Of the 99 articles retrieved, 10 will be analyzed in the integrative literature review. The remaining 89 articles were excluded due to the following parameters: duplicate article, application of harm reduction to alternate health disparities (fall prevention, smoking cessation, or cardiovascular disease), no clear relationship to nursing practice, or a position piece.

Results of the literature review yielded 6 studies identifying current uses of harm reduction, and 4 studies focusing on clinician perspectives about providing harm reduction therapy. Selected literature was rated using the Melnyk Fineout-Overholt Hierarchy of Evidence (2011) (Appendix A). Analysis of the literature regarding clinician perspectives revealed common themes such as: harm reduction as a bridge to abstinence; harm reduction’s ability to address the patient as a holistic being; and harm reduction as honoring a patient’s autonomy. A research matrix was created to holistically analyze and categorize the body of selected literature. Studies regarding current use of harm reduction found positive results in patients’ self-reported advocacy, self-esteem, and ability to navigate social services. Patients also experienced a decrease in problems associated with drug and alcohol use, as well as a decrease in money spent on drugs or alcohol. In addition to the evidence-based successes, the ethical components of harm reduction align with much of the nursing code of ethics. Patient autonomy, and trust in a patient’s ability to make health related decisions, is one of the key tenants of Pender’s Health Promotion Model; both perceived self-efficacy and perceived barriers to action greatly influence a patient’s commitment to action, and ultimately the adoption of a health promoting behavior (Alligood, 2013). While it is unlikely that stand-alone facilities modeled under harm reduction will be created in the United States, there are elements of harm reduction that can be readily integrated, and may be unknowingly permeating, current nursing practice.

 

Appendix A.

Melnyk Fineout-Overholt Heirarchy of Evidence Rating

Frequency

Cumulative Percentage

Level 1: Systematic review & meta-analysis of randomized control trials (RCT) or evidence-based clinical practice guidelines

