Description
INSTRUCTIONS
Now that you have explored and developed many of the components to resolve a gap in practice, it is time to pull it all together! The purpose of this assessment is to develop skills in creating a cohesive argument using data and feedback from the course Assessments.
This assessment may lay the foundation for the doctoral project you will create later in your program, along with creating a capstone project charter, in which you will identify the evidence to support the need for your intervention. So, consider this a “trial run” of writing your doctoral project, and not the real thing.
PART 1: INTRODUCTION AND PICOT QUESTION
Using feedback and evidence from Assessments 5 and 6, create a 1–2 paragraph introduction to this paper that identifies the gap in practice.
End this introductory section with a clearly stated PICOT question that has an appropriate scope for a DNP project, and the proposed outcome measures match the proposed intervention.
PART 2: ANALYSIS AND SYNTHESIS OF RESEARCH
In this section, refine the Assessment 5 literature synthesis based on feedback from that assessment and substantiate the need for a project.
Analyze and synthesize your research related to a gap in practice for a specific organization.
Address whether the evidence you found is strong enough to substantiate your practice gap.
Identify areas of uncertainty, knowledge gaps, or a need for additional information to support a more complete understanding. Additionally, identify areas where further research is needed.
PART 3: RECOMMENDATIONS TO STAKEHOLDERS
Now that you have identified a gap in practice, and shown there is research to substantiate this gap, it is time to make recommendations to your stakeholders to address it.
In this section:
Using feedback and references from Assessment 6, make clear recommendations for an intervention that is appropriate for a sponsoring organization based on the analysis and synthesis of articles related to your project topic.
Analyze and synthesize your research related to a gap in practice for a specific organization.
Address whether the evidence you found is strong enough to substantiate your practice gap.
Identify areas of uncertainty, knowledge gaps, or a need for additional information to support a more complete understanding. Additionally, identify areas where further research is needed.
PART 4: COMMUNICATE WITH STAKEHOLDERS
In this section, explain how you plan to tailor your message to an implementation team. Describe strategies for making your communication clear, understandable, and respectful of the needs of this specific group. Consider how you would handle challenges, such as pushback or non-compliance.
PART 5: USING FEEDBACK TO IMPROVE WRITING
Receiving and implementing feedback is an important part of how we grow and improve as professionals. Throughout this course, you have received feedback on each assessment, and you were encouraged to use that feedback to improve your writing.
In this section:
Reflect on how you used feedback to improve your writing throughout the course.
How has implementing writing feedback moved your work closer to one or more of the writing quality indicators identified in the Writing Feedback Tool?
How do you plan to use feedback in your professional career?
PART 6: CONCLUSION
Conclude your assessment with a brief synthesis of the main points you covered. No new information should be provided in this section, as its purpose is to provide closure for the paper.
ADDITIONAL REQUIREMENTS
Sources: 10 minimum; use the same resources from Assessment 5 and Assessment 6.
APA Formatting: Provide in-text citations and full reference page for all outside sources.
Length: Your paper should not exceed 8 pages; page count does not include title page and reference page.
GRADING CRITERIA
Your assessment will be graded using the following scoring guide criteria:
Construct an introduction that provides an overview of your gap in practice, and ends with a PICOT question in the correct format, and is an appropriate scope for a DNP project.
Synthesize research related to a gap in practice, including appropriateness for a specific organization.
Make recommendations, including possible solutions, planned actions, and appropriateness for a sponsoring organization, based on the analysis and synthesis of articles related to a project topic.
Explain how you will tailor your message to your implementation team.
Conclude with a synthesis of your main points.
Produce text with minimal grammar, usage, spelling, and mechanical errors.
Apply APA formatting to in-text citations and references.
Unformatted Attachment Preview
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Much improved
Difference between a Quality Improvement (QI) or Project Improvement (PI) Project and
Research Study
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
August, 2023
Beautiful title page !!!
