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NURS FPX 9904 Assessment 1
Project Summary Report
From the study, it is evident that the worldwide epidemic of opioids has been ranked as one of the most pressing challenges in public health in the present generation. This proposal aimed at implementing possible improvement one the treatment plans for the clients with the opioid use disorder who could benefit from CBT and MI.
This enables the individuals to indulge in substance abuse which is forcing the abnormal increase in the rates of illness and mortality as well as being the number one drain on the economies of the countries. The qualitative inquiry thus aimed at evaluating the efficacy of the two multifaceted therapeutic modalities of treatment in reducing the readmission rates and enhancing the adherence of the patients afflicted with opioid dependency.
It was the goal of the project to increase the treatments efficacies of patients, upon the enhancement of the conventional focus on disease pathology, psychological and physiological aspects of addicted behaviors. The assessment report featured a project description and data gathered from several sources along with the results analysis, concluding part together with the recommendations for the further application of the interventions in many health care facilities.
Background and Organization Gap Analysis
According to Dydyk et al. (2024), opioid dependence disorder is a significant health issue, which is present all across the world and is observed in over 16 million individuals, thus having a massive impact on the society and the economy of the countries affected by this issue.
Psycho-social intervention, drug counseling, and other forms of psychological treatments and pharmacological treatments are some of the conventional treatments for drug dependence and chronic pain. They do not, however, often fulfill the comprehensive requirements of these patients. The types of treatment that have been proven effective include Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI).
These are useful for the head and occasionally the body involved in the creation of addiction. The challenge that arises from this is how to place the ideas in a manner that is systematic and sequential to make a whole treatment process.
Since the beginning of the graduate project, the project site relied on the normal intervention methods such as medication, therapy, and counseling. The methods failed to pay adequate attention to every addict’s circumstances as needed by designing treatments best for each of them (Volkow & Blanco, 202).
There were high readmissions rates and even though they needed ongoing care, patients improved at a slower pace as compared to before. The currently used methods did not address the root psychological features of dependency so they may be better.
The first important issue we identified in the treatment plan approach for the project site was that it failed to incorporate a tailored approach that integrates CBT and MI, for opioid dependent patients as part of the patient-centered, interdisciplinary model for patients in primary care settings. The current rules were insufficient for achieving the needed outcome like the reduction of readmission rates or patients compliance with treatment regimens (S. D. , Personal Communication, November 29, 2023).
According to the utilization patterns of hospitals in the third quarter of 2023, readmissions that occur from a relapse of opioid use disorder account for half of all readmission occurrences. This indicates that what is currently being done in trying to ‘treat’ persons with drug use disorders is no longer effective (S. D, Personal Communication, November 29, 2023).
Identifying this lacuna, the project site envisaged the potential of offering a patient-centred approach to the CBT plus MI regime where it would be possible to enhance the synergy of both the approaches. This would help reduce and close the gap and offer a more holistic understanding of addiction treatment.
This seems to have been the rationale of the project because it was aimed at enhancing patient results as well as reducing pressures on healthcare systems by assessing the efficacy of the treatments.
The intention of the plan was to exclude a “blanket approach,” where doctors lack the discretion to adapt interventions to focus on the individual risks factors, drug usage and mental health states of the client (Pollok et al. , 2019). The objectives of the undertaking were to raise efficacy and quality of care in unit to enhance patients’ outcomes and reduce the rate of readmissions due to relapses in OUD, hence making addiction treatment more effective and compassionate.
Significance of the Practice Problem
Opioid abuse remains a significant issue, which impacts millions of people globally and considerably shatters hundreds of millions in terms of costs, lives lost, and health deteriorated. The annual death figure due to drug abuse is more than seventy thousand in the USA, which underlines the significance of having efficient intervention strategies (Dydyk et al. , 202 ).
