Nursing Education and Continuing Education: Promising Practices and Persisting Gaps

Deborah S. Finnell, DNS, CARN-AP, FAAN

Professor Emerita, Johns Hopkins School of Nursing

May 21, 2020

National Academy of Medicine

Virtual Symposium of the Action Collaborative

Nursing Educational Initiatives

Substance use-related content including Screening, Brief Intervention, and Referral to Treatment (SBIRT)

• Substance Abuse and Mental Health Services Administration (SAMHSA)

• Health Resources & Services Administration (HRSA) grant funding

Nursing Educational Initiatives

Opioid-related content

• American Association of Colleges of Nursing (AACN): Opioid Initiative Pledge

• SAMHSA Provider Clinical Support Services – University

Nursing Educational Initiatives

Curriculum related to identification and treatment of substance use disorders

• SAMHSA Provider Grants

Continuing Nursing Education

• On-line self-paced programs promoting evidence base related to the substance use continuum• Screening, Brief Intervention, and Referral

to Treatment (SBIRT) for Healthcare Providers. Accessible at https://learn.nursing.jhu.edu/SBIRT(SAMHSA funded)

• Alcohol Screening and Brief Intervention: A self-paced on-line course. Accessible at https://learn.nursing.jhu.edu/aSBI(AACN/CDC funded)

Guidance for Nursing Practice and Higher Education

COMPETENCIES ESSENTIALS

Promising Practices:Nurse-delivered alcohol brief interventions

•Across 52 trials, where different providers delivered brief Interventions focusing on alcohol use, those delivered by nurses had the most effect in reducing quantity, but not frequency of alcohol consumption (Platt et al., 2016).

(Barnett, et al., 2019)

Persisting Gaps

• Wide dissemination of evidence-based activities in practice has yet to occur

• Essential substance use-related content is absent or limited on nursing licensing and nursing certification examination

• Requirements for obtaining and utilizing X waiver for buprenorphine limit access to and receipt of treatment

• American Association of Nurse Practitioners. (2020). COVID-19 state emergency response: Temporarily suspended and waived practice agreement requirements. https://www.aanp.org/advocacy/state/covid-19-state-emergency-response-temporarily-suspended-and-waived-practice-agreement-requirements

• American Association of Nurse Practitioners. (2019). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

• Barnett, M. L., Lee, D., & Frank, R. G. (2019). In rural areas, buprenorphine waiver adoption since 2017 driven by nurse practitioners and physician assistants. Health Affairs, 38(12), 2048-2056.

• Finnell, D.S., Tierney, M., & Mitchell, A.M. (2019). Nursing: Addressing substance use in the 21st century. Substance Abuse, 40(4), 412-420.

• Mitchell, A.M., Mahmoud, K., Finnell, D.S., Savage, C.L., Weber, M., & Bacidore, V. (2019). The Essentials competencies: A framework for substance use-related curricula. Nurse Educator, doi: 10.1097/NNE.0000000000000753