2
Difference between a Quality Improvement (QI) or Project Improvement (PI) Project and
Research Study
•
You cant use the it word = lacks reader clarity
M (Main Point): The main difference between Quality Improvement (QI) or Project
Improvement (PI) and a research study is that QI/PI projects are focused on improving
performance in a single facility using existing evidence, while research is focused on producing
evidence that can be generalized to practice. LOVE THAT E (Evidence): The proposed
doctoral project is a QI/PI project because it is focused on improving care for an underserved
community rather than systematic investigation. The project outcome aims to fulfill the urgent
need for an outpatient substance abuse program in an underserved community located in Miami,
FL. Research studies often subjective seek to generate new evidence through systematic
investigation, with human subjects’ recruitment but QI/PI projects such as the proposed project
apply current evidence to improve outcomes or practice (Knudsen et al., 2019). A (Analysis):
The generation of new evidence, as in research, is a systematic and closely controlled process of
investigation with the goal of producing evidence that can be used in various facilities or settings
to address the investigation issue. The proposed outpatient substance abuse program in Miami,
FL, aims to improve current substance abuse care in the community rather than produce new
evidence. It is, therefore, a QI/PI project rather than a research study. L (Lead out): QI/PI
projects are ideal for doctoral projects with the aim of healthcare services and practice
improvement, such as the proposed outpatient substance abuse program in Miami. They APA
proclaims when you use the word they you better be discussing human and you are not PI/QI
differ from research because they PI/QI focus on quality improvement rather than generating
new evidence.
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Reference
Knudsen, S. V., Laursen, H. V. B., Johnsen, S. P., Bartels, P. D., Ehlers, L. H., & Mainz, J.
(2019). Can quality improvement improve the quality of care? A systematic review of
reported effects and methodological rigor in plan-do-study-act projects. BMC Health
Services Research, 19, 1-10. https://doi.org/10.1186/s12913-019-4482-6
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Interprofessional Communication and Practice Gap
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
September, 2023
2
Interprofessional Communication and Practice Gap
Quality improvement (QI) and practice improvement (PI) projects are developed based
on assessing existing gaps in practice and opportunities for improvement. Substance abuse is one
of the crucial topics in community health in the United States, and healthcare professionals strive
to promote access to care for affected people. In Little Havana, Miami, many people with an
addiction or are at risk of addiction do not have access to timely substance use treatment
programs. Improving the current screening for substance use disorders can help promote access
to care. In this paper, a discussion of a gap in practice in substance use programs in Miami,
Florida, and the interprofessional collaboration skills that have been applied in proposing the
change is advanced.
Practice Gap
The identified practice gap is low avoid all use of subjective terms of measure in a APA
exact paper utilization of substance use treatment services despite high subjective addiction rates
in the community. There are several substance use treatment programs in Little Havana and
across Miami. However, few people seek care in these facilities, and most of those do have
severe addiction problems. Despite the presence of substance use treatment services, there is a
gap in how people who need these services access them. Avoid all pronouns The gap is due to
inadequate screening and referral to the available programs. The proposed project will close the
gap by providing screening and brief intervention training. Wait the gap is not enough screening
or not enough resources
You said it both ways
Multiple factors affect access to substance use treatment programs, including
socioeconomic factors and knowledge of the appropriate treatment resources. This project
focuses on the Banyan Health System in Little Havana, FL. The community health organization
has a substance abuse program, but nurses working in the center have reported the lack of
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adequate services in the Little Havana location. Little Havana has a high poverty level, with
around 39.1% of the population living below the poverty line (Briseus et al., 2021). Low-income
populations have relatively high levels of substance abuse and poor access to healthcare services,
leading to poor overall health outcomes (Beech et al., 2021). Stigma and lack of knowledge on
where to go for substance use treatment services are also important determinants of access to
care (Solberg & Nåden, 2020). Socioeconomic challenges can be handled through referral to
appropriate facilities that provide affordable or free services. Stigma and lack of knowledge can
be addressed by normalizing screening for substance use disorders and timely provision of
information on treatment options (Bunn et al., 2019). Timely assessment, brief intervention, and
referral to appropriate treatment may improve access to and utilization of substance use
treatment services.
The proposed project will focus on introducing Screening, Brief Intervention, and
Referral to Treatment (SBIRT) guidelines in Little Havana to improve early detection of
addiction disorders and timely intervention. The PICOT question construct is helpful in clearly
outlining the variables of the QI project. The proposed PICOT question is: For the staff caring
for patients in the community mental health center (P), how does training and policy for routine
Brief Intervention and Referral to Treatment (SBIRT) implementation (I) compared to current
practice (C) affect the use of substance use treatment services (O) in twelve weeks (T)?GOOD
In this question, the proposed intervention is training staff on conducting SBIRT and creating a
policy for SBIRT implementation. The intervention will be based in a Community Mental Health
Center in Little Havana, and the expected outcomes are increased utilization of substance use
treatment services.