1

10%

Level 4: Case control & cohort studies

3

40%

Level 6: Single descriptive or qualitative study

4

80%

Level 7: Expert opinion

2

100%

Totals

10

100%

Keywords:
Addiction; Harm Reduction; Health Promotion
Repository Posting Date:
22-Jun-2017
Date of Publication:
22-Jun-2017
Other Identifiers:
INRC17PST204
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleHarm Reduction in Nursing Practice: Compassionate Care for Persons With Addictionen_US
dc.contributor.authorKillarney, Audrey Catherineen
dc.contributor.authorNeuman, Michelle Estheren
dc.contributor.departmentZeta Sigmaen
dc.author.detailsAudrey Catherine Killarney, BS, Professional Experience: 2014-2016 -- Research Study Coordinator, Northwestern University, Division of Hospital Medicine, Chicago, IL 2016-present -- Student Intern, Enlace Chicago, Health Promotion & Outreach, Chicago, IL Coauthor of 3 publications related to health promotion interventions for the hospitalized patient. Author Summary: Audrey Catherine Killarney is a Master's in Nursing Student at DePaul University, graduating August 2017. Prior to nursing school, Audrey worked as a Research Study Coordinator under Dr. Kevin J. O'Leary studying health promotion interventions for hospitalized patients. Audrey has a profound interest in how the profession of nursing can be leveraged to yield higher patient engagement and facilitate healthy behaviors, ultimately leading to better care and patient outcomes.en
dc.identifier.urihttp://hdl.handle.net/10755/621571-
dc.description.abstract<p><span>Substance abuse and overdose deaths are increasing at profound rates in the United States. Nurses and clinicians must evaluate their response to this growing epidemic. Harm Reduction is an alternative therapy for rehabilitation and was traditionally used in tobacco cessation, and to control the spread of HIV and HCV. The concept of harm reduction can be described as accepting the possibility that individuals will abuse harmful substances, and the goal of treatment is to reduce the harm associated with the addictive behavior; ultimately, this treatment nurtures a non-judgmental environment that facilitates a therapeutic nurse-patient relationship. Much of the literature regarding harm reduction in nursing is isolated to Canada and parts of Europe. However, the 6-fold increase in heroin overdose deaths in the United States from 2001-2013, has prompted lawmakers, parents, and clinicians to explore alternatives to standard rehabilitation practices (National Institute on Drug Abuse, 2015).</span></p> <p dir="ltr">This integrative literature review sought to explore current uses of harm reduction, evaluate their efficacy, and examine harm reduction for inclusion into nursing practice in the United States. The following nursing databases were utilized for provision of literature: CINAHL complete and PubMed. Databases were searched using the following terms and Boolean phrases: “harm reduction & nurs*,” and “harm reduction & addiction,”. Articles were chosen if the language was in English, published within the last 10 years (2006-2016), published in an academic peer-reviewed journal, and were primary sources. Of the 99 articles retrieved, 10 will be analyzed in the integrative literature review. The remaining 89 articles were excluded due to the following parameters: duplicate article, application of harm reduction to alternate health disparities (fall prevention, smoking cessation, or cardiovascular disease), no clear relationship to nursing practice, or a position piece.</p> <p><span id="docs-internal-guid-4d06b4d0-8035-750b-c2be-d5db951e3338">Results of the literature review yielded 6 studies identifying current uses of harm reduction, and 4 studies focusing on clinician perspectives about providing harm reduction therapy. Selected literature was rated using the Melnyk Fineout-Overholt Hierarchy of Evidence (2011) (Appendix A). Analysis of the literature regarding clinician perspectives revealed common themes such as: harm reduction as a bridge to abstinence; harm reduction’s ability to address the patient as a holistic being; and harm reduction as honoring a patient’s autonomy. A research matrix was created to holistically analyze and categorize the body of selected literature. Studies regarding current use of harm reduction found positive results in patients’ self-reported advocacy, self-esteem, and ability to navigate social services. Patients also experienced a decrease in problems associated with drug and alcohol use, as well as a decrease in money spent on drugs or alcohol. In addition to the evidence-based successes, the ethical components of harm reduction align with much of the nursing code of ethics. Patient autonomy, and trust in a patient’s ability to make health related decisions, is one of the key tenants of Pender’s Health Promotion Model; both perceived self-efficacy and perceived barriers to action greatly influence a patient’s commitment to action, and ultimately the adoption of a health promoting behavior (Alligood, 2013). While it is unlikely that stand-alone facilities modeled under harm reduction will be created in the United States, there are elements of harm reduction that can be readily integrated, and may be unknowingly permeating, current nursing practice.</span></p> <p> </p> <p dir="ltr">Appendix A.</p> <div dir="ltr"> <table><colgroup><col width="205" /><col width="79" /><col width="96" /></colgroup> <tbody> <tr> <td> <p dir="ltr"><em>Melnyk Fineout-Overholt Heirarchy of Evidence Rating</em></p> </td> <td> <p dir="ltr"><em>Frequency</em></p> </td> <td> <p dir="ltr"><em>Cumulative Percentage</em></p> </td> </tr> <tr> <td> <p dir="ltr">Level 1: Systematic review & meta-analysis of randomized control trials (RCT) or evidence-based clinical practice guidelines</p> </td> <td> <p dir="ltr">1</p> </td> <td> <p dir="ltr">10%</p> </td> </tr> <tr> <td> <p dir="ltr">Level 4: Case control & cohort studies</p> </td> <td> <p dir="ltr">3</p> </td> <td> <p dir="ltr">40%</p> </td> </tr> <tr> <td> <p dir="ltr">Level 6: Single descriptive or qualitative study</p> </td> <td> <p dir="ltr">4</p> </td> <td> <p dir="ltr">80%</p> </td> </tr> <tr> <td> <p dir="ltr">Level 7: Expert opinion</p> </td> <td> <p dir="ltr">2</p> </td> <td> <p dir="ltr">100%</p> </td> </tr> <tr> <td> <p dir="ltr"><strong>Totals</strong></p> </td> <td> <p dir="ltr"><strong>10</strong></p> </td> <td> <p dir="ltr"><strong>100%</strong></p> </td> </tr> </tbody> </table> </div>en
dc.subjectAddictionen
dc.subjectHarm Reductionen
dc.subjectHealth Promotionen
dc.date.available2017-06-22T13:35:17Z-
dc.date.issued2017-06-22-
dc.date.accessioned2017-06-22T13:35:17Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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