Experiences of care among individuals with opioid use disorder-associated endocarditis and their healthcare providers: Results from a qualitative study

Bearnot, Benjamin; Mitton, Julian; Hayden, Margaret; Park, Elyse R.

doi:10.1016/j.jsat.2019.04.008

Cited by 67 publications

(63 citation statements)

References 20 publications

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“…The inpatient healthcare system was ill-prepared for the rapid influx of patients who have OUD, who often present with medical complexities, co-morbid psychiatric disease, and have an increased risk of experiencing poverty, homelessness and other socio-economic barriers to health. People who have a substance use disorder (SUD) encounter stigma in the medical system reflective of a broader culture that has historically criminalized drug use and framed addiction not as a disease, but as a choice [7,8]. The direct consequences of stigma include: delay of medical care, nondisclosure of risky behaviors, rushed visits, downplaying pain, avoidance of harm reduction services (such as needle exchange programs) and decreased drug treatment completion [9–11].…”

Section: Introductionmentioning

confidence: 99%

“You’re kind of at war with yourself as a nurse”: Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder

et al. 2019

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BackgroundIn the midst of an opioid epidemic, health care workers are encountering an increasing number of patients who have opioid use disorder in addition to complex social, behavioral and medical issues. Of all the clinicians in the hospital, nurses spend the most time with hospitalized patients who have opioid use disorder, yet there has been little research exploring their experiences in caring for this population. The objective of this study was to assess the attitudes, perceptions, and training needs of nurses in the inpatient setting when caring for patients who have opioid use disorder.MethodsOne-on-one in-depth interviews were conducted with nurses working at a large academic medical center in Boston, MA, using a semi-structured interview guide. Nurses were recruited via email notifications and subsequent snowball sampling. Interviews were recorded, transcribed and analyzed using a grounded theory approach.ResultsData from in-depth interviews with 22 nurses were grouped into six themes: (1) stigma, (2) assessing & treating pain, (3) feelings of burn out, (4) communication between providers, (5) safety & security, and (6) opportunities for change. These themes were organized within four ecological levels of the Socio-Ecological Model: I) societal context, II) hospital environment, III) interpersonal interactions, and IV) individual factors. Nurses were cognizant of the struggles that patients who have opioid use disorder confront during hospitalization such as pain, withdrawal and stigma, and elaborated on how these challenges translate to professional and emotional strain among nurses. Nurses offered recommendations by which the hospital could streamline care for this population, including expanded role support for nurses and more structured policies regarding care for patients who present with a comorbid opioid use disorder.ConclusionOur results highlight the need for the development of programs targeting both organizational culture and the inpatient nurse quality of life to ultimately enhance quality of care for patients who present with opioid use disorder.

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Section: Introductionmentioning

confidence: 99%

“You’re kind of at war with yourself as a nurse”: Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder

et al. 2019

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“…These lessons also apply to the care of patients who require prolonged hospitalization for other reasons. For example, individuals with serious, injection-related infections are expected to abstain from using substances or risk increased stigma, scrutiny, confiscation of substances and syringes, and even refusal of care ( Bearnot, Mitton, Hayden, & Park, 2019 ). Instead of optimizing safety within these clinical settings, the abstinence-focused perspectives that are pervasive within many large medical institutions establish hospitals as “risk environment[s]” in which people who use drugs face limited choices and constrained abilities to maintain their health and well-being ( McNeil, Small, Wood, & Kerr, 2014 ).…”

mentioning

confidence: 99%

Integrating harm reduction and clinical care: Lessons from Covid-19 respite and recuperation facilities

Kimmel

Bazzi

Barocas

2020

Journal of Substance Abuse Treatment

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In response to the novel coronavirus 2019 (Covid-19) pandemic, many people experiencing homelessness and substance use disorders entered respite and recuperation facilities for care and to isolate and prevent subsequent SARS-CoV-2 transmission. However, because drug use was officially prohibited in these facilities, we observed people who use substances leaving isolation temporarily or prematurely. The initial Covid-19 surge magnified the need for harm reduction access for those who use substances to ensure their safety and well-being and that of their local communities. In this commentary, we argue that expanding harm reduction access is crucial for subsequent waves of SARS-CoV-2 infection and also for patients who use substances and are hospitalized for other reasons.

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“…We found that despite reports of stigmatization of people who inject drugs [7], patients with IDU-SAB received all of the appropriate ID-related interventions, which were associated with improvements in mortality [3, 6]. However, this care broke down for those who left AMA, none of whom received intravenous or oral antibiotics or medical follow-up.…”

Section: Discussionmentioning

confidence: 95%

Disparity in Quality of Infectious Disease vs Addiction Care Among Patients With Injection Drug Use–Associated Staphylococcus aureus Bacteremia

Serota

Niehaus

Schechter

et al. 2019

Open Forum Infectious Diseases

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Experiences of care among individuals with opioid use disorder-associated endocarditis and their healthcare providers: Results from a qualitative study

Cited by 67 publications

References 20 publications

“You’re kind of at war with yourself as a nurse”: Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder

“You’re kind of at war with yourself as a nurse”: Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder

Integrating harm reduction and clinical care: Lessons from Covid-19 respite and recuperation facilities

Disparity in Quality of Infectious Disease vs Addiction Care Among Patients With Injection Drug Use–Associated Staphylococcus aureus Bacteremia

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