Interprofessional Communication
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Open communication lines and shared decision-making facilitated discussions with
healthcare professionals at the health center. Gaining buy-in for projects from other healthcare
professionals requires considering the professionals’ opinions and promoting open
communication lines (Wei et al., 2020). These strategies involve an environment welcoming to
all stakeholders and their opinions. Open communication was achieved by setting up an open
forum, encouraging other staff to voice their opinions, and integrating them in defining the
current gap, as in shared decision-making. The strategies effectively obtained collaboration from
colleagues; in this case, they worked to elicit input into the project plan.
Plain language, demonstrating empathy, and asking open-ended questions facilitated
discussions and interactions when discussing with patients. Culturally competent communication
recognizant of the patient’s experiences will likely produce cooperation and effective
communication (Handtke et al., 2019). This approach to communication can be facilitated by
focusing on patients’ experiences and showing empathy for their struggles. Similarly, asking
open-ended questions allows patients to express themselves extensively and relay their opinions,
contributing to quality improvement efforts. These approaches also integrated consideration of
the health literacy of the target population. This necessitated plain language communication to
ensure patients understand and contribute to the program. Effective communication with patients
has been based on evidence of inclusive and culturally competent care and communication.
The stakeholders’ feedback and ideas helped create a more explicit focus on the program
as a gap in practice. Stakeholder involvement from project commencement is essential in
problem definition (Smith et al., 2020). In this project, nurses and patients were involved, and
their feedback identified the lack of adequate care access. Although patients could be referred for
substance abuse treatment programs, the affordability and accessibility in other locations were
seen as significant barriers for the low-income population in Little Havana. The feedback thus
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identified access and affordability as the main issues to address in this project. Therefore, the
ideas and feedback helped narrow the practice gap definition to a manageable scope and clearly
defined problem.
While in-person discussions were practical, written communication could have been
more effective with the stakeholders in discussing the practice gap. Different modes of
communication should be adopted depending on stakeholder preferences, project focus, and the
need to persuade the target population (Arnold & Boggs, 2019). In this project, a request for
feedback was made through a written notice. No responses were received from either patients or
staff. Alternatively, a short meeting was held with the staff in a verbal and informal setting. This
verbal communication made staff more receptive and willing to discuss the issue further.
Similarly, a short conversation with patients as they were leaving the health center was held,
eliciting cooperation and collaboration. In this case, verbal in-person communication was more
effective than written communication and, hence, has been preferred for project planning and
management.
Conclusion
The practice gap identified is inadequate substance use treatment services in Little
Havana, Miami. This gap has been identified in communications with stakeholders at Banyan
Health Center in the community. The lack of services significantly determines mental health
outcomes and overdoses due to substance abuse. An inclusive and empathetic approach was used
when communicating with patients and healthcare staff. Verbal in-person discussions were the
most effective communication mode in this case and will continue to be used in the program’s
future. The PICOT question developed communicates the practice gap and the proposed
intervention to address it.
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Reference
Arnold, E. C., & Boggs, K. U. (2019). Interpersonal relationships e-book: Professional
communication skills for nurses. Elsevier Health Sciences.
Beech, B. M., Ford, C., Thorpe Jr, R. J., Bruce, M. A., & Norris, K. C. (2021). Poverty, racism,
and the public health crisis in America. Frontiers in Public Health, 9, 699049.
https://doi.org/10.3389/fpubh.2021.699049
Briseus, V., Carter-Richards, K., & Dorelien, M. (2021 Apr. 14). Financial Insecurity in MiamiDade County. https://storymaps.arcgis.com/stories/12b4058c89584f73af1857bf6688e28b
Bunn, T. L., Quesinberry, D., Jennings, T., Kizewski, A., Jackson, H., McKee, S., & Eustice, S.
