Description
Objective: To evaluate key lessons learned from efforts at increasing engagement in integrated prenatal and opioid use disorder services.
Design: An interdisciplinary team consisting of a board-certified obstetrician and registered nurse led the implementation of this multipronged approach driven by several Plan-Do-Study-Act cycles to develop an integrated prenatal and opioid use disorder program.
Setting/Local Problem: An urban community health center in Chicago, Illinois, where mental health issues, including substance use, are the leading cause of death for pregnant people.
Participants: Connections were made with local harm reduction agencies, substance use treatment facilities, and community outreach programs to develop partnerships with organizations providing existing addiction and maternal child services in the community.
Intervention/Measures: Partnership building was achieved through organization needs assessments, dissemination of information about integrated services, and sustained communication. Referral workflow guides and patient education cards were created and distributed to community partners. Incoming referrals were tracked at the clinic site. Usage of referral materials were evaluated via online surveys distributed to community partners.
Results: In the 18 weeks of enhanced integration, three patients engaged in services and were initiated on medication for opioid use disorder, two of which had been referred from agencies targeted in the outreach efforts. Surveys revealed community partners believe the referral guides were easy to use and the harm reduction information on the patient cards was useful.
Conclusion: An urban, community health center was equipped to provide comprehensive, integrated services to pregnant people with opioid use disorder, but barriers such as community unawareness and stigma impeded engagement. Sustained collaboration with community partners serving pregnant people with opioid use disorder supports program development and linkage to care. Integrated prenatal and opioid use disorder care is feasible, de-stigmatizing in nature, and can lead to improved maternal and fetal outcomes.
Learning Objectives:
- Examine the barriers pregnant people with opioid use disorder may encounter when accessing routine prenatal care.
- Evaluate the impact of an integrated treatment model for pregnant people with opioid use disorder.
- Assess the role of nurses in the success of an integrated prenatal opioid use disorder program.
Citation:
Anderson, C., Braverman, A., Maes, P., & Reising, V. (2022). Lessons learned from the implementation of an integrated prenatal opioid use disorder program. Nursing for Women’s Health, 26(3). https://doi.org/10.1016/j.nwh.2022.03.007
Faculty & Faculty Disclosures:
Casey Anderson, BSN, RN
Alexis Braverman, MD, FACOG
Phillip Maes, MS, RN, CARN
Virginia Reising, DNP, RN, PEL-CSN, PHNA-BC
The authors and planners of this learning activity report no conflicts of interest or relevant financial relationships. No commercial support was received for this learning activity. Implementation of the project described in this article was supported by a $1,000 grant to Casey Anderson from CVS Health Foundation.
Publication:
Nursing for Women’s Health
Nursing Contact Hours:
1.4 nursing contact hours (CNE available until June 3, 2025)
AWHONN Accreditation Statement
The Association of Women’s Health, Obstetric and Neonatal Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Accredited status does not imply endorsement by AWHONN or the ANCC of any commercial products displayed or discussed in conjunction with an educational activity. AWHONN is approved by the California Board of Registered Nursing, provider # CEP580.
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Keywords: community health, harm reduction, integrated care, opioid use disorder, pregnancy, referral and consultation
Target Audience: women’s health, obstetric, and neonatal nurses