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Item Nurse-led screening, brief intervention, and referral to treatment for patients with alcohol use disorder in an inpatient setting(Montana State University - Bozeman, College of Nursing, 2022) Winter, Angela Kim; Chairperson, Graduate Committee: Sandra Benavides-VaelloMany preventable health risks result from unhealthy alcohol use. Two hundred thirty International Classification of Diseases (ICD-10) diagnosis codes are partially or completely associated with alcohol use disorder. The prevalence of alcohol use disorder (AUD) has risen in tandem with the COVID-19 pandemic. This creates an urgent call to action for clinicians to help patients recognize risky alcohol use and decrease the devastating burden this disease causes the individual and society. Healthcare providers generally receive limited content on how to address alcohol abuse in their training, and nurses generally lack confidence in addressing patients with AUD. Screening, brief intervention, and referral to treatment (SBIRT) is an effective, evidence-based process to identify and mitigate risky substance use. The screening portion of the SBIRT process involves the utilization of an Alcohol Use Disorder Identification Test (AUDIT-C) to stratify a patient's drinking into zones of risk. The purpose of this project was to utilize the literature to develop an educational training for nurses on the use of the AUDIT-C tool and motivational interviewing techniques to assist them in the SBIRT process. The project was implemented over a 6-week period on a 29-bed medical oncology unit within a 150-bed hospital in Western Montana. Forty-five nurses were administered a Likert scale survey at baseline and after watching the SBIRT educational PowerPoint to assess their confidence in addressing patients with AUD. The primary goal of this project was to increase nurses' self-reported levels of confidence in performing SBIRT care tasks. A secondary goal was to increase the frequency of AUDIT-C and SBIRT tool documentation within the electronic medical record (EMR). Outcomes of the project demonstrated that 70% (n=28) of survey respondents either agree or strongly agree they have confidence to carry out SBIRT-related care tasks after the SBIRT educational training as compared to 12.6% (n=2) at baseline. The project did not increase the frequency of AUDIT-C and SBIRT documentation within the EMR. These results are consistent with results in the literature, which suggest that, with adequate training, nurses in inpatient settings can play active roles in interdisciplinary initiatives to address unhealthy alcohol use among hospitalized patients.Item An integrative review of the use of gabapentin in treatment-seeking adults with alcohol use disorder in an outpatient setting(Montana State University - Bozeman, College of Nursing, 2020) Schell, Angela Marie; Chairperson, Graduate Committee: Casey ColeBackground: Alcohol use disorders (AUD) and alcohol consumption are complex public health issues that involve multiple comorbidities and significant healthcare costs. In the United States, one-third of adults will be diagnosed with an AUD within their lifetime and over 59.5 million Americans are at risk for an AUD due to reported binge drinking. The State of Montana has one of the highest AUD statistics in the country costing Montanans millions of dollars managing AUD-related physical and psychological illnesses. Despite the high rate of AUDs in Montana, the State has very few inpatient treatment facilities for Medicaid recipients to address alcohol abuse and addiction, causing significant lag time to enter alcohol-abuse inpatient treatment. Gabapentin, an anticonvulsant, has recent evidence for use as a medication to aid in mild to moderate alcohol withdrawal symptoms, remedy symptoms of protracted abstinence, and help treatment-seeking individuals remain abstinent until inpatient alcohol addiction services are available. Objective: The purpose of this integrative literature review was to identify current knowledge related to the use of gabapentin in an outpatient setting for treatment-seeking adult patients (18-65 years) with an AUD, for preventing the symptoms of mild to moderate alcohol withdrawal syndrome, for treatment of symptoms related to protracted abstinence, and for assisting the individual to abstain from alcohol until initiation of inpatient substance-abuse treatment. Method: This topic was explored using an integrative literature review. Research articles were identified using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PubMed, PsycINFO, and Medline, from January 2014-December 2019. A review of abstracts using inclusion and exclusion criteria was conducted to determine relevant studies. Conclusion: The integrative review revealed limited evidence for the use of gabapentin to decrease symptoms of mild to moderate alcohol withdrawal and protracted abstinence in treatment-seeking adults on an outpatient basis. Heterogeneity of sample populations, interventions, and study aims should be addressed in future research studies.Item Improving quality through the development of a benzodiazapine sparing