SHM Converge Scientific Abstract ePoster Gallery-Improving the Screening and Management of Substance Use in Hospitalized Adolescents

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This quality improvement project aimed to increase substance use (SU) screening among hospitalized adolescents from 50% to 80% over 6 months, while also improving identification of withdrawal risk, brief intervention, and linkage to resources. The need for the project was driven by rising adolescent overdose deaths and inconsistent inpatient screening practices, partly due to lack of a standardized process and discomfort among providers.<br /><br />The team integrated the validated CRAFFT 2.1N screening tool and brief interventions into a standardized psychosocial history. They also created and implemented a SU risk assessment/management guide and withdrawal protocols for opioids, alcohol, and benzodiazepines. Outcomes measured included screening rates, use of validated tools, brief interventions, resource provision, and naloxone prescribing at discharge.<br /><br />A total of 1,049 encounters were reviewed. Overall SU screening increased from a mean of 50% to 74%, and validated screening increased from 0% to 62%. Brief interventions were completed in 95% of encounters with a validated screen. Among CRAFFT screens, 19% were positive; 6% indicated medium risk and 13% high risk for SU disorder. For patients with positive screens, receipt of resources increased from 0% to 45%. Withdrawal order sets were used in 28% of patients at risk for opioid withdrawal and 67% of those at risk for alcohol withdrawal. Naloxone was prescribed to 39% of patients screening positive for substances other than alcohol or cannabis.<br /><br />The project improved SU screening and management in hospitalized adolescents, though the 80% screening goal was not yet reached. Future work will examine long-term outcomes and add electronic health record reminders to improve naloxone prescribing.

Asset Subtitle

Shiksha Sharma

Meta Tag

Author List Alexandra Falsey, Amy Weis, Courtney Port DO, MPH, Kiet Zhou, Lorin Ferris, Shiksha Sharma, Talisa L. Tait, Zeina Saliba

Category Research

Concept Screening test

Concept CRAFFT 21N

Concept Naloxone

Concept Substance Use Disorder

Concept Brief Intervention

Distinguished Non-Finalist

Presenter Organization Inova Fairfax Children's Hospital

Presenting Author Shiksha Sharma

Track Pediatric

Keywords

adolescent substance use screening

CRAFFT 2.1N

hospitalized adolescents

quality improvement

brief intervention

withdrawal risk assessment

naloxone prescribing

substance use disorder

standardized psychosocial history

inpatient screening protocols

Screening test

CRAFFT 21N

Naloxone

Substance Use Disorder

Brief Intervention