The CDC and SAMHSA, along with other organizations, emphasize the concept of treatment approaches that are evidence-based and require addressing the biological, psychological, and social components of Substance Use Disorders. The project’s goal was to answer the TWICE question below: Consequently, is the number and commitment to complete treatment and/or number of readmissions within 12 weeks affected when using individualized CBT and MI (I) rather than normal treatment methods (C) to treat opioid dependents (P)?
NURS FPX 9904 Assessment 1 CBT Sessions and Motivational Intervening
Coordinating between CBT and MI serves the national purpose of enhancing the quality of life for the patients who are addicted to opioids (Chand et al. , 202^). Generally, effective treatment for drug addicts is beneficial to the drug user and their family. It elevates well-being, reduces mortality, and enhances life in every way possible. In the health system, good measures can minimize return rates, cut on the amount of money spent on healthcare services and relieve pressures on emergency services and healthcare personnel (Volkow & Blanco, 2023).
Employer cost include costs of health care, medications, missed days at work due to opioid use, and crime-related expenses. An integration of the samples followed CBT and MI to reduce readmissions, and, thus, spread them out and make the situation better in the end (Pranckeviciene et al. , 2022).
When it comes to the issue of drug addiction, people should consider several critical cultural and moral factors like embarrassment of being forced to join a drug-rehab program, patient’s privacy and legal constraints in the management of this. shared Instance Delivering individualised CBT and MI also respects patient’s autonomy and their cultural preferences to practice patient-centered care. This is as per the principles of ethically, and generally makes the treatment much more efficient (Corbett et al., 2023).
Summary of the Evidence
Focusing on the PICOT question revolving around the identified population of nurses that cater to individuals with opioid addiction, thirty sources were regarded concerning relevancy, adherence to research methodologies, and utility in the context of the quality improvement project. The new search conducted the search in every similar sources with higher sensibility, such as CINAHL, PubMed, and the Cochrane library.
According to the findings of the current review of customized CBT and MI treatments for opioid-dependent patients, the following six main concerns can be underlined. First of all, the obtained outcome identified that CBT can be an effective approach to treat OUD as well as chronic pain. For instance, in their systematic review carried out to determine the perception of the mental health workers on the effectiveness of CBT in the treatment of OUD conducted in Lent et al. (2021).
Moreover, motivational interviewing (MI) could also be employed for manipulative use of opioids and other drug issues; Smedslund, Stileg, and Middelthon (2011) argued that it indeed works for substance use outcomes. The project has also sought to determine whether it is feasible and how much it would be for patients to receive MI or CBT for drug use disorder and chronic pain. This is evidenced by Olmstead and colleagues’ quantitative work on the feasibility and efficacy of MI intervention methods.
In a particular group of individuals with both OUD and other mental health disorders, two treatments that have been considered are the CBT and MI. Of these, one is MI-CARE, conducted by DeBar et al.
Unfortunately, the conversation that has revealed the efficacy of the CBT and MI treatments indicates that there is still some important work to be done — that of ensuring that these treatments are effective for people of all cultures and can be made useful to them. In a study by Adams et al. (2023), MI was noted to have good results for the increased drug users and thus it can be adopted in low-income settings.
The topics assist us in defining what is currently known about the effectiveness and feasibility of integrating the elements of personalized CBT and MI care for opioid dependent patient into practice for patients with OUD, the cost of the intervention, its potential applicability to culturally diverse populations.
Quality Improvement Framework
Based on the notion that the care experience should be more logical and technical to achieve the intended goals of the doctoral project, the Plan-Do-Study-Act model was adopted as the QI framework for the project (Triplett et al. , 2022).
The PDSA model consists of an ongoing confirmation undertaking: repeatedly plan, do, study, and act When particular challenges were important and complex, for example when the hospital was targetting a low readmission rate among opioid-dependent patients, the reasoning process would be utilised.
Stakeholder involvement and interim review were reported as highly critical in the project so that it can meet its overall goals and objectives and all the relevant change perspectives he planned to implement (Benetato et al. , 2020).