protocol for treating alcohol withdrawal in a community correctional setting(Montana State University - Bozeman, College of Nursing, 2018) Hill, Wade G.; Chairperson, Graduate Committee: Maria WinesAlcohol detoxification within community correctional environments poses significant challenges to local jurisdictions that are called to manage rising rates of incarceration among citizens with complex health needs including multiple comorbidities and mental illness and substance abuse. Traditional methods for intervening during detoxification have relied upon benzodiazepine tapers to reduce chances of the most serious consequences of alcohol withdrawal syndrome (AWS) but these medications have been increasingly attributed to poor outcomes such as increased risks of delirium, medication interactions, and risk of diversion among others. This project describes an evidence-based benzodiazepine sparing protocol that can be used to avoid use of this class of medications as well as an associated education intervention for detention officers and healthcare staff in one community correctional institution designed to improve knowledge of monitoring and treatment for inmates suffering from AWS. In total, 28 staff participated in the training and results suggest excellent overall quality and accomplishment of objectives at a high level. Implications for advanced practice nursing are discussed as well as directions for future dissemination efforts for BZ-sparing treatment.Item A comparative study of personality trait profiles in three alcoholic groups(Montana State University - Bozeman, College of Professional Schools, 1970) Morgan, Lura Irving; Co-chairs, Graduate Committee: Virginia Felton and Rita M. DarraghThis study was an attempt to determine (l) if alcoholics have a common personality trait profile, (2) if there are identifyable differences in trait profiles of groups of alcoholics and (3) if differences can be applied to the treatment program at the Alcoholic Treatment Center, Galen, Montana. Groups were arranged in a bi-polar formation with a Receiving Hospital Group at Warm Springs State Hospital as one extreme and a group of Alcoholics Anonymous members at the other. Three mid-groups were formed from alcoholics at the Alcoholic Treatment Center with the time spent in treatment as the basis for group division. The author attempted to determine if treatment would result in group profiles becoming more similar to the Alcoholics Anonymous Group as treatment progressed. Five traits. Abasement, Impulsivity, Play, Endurance, and Succorance remained relatively constant throughout all groups while sixteen varied. The main conclusion was that all groups have common basic characteristics but each group had a degree of variation unique to itself. Surprisingly, the group nearest dismissal at the Alcoholic Treatment Center had a profile more like that of the Receiving Hospital Group thatn that of the Alcoholics Anonymous Group.Item Community health nurses' perceptions of their ability to work with alcoholics and their families(Montana State University - Bozeman, College of Nursing, 1983) Judge, Carol AndersonItem Rodeo participants : life styles and alcohol(Montana State University - Bozeman, College of Nursing, 1981) Bushy, Angeline SilbernagelItem Medical-surgical, emergency, alcoholism rehabilitation : registered nurses' attitudes toward alcoholism(Montana State University - Bozeman, College of Nursing, 1982) Gillespie, Phyllis BeatriceItem Lessons learned from piloting an internet survey to nurse practitioners in Montana on alcohol abuse and education(Montana State University - Bozeman, College of Nursing, 2012) Skordal, Amy Jo; Chairperson, Graduate Committee: Susan LuparellThis purpose of this research study was to explore the perceptions of rural providers about alcohol misuse services and related formal education. A web-based self-report survey was developed and piloted to NPs in Montana about how important it is for rural NPs to be proficient in providing care clients with Alcohol Use Disorders (AUD) and alcohol detoxification needs, their proficiency in providing related services, and formal education received in these areas. An invitational email with a hyperlink to the web-based survey was sent to 412 NPs in Montana through the use of a private marketing company over six launches. A total of five respondents started the survey and three completed it. Though the response rate was too small to reach significance, findings suggested that large scale future research replicating this survey would likely reveal important new information about rural health care that could inform policy and educational curriculum. Perceptions of proficiency were generally low yet all respondents agreed that rural NPs need to be proficient in providing AUD services and alcohol detoxification. Until this point, alcohol detoxification has been considered a specialty function. This appears to be new information that could impact policy and graduate nursing education curriculum for rural states. In addition, concerns for future research using internet surveys were discussed in the context of a low response for the survey administered in this study.