(2019). Timely linkage of individuals to substance use disorder treatment: development,
implementation, and evaluation of FindHelpNowKY.org. BMC Public Health, 19(1), 114. https://doi.org/10.1186/s12889-019-6499-5
Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A scoping
review of strategies implemented in healthcare organizations and a model of culturally
competent healthcare provision. PloS One, 14(7), e0219971.
https://doi.org/10.1371/journal.pone.0219971
Smith, I., Hicks, C., & McGovern, T. (2020). Adapting Lean methods to facilitate stakeholder
engagement and co-design in healthcare. BMJ, 368. https://doi.org/10.1136/bmj.m35
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Solberg, H., & Nåden, D. (2020). It is just that people treat you like a human being: The meaning
of dignity for patients with substance use disorders. Journal of Clinical Nursing, 29(3-4),
480-491. https://doi.org/10.1111/jocn.15108
Wei, H., Corbett, R. W., Ray, J., & Wei, T. L. (2020). A culture of caring: The essence of
healthcare interprofessional collaboration. Journal of Interprofessional Care, 34(3), 324331. https://doi.org/10.1080/13561820.2019.1641476
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Synthesis of Evidence Substantiating a Practice Gap
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
September, 2023
2
Synthesis of Evidence Substantiating a Practice Gap
A literature review is essential in outlining the utility of previous research in informing
quality-improvement (QI) projects. The practice gap identified in this project is the
underutilization of drug and substance treatment resources in Little Havana, Miami. The
proposed change is the implementation of Screening, Brief Intervention, and Referral to
Treatment (SBIRT) training and policy in a primary care community clinic to improve the
community’s access to and utilization of drug and substance use treatment resources. Researchers
have paid attention to the practice gap and proposed approaches in the past and conducted
studies. This paper is a critical review of the literature, a synthesis of that literature, and a
discussion of writing feedback on the project practice gap and proposed solution.
Critical Review of the Literature
The study by Bunn et al. (2019) focused on the effectiveness of a website to link people
with substance use disorders (SUD) to treatment resources. The website developed was
FindHelpNowKY.org, and the researchers aimed to develop, implement, and evaluate the
website as a platform for linking people requiring SUD treatment with appropriate resources.
Bunn et al. (2019) used a case-study qualitative research methodology to assess pre- and postintervention content, ease of use, and flow. Based on the “Strength of Recommendations Table”
(SORT) criteria, this study belongs to a level 2 rating because it is a case-control design. The
findings apply to a limited scope of patients but are generalizable to people with SUDs. Barriers
identified were lack of up-to-date information on facilities, partner lack of understanding of the
website, and lack of promotion of the website, among others. Facilitators were strategic
collaborations and support. The study is evidence of the effectiveness of web-based SUD linkage
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processes and may be adaptable to the proposed project. Knowledge of barriers and facilitators
from Bunn et al. (2019) may be transferred to planning the proposed project intervention.
Gomez et al. (2023) conducted a study on the impact of Screening, Brief Intervention,
and Referral Treatment (SBIRT) on stigmatization of SUD. The researchers in this study aimed
to determine the impact of SBIRT training on students’ and practitioners’ attitudes toward SUD
and substance-using patients. To achieve the aim, the researchers deployed quasi-experimental
quantitative research methods with pre- and post-intervention surveys of attitudes towards SUD
and substance-using patients. The SBIRT is an evidence-based theory on which this study is
based. This study is a closely controlled quasi-experimental research and can be ranked as level 1
evidence on the SORT criteria because of the controlled nature. The researchers reported a
statistically significant decline in moralistic attitudes and stereotypical behaviors among the
participants following 12 months of training on SBIRT. The findings from the Gomez et al.
(2023) study indicate the potential improvement in practitioners’ attitudes towards people
seeking SUD treatment. The findings will be transferred to the proposed project by implementing
SBIRT training.
Another study considered for this project is Cordes et al. (2022), which focuses on
knowledge and self-efficacy of SBIRT training among health and behavioral health students. The
study aimed to evaluate the effectiveness of an SBIRT student training program in enhancing
knowledge and self-efficacy in SUD screening and referral. The researchers conducted a cohort
study of the knowledge and self-efficacy changes by collecting data via surveys in pre-training
and post-training. Cordes and colleagues based the study on the SBIRT theoretical framework
for early screening, brief intervention, and referral. This study is a level 2 evidence rating on
SORT criteria because it is a case-control study with inconsistent follow-up. At post-training,
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scores of percentage knowledge increased between 1 and 7 in the student groups, and selfefficacy scores increased between 19.86 and 39.34 percent points (Cordes et al., 2022). The
researchers demonstrate the importance of training in improving knowledge and self-efficacy in
SBIRT, and these findings can be transferred to the proposed project. The proposed intervention
will include SBIRT training, as informed by findings from the study.
Moberg and Paltzer (2021) focused on the impact of SBIRT in clinics serving Medicaid
beneficiaries on SUD diagnosis and care access. The research question for the study was whether
participation in universal SBIRT was a predictor for alcohol and drug use and dependence
diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
(DSM-IV). Moberg and Paltzer (2021) used a correlational research design by comparing patient
data from a sample of patients in SBIRT and non-SBIRT clinics. The researchers based the study
on the concepts of screening and brief intervention. The evidence from this study is rated level 1
evidence due to the large scope of data, close monitoring, and controlled trial approach of the
researchers. Moberg and Paltzer (2021) study reported that patients in SBIRT clinics had 42%
greater odds of SUD diagnosis. These findings indicate the usefulness of SBIRT in improving
diagnosis and will be transferred to the current project by justifying SBIRT training for
community mental health care staff.
The last article considered for this review is the study by Martin et al. (2020), who
focused on an SBIRT training program. The researchers aimed to determine whether SBIRT
training could improve SBIRT and motivational interviewing (MI) knowledge and self-efficacy.
The target population was psychology students, and the study design was quasi-experimental.
The researchers invited students for training and later assessed students’ competence and
knowledge of SBIRT and MI. The trainers-based training on the conceptual framework of
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SBIRT and MI. Evidence from this study is highly reliable as it is level 1 evidence since it is a
controlled trial with good follow-up. Martin et al. (2020) found a statistically significant increase
in knowledge and self-efficacy of both SBIRT and MI. The study concluded that training
psychology students improves competence in using SBIRT and MI. Training approaches from
this study will be deployed in the proposed project.
Synthesis of Literature
Training healthcare staff in SBIRT will improve their knowledge, attitude, and provision
of SUD interventions and referrals for people requiring assistance. SBIRT training increases
healthcare professionals’ knowledge and self-efficacy in SUD screening and intervention (Martin
et al., 2020; Cordes et al., 2022). The evidence on knowledge and self-efficacy indicates
enhanced competence in interventions for people with SUD. Using SBIRT is also associated
with increased diagnosis of SUD (Moberg & Paltzer, 2021) and reduced stigma against
substance-using patients among providers (Gomez et al., 2023). Healthcare professionals can
assess patients in a positive light and provide adequate services. Also, it is imperative to enhance
access through channels that link care seekers with the appropriate resources (Bunn et al., 2019).
Findings from these studies are evidence of the importance and utility of SBIRT training and
facilitating access to care resources for patients with SUD. These findings support the proposed
intervention to train community health professionals and mandate SBIRT in the community
health center.
Writing Feedback
I have received great feedback on this and previous assignments, helping me develop my
writing skills. The evidence I have received is mainly on the voice I use in writing and the
organization of my ideas. I will improve my writing by practicing active voice writing in all my
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work, even outside this course. The feedback has also pointed me to essential tutorials on
organizing ideas, especially on online writing websites and Capella resources. Implementing the
feedback will move me closer to being a proficient writer who can communicate accurately and
succinctly.
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References
Bunn, T. L., Quesinberry, D., Jennings, T., Kizewski, A., Jackson, H., McKee, S., & Eustice, S.
(2019). Timely linkage of individuals to substance use disorder treatment: Development,
implementation, and evaluation of FindHelpNowKY.org. BMC Public Health, 19(1), 114. https://doi.org/10.1186/s12889-019-6499-5
Cordes, C. C., Martin, M. P., Macchi, C. R., Lindsey, A., Hamm, K., Kaplan, J., & Moreland, D.
(2022). Expanding interprofessional teams: Training future health care professionals in
screening, brief intervention, and referral to treatment (SBIRT). Families, Systems, &
Health, 40(4), 559. https://doi.org/10.1037/fsh0000755
Gomez, E., Gyger, M., Borene, S., Klein-Cox, A., Denby, R., Hunt, S., & Sida, O. (2023). Using
SBIRT (Screen, Brief Intervention, and Referral Treatment) training to reduce the
stigmatization of substance use disorders among students and practitioners. Substance
Abuse: Research and Treatment, 17, 11782218221146391.
https://doi.org/10.1177/11782218221146391
Martin, J. L., Cimini, M. D., Longo, L. M., Sawyer, J. S., & Ertl, M. M. (2020). Equipping
mental health professionals to meet the needs of substance-using clients: Evaluation of an
SBIRT training program. Training and Education in Professional Psychology, 14(1), 42–
51. https://doi.org/10.1037/tep0000258
Moberg, D. P., & Paltzer, J. (2021). Clinical recognition of substance use disorders in Medicaid
primary care associated with Universal Screening, Brief Intervention and Referral to
Treatment (SBIRT). Journal of Studies on Alcohol and Drugs, 82(6), 700-709.
https://doi.org/10.15288/jsad.2021.82.700
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Evidence Table
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
Bunn et al.
(2019)
None
Mixed-
The website
Barriers and
Two parallel
Content
Barriers
Strengths: –
identified
methods
was
facilitators-
focus groups of
analysis of
identified
Combined
research
developed for
These are the
25 participants
transcripts of
were lack of
qual and
Pre- and post-
the general
factors that
each.
the focus
up-to-date
quant methods
intervention
public. Focus
were
Discussions
groups was
information
Weaknesses: –
evaluation
group of 50
identified as
were recorded.
conducted.
on facilities,
Small sample
Aim of the
employees
affecting the
partner lack of Ranking:
study was to
reviewed the
project
understanding
Level 2
evaluate the
website.
implementatio
of the website,
Valid yes
effectiveness
n whether
and lack of
Reliable yes
of a website to
positively or
promotion of
Applicable
help link
negatively.
the website
yes Overall
people with
Flow, content,
among others.
rank: High
SUD
and ease of
Facilitators
treatment
use- These are
were strategic
resources
subjective
collaborations
9
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
views of
and support.
website users
on the user
experience.
Martin et al.
SBIRT and
Quantitative
87 graduate
Knowledge-
Pre and post-30-
Data analyzed
Statistically
Strengths:
(2020)
MI
research
school
Competence
day follow-up
using one-way significant
Repeated
students in a
in using
repeated
analysis of
increase in
measures
Quasi-
large public
SBIRT and
measures design. variance
knowledge
approach
experimental
institution
MI in
Knowledge was
and self-
Close control
pre- and post-
providing
practical work
measured using
efficacy of
of the
intervention
degree
Self-efficacy-
multiple choice
both SBIRT
interventions
evaluation.
programs in
Belief in
questions for
and MI
and evaluation
Aim of the
psychology
personal
SBIRT and the
processes
study was to
ability to use
Motivational
Weaknesses: –
determine
the
Interviewing
Limited to a
whether
approaches
Knowledge
single location
10
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
training could
Self-reported
Assessment Test
Limited to
improve
use of SBIRT
(MIKAT) for
psychology
SBIRT and
and MI-
MI. A Likert
students
MI knowledge
Current trends
scale was used
Ranking:
and self-
in using
to measure self-
Level 1
efficacy.
SBIRT and
efficacy.
Valid yes
MI
Reliable yes
approaches
Applicable
yes Overall
rank: High
Gomez et al.
(2023)
SBIRT
Quasi-
136
Attitudes
Brief Substance
t-tests were
Attitudes
Strengths: –
experimental
behavioral
towards
Abuse Attitude
conducted on
towards SUD
Well-
quantitative
and primary
substance
survey was used
SPSS to
and care for
controlled
research
care students
abuse are the
to measure
determine any
the patients
research
methods with
in an
participants’
attitudes towards outcome
improved with process
pre- and post-
addictive
views of
substance abuse
SBIRT
Inclusion of
intervention
disorders
morality and
for pre- and
training
federal
differences
11
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
surveys of
training
stereotypical
post-training
agencies in
attitudes
project
beliefs of
research
towards SUD
people who
monitoring
and
use drugs
Weaknesses: –
substance-
Small sample
using patients.
Ranking:
Aim of the
Level 1
study was to
Valid yes
determine the
Reliable yes
impact of
Applicable
SBIRT
yes Overall
training on
rank: High
students’ and
practitioners’
attitudes
towards SUD
and
12
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
substanceusing patients
Cordes et al.
(2022)
SBIRT
Quantitative
293 students
Participant
Data was
t-test
At post-
Strengths: –
Cohort study
from two
knowledge-
collected using
comparing
training,
Quasi-
of students