The role of nurse-led groups in relapse prevention
Review TypeFaculty Approved: Degree-based Submission
Repository Posting Date2020-07-22T20:04:10Z
Author DetailsDanielle Hallman MSN, RN, Nurse Manager, C.W. Bill Young V.A. Medical Center, Bay Pines, Florida, USA; Lindsay McKim, MSN, PhD, APRN, Faculty Mentor and Chair; Lila de Tantillo, PhD, MS, FNP-BC, Committee Member; Kelly A. Fethelkheir, DNP, RN-BC, Committee Member and Preceptor
Lead Author Sigma AffliationNon-member
Lead Author AffliationC.W. Bill Young, Department of Veterans Affairs Medical Center, Bay Pines, Florida, USA
TypeDNP Capstone Project
Level of EvidenceQuality Improvement
Research ApproachPilot/Exploratory Study
KeywordsVeterans; Substance Use Disorder; SUD; Mindfulness; Veterans' Health; Relapse Prevention; Nurse-Led Groups; Substance Abuse Treatment Program; SATP
Background: Substance use disorder (SUD) is a debilitating disease with negative consequences for the Veteran's health and wellbeing. The Department of Veterans Affairs (VA) treats more than 1.5 million Veterans annually for SUD in a variety of settings (Lan et al., 2016). There are inpatient, residential and outpatient programs. The residential Substance Abuse Treatment Program (SATP) encompasses comprehensive SUD treatment, which includes traditional psychotherapy, group therapy, pharmacologic therapy, and peer counseling throughout the week. Less structure and therapeutic interaction are available on the weekend, which often translates to higher incidents of relapse. Current statistics show that 75% of in-program relapses occur on Saturday and Sunday.
Purpose: To explore the possibility that residents in the SATP are less likely to relapse if offered nurse-led groups on the weekends, compared to current weekend group programming.
Methods: Nurses received training on Mindfulness-based stress reduction techniques and the facilitation of psychoeducational nurse-led groups. Upon initiation of the project, all Veterans participating in the SATP program were required to attend the Saturday and Sunday groups. Statistical analyses compared the proportions of veterans who experienced a relapse on the weekends before the implementation of nurse-led groups in 2019 and during the implementation phase of the intervention in 2020.
Results: There were 5 (3.5%) total relapses (Monday through Sunday) out of a census of 144 Veterans in 2020, while in 2019, there were 9 (7%) relapses out of 129 Veterans (p=0.15, Fisher’s exact test, one-sided). Similarly, the number of weekend relapses in 2020 was 2 (1.4%) and 5 (4%) in 2019, respectively. This difference (p=0.18, Fisher’s exact test, one-sided) did not reach statistical significance but suggests that the intervention has the potential to reduce relapse rates, both weekend and overall. The objective of the QI project was to reduce weekend relapses by 25% and exceeded this goal, with a 50% reduction in documented relapses in 2020. The QI project was concluded early due to the COVID-19 pandemic; therefore, fewer data points were recorded, and the timeline was shortened.
Conclusion: The outcome of the QI project, although encouraging, lacked conclusive evidence to demonstrate its effectiveness on relapse prevention. Further testing and research are warranted.
Degree GrantorJacksonville University
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