Since every project requires a comprehensive strategy in its implementation, creating a sound plan was the initial step to be taken to ensure that the QI/PI project flowed smoothly. When planning the actions of the nursing intervention, the nurses were very precise to ensure that everyone was compliant with all the steps and rules during the planning process.
In the first step, detailed examination and dialogue about essential practices, as well as the ratification of the comprehensiveness of healthcare quality improvement processes, conducted by Abuzied et al. (2023). Thus, ensuring the construction of the framework helped the nurses to make it possible to effectively implement the project and proceed to the further stages.
At the second stage at the same location nurses whom had been assisted by their patients to overcome drug abuse also adopted the program at the workplace. Utilizing the program in real life meant incorporating it into working experience and introducing countless modifications in order to follow new regulations. During the third strategy cycle, the nurses endeavored to ascertain the effectiveness of the developed strategy.
In collecting data they incorporated motivated interviews and cognitive behavioural therapy in a bid to gather both qualitative and quantitative data. The final aspect of successful treatment utilization was to tailor the current methods to clients’ conditions. This was because it ensured that each patient received individual attention, coordination and documented care which would enhance his/her outcome. Which, as Wasim et al. (2023) called it, not only improved the outcomes of the treatments but also built a healthcare environment that was beneficial and patient-focused.
One of the significant focuses within a portion of the project was to collect and evaluate data, which ensured that a particular action, as well as work implemented within the project, met its purpose (Serwer, 2021). As Blanchard et al. (2019) pointed out, the implementation of an EHR in the healthcare delivery system ensures that the collected, verified, and normalized data is done correctly.
This makes it possible to have quality as well as sound research [1]. Also, simple quantitative aspects were examined in the study; therefore, it was easy to disseminate basic quantitative details such as the rate of return – the increased level of applications for CBT treatments and even patients’ compliance with the treatment regimens.
With regards to objectives, the project has the following; to reduce drug addicts readmission rate (Kelley et al. , 2022). CBT lessons and contingency management can be combined as an approach, which will assist in providing more effective treatment.
According to the duration and type of work, the expected objectives include research on the way of reducing readmission rate to an average of 20%; eliminate the possibility of 10% of patients’ noncompletion of CBT; establish an average of not less than 90% completion within 12 weeks (Barry et al. , 2020). Despite the fact that an organization may have to deal with staff reluctance and cultural incompetence, and despite the fact that one can usually identify factors and support that connect to the goal of a project, the next question to address is how to understand those factors and support better.
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Project Description
It was planned and implemented in a full scope of an actually possessing full range of healthcare facilities from hospitals to basic care centers and specialized treatment programs. I observed that there were numerous tools available to perform the treatments as well as assess the results, and the patients had different backgrounds. In regards to the population, only outpatients with OUD and over the age of 18, who were motivated to attend specialized CBT and MI group classes, had the chance to participate in the project.
The latter was excluded due to medical conditions such as severe mental disorder, inability to speak English the patient did not choose to use a translator since language services were not provided, and those in another treatment program that conflicted with this one. The project also ensured it had a defined and useful group of employees to work with, while avoiding the confusion of including various employees who could not be useful to the project while still staying within the healthcare medium.
Education in the form of individualized CBT and MI lessons was employed in the intervention. And each specifically offered coverage for both the psychological and physical aspects of substance misuse. Methods including cognitive restructuring, controlled problem-solving, and stress-coping skills (Chand et al. , 2023) in CBT sessions assisted patients with substance dependence into identifying and modifying their distressed thinking patterns and activities.
In MI meetings the focus was to enhance the individual patient’s intrinsic motivation for change, coming up with the states or reasons as to why the change was not desirable. The meetings were held based on the strategies and values which enable the focus on the client, values of empathy, teamwork, and support (Fragkiadaki et al. , 2023).
Project Evaluation Results
Using instruments such as the ORT and only admitting the practices that come under AQR Qualitative analysis guaranteed the outcomes were accurate. It is worth adding that best practices were implemented to collect the data and to make initial evaluations all the time; therefore, the results of the project were improved even more. This laid the foundation for further examination and to be used across various health care environments.
