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Implementation of a nurse-led overdose prevention site in a hospital setting: lessons learned from St. Paul’s Hospital, Vancouver, Canada Dogherty, Elizabeth J.; Patterson, Carlin; Gagnon, Marilou, 1980-; Harrison, Scott; Chase, Jocelyn; Boerstler, Jill; Gibson, Jennifer; Gill, Sam; Nolan, Seonaid; Ryan, Andy

Abstract

Objectives In May 2018, St. Paul’s Hospital (SPH) in Vancouver (Canada) opened an outdoor peer-led overdose prevention site (OPS) operated in partnership with Vancouver Coastal Health and RainCity Housing. At the end of 2020, the partnered OPS moved to a new location, which created a gap in service for SPH inpatients and outpatients. To address this gap, which was magnified by the COVID-19 pandemic, SPH opened a nurse-led OPS in February 2021. This paper describes the steps leading to the implementation of the nurse-led OPS, its impact, and lessons learned. Methods Four steps paved the way for the opening of the OPS: (1) identifying the problem, (2) seeking ethics guidance, (3) adapting policies and practices, and (4) supporting and training staff. Results The OPS is open between 10:00 and 20:00 and staffed by two nurses per shift. It is accessible to all patients including inpatients, patients in the Emergency Department, and patients attending outpatient services. Between February 1, 2021 and October 23, 2021, the OPS recorded 1612 visits for the purpose of injection, for an average weekly visit number of 42. A total of 46 overdoses were recorded in that 9-month period. Thirty-seven (80%) required administration of naloxone and 12 (26%) required a code blue response. Conclusions Due to the unique nature of our OPS, we learned many important lessons in the process leading to the opening of the site and the months that followed. We conclude the paper with lessons learned grouped into six main categories, namely engagement, communication, access, staff education and support, data collection, and safety.

Item Metadata

Title
Implementation of a nurse-led overdose prevention site in a hospital setting: lessons learned from St. Paul’s Hospital, Vancouver, Canada
Creator
Dogherty, Elizabeth J.; Patterson, Carlin; Gagnon, Marilou, 1980-; Harrison, Scott; Chase, Jocelyn; Boerstler, Jill; Gibson, Jennifer; Gill, Sam; Nolan, Seonaid; Ryan, Andy
Contributor
British Columbia Centre on Substance Use; St. Paul's Hospital (Vancouver, B.C.); Providence Health Care (Vancouver, B.C.)
Publisher
BioMed Central
Date Issued
2022-02-05
Description
Objectives In May 2018, St. Paul’s Hospital (SPH) in Vancouver (Canada) opened an outdoor peer-led overdose prevention site (OPS) operated in partnership with Vancouver Coastal Health and RainCity Housing. At the end of 2020, the partnered OPS moved to a new location, which created a gap in service for SPH inpatients and outpatients. To address this gap, which was magnified by the COVID-19 pandemic, SPH opened a nurse-led OPS in February 2021. This paper describes the steps leading to the implementation of the nurse-led OPS, its impact, and lessons learned. Methods Four steps paved the way for the opening of the OPS: (1) identifying the problem, (2) seeking ethics guidance, (3) adapting policies and practices, and (4) supporting and training staff. Results The OPS is open between 10:00 and 20:00 and staffed by two nurses per shift. It is accessible to all patients including inpatients, patients in the Emergency Department, and patients attending outpatient services. Between February 1, 2021 and October 23, 2021, the OPS recorded 1612 visits for the purpose of injection, for an average weekly visit number of 42. A total of 46 overdoses were recorded in that 9-month period. Thirty-seven (80%) required administration of naloxone and 12 (26%) required a code blue response. Conclusions Due to the unique nature of our OPS, we learned many important lessons in the process leading to the opening of the site and the months that followed. We conclude the paper with lessons learned grouped into six main categories, namely engagement, communication, access, staff education and support, data collection, and safety.
Subject
Addiction; Injection drug use; Harm reduction; Hospital; Overdose; Overdose prevention; Substance use
Genre
Article
Type
Text
Language
eng
Date Available
2022-03-01
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0406671
URI
http://hdl.handle.net/2429/80896
Affiliation
Medicine, Faculty of; Non UBC; Medicine, Department of
Citation
Harm Reduction Journal. 2022 Feb 05;19(1):13
Publisher DOI
10.1186/s12954-022-00596-7
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher; Other
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)