Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 27 Apr 2022

A Pilot Program of Interprofessional Care for the Patient with a History of Injectable Drug Use Requiring Intravenous Medication

DNP, RN, CRNI, VA-BC
Page Range: 30 – 39
DOI: 10.2309/JAVA-D-22-00001
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Highlights

  • Early identification of patients with a history of injectable drug use is vital.

  • Interprofessional collaboration is needed to increase safe completion of IV therapy.

  • Stratifying risks and realistic protocols are required in care settings for PWID.

  • In-patient use of illicit drugs may be 40% or higher.

  • Development of new tamper evident technology is urgently needed.

Abstract

Background:

The use of injectable drugs and alcohol increased during the months of lockdown and continual uncertainty of the worldwide response to the COVID-19 virus and its variants. As the world adjusts to living with multiple transmissible viruses, the health care system needs a comprehensive approach to care for people who inject drugs. Although the problem of injectable drug use is wide-ranging, this article will focus on the intersection of the person who injects drugs and the health care system.

Methods & Findings:

After an initial case involving a person who injects drugs requiring 42 days of intravenous antibiotics, the hospital began to develop plans to care for this patient population. Finding gaps in the research, a team at the hospital developed a Substance Use Risk Reduction Program that included a risk assessment scale, an interprofessional communication plan, and a set of protocols, then trialed these components between 2017 and 2019. The program successfully screened and collaborated care for patients with a history of injectable drug use. The goals to increase safety were addressed through the protocols that included tamper-evident technology and frequent observations by the staff. The risks of blood stream infection and overdose while a patient was in the hospital were reduced by using the risk reduction protocols. In addition, repudiated costs were decreased by thousands of dollars because of early planning for transfer from inpatient to outpatient, skilled nursing facility, or long-term acute care for the completion of intravenous therapy.

Copyright: Copyright © 2022 Association for Vascular Access. All rights reserved.
Figure 1.
Figure 1.

Wiedenbach, theory of dynamic nursing.


Figure 2.
Figure 2.

Interprofessional communication model.


Figure 3.
Figure 3.

Memorial Hospital Substance Use Risk Assessment.


Figure 4.
Figure 4.

Cost comparison with transition to postacute care.


Contributor Notes

Correspondence concerning this article should be addressed to mlhawes@datatowisdom.net
Received: 08 Jan 2022
Accepted: 03 Mar 2022
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