Given that unique CBT and MI tools were used, this study applied a mixed-methods approach to understand how well it supported those with Opioid Use Disorder (OUD). Again, the data collection involved both quantitative and qualitative approach to ensure an optimal understanding of how the treatments applied will be.
According to guidelines that are adopted in most healthcare research, both quantitative data and subjects’ feelings were collected by using the mixed research method. The Institutional Review Board (IRB), approved all the methods through which the data was collected to ensure that they were viable and safeguarded the participants’ welfare.
Actual quantitative data were collected utilizing global outcome measures that must have been established. For these, they considered factors such as return rates as well as compliance to treatment regimens. To assess the outcome, only appraisal icons such as figures were applied (Cooksey, 2020).
The drug Risk Tool (ORT) was the main method to measure numeric data. The following specifics were noted regarding the data collection methods used: Dependability it has get 0. 83 and has been validated in the previous research as a tool capable of correctly estimating the rate of drug abuse (Brott et al. , 2022).
ORT authors allowed taking their abbreviation to use, which provided that no violations of the rights to an intellectual product would be made. With the help of the tool, it became possible to employ the same metric to measure the risk factors within patients and their impact, and that made it easier to compare the effectiveness of interventions.
On the other hand, qualitative information was got through structured interviews with the patients, the healthcare providers, and every other project stakeholder involved. Fragkiadaki et al. (2023) conducted a qualitative study to explore participants’ emotional experiences, perceptions and views about the CBT and MI treatment.
They were designed to reveal how satisfied the subjects were with the treatments and how they believed they impacted the physical health and well-being of the patients. These interviews collected qualitative data that was analyzed using thematic analysis and had similar themes and trends to give additional information of how well the researched intervention has worked. It made the researchers gain insights about issues concerning the subjects where the study was done besides knowing the outside influences on the outcome of the interjection.
The formal assessment was conducted continuously during the project alongside daily discussions with stakeholders in order to check how the treatments were being performed (Corbett et al. , 2023).
The nature of the intervention meant that the methods could be modified during the implementation process to address new emergent issues in order to improve the process and the sustainability of the intervention. Face-to-Face contacts with patients, doctors and managers regularly provided helpful knowledge about the benefits and drawbacks of the treatments to make them continue enhancing the treatments to meet the needs on a regular basis.
Based on various suggestions by Nair (2023), the project incorporated end result sorting, matching and multivariable regression modeling as part of its analysis approach, to address possible influence factors. In making a guarantee that the right results had been determined the study used sensitivity analysis in testing all possible influences that might have distorted the data.
The discussed methods may contribute to enhancing the relevancy of the project’s findings for other settings and can thus contribute to the utilization of evidence-based practice in drug abuse treatment.
Specific details of the treatments implemented are Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI), and the following statistical tests were conducted to compare the efficiency of the treatments.
In doing so, the following conclusions should be made for the unequal variances t-test: Descriptive statistics including the t-test, means, and standard deviations were applied. In order to compare the return rates and the treatment compliance before and after the intervention anovas were used with individual t-tests. It is notable that thematic analysis was employed to identify themes and ideas that were equivalent within the provider and patient comments.
The one thing that was monitored was the number of opioid-dependent patients who would be admitted to the hospital after the . Their analysis of data indicated that the number of readmissions was reduced more than in the case of attempting other individual CBT and MI approaches.
Pre-intervention, 48% of the patients they observed had at least one readmission. This reduced to 20 %( p < 0. 05, S. D. During the post-intervention assessment, only 20 percent of the participants reported that they had experienced this feeling, (Personal Communication, 2023). The drastic reduction in readmission for the targeted samples indicates that the treatments indeed reduced the probability of readmission among patients with HF.
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Figure 1
Before Intervention Rate of Readmission and Treatment Compliance
Figure 2
After Intervention Rate of Readmission and Treatment Compliance
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NURS FPX 9904 Assessment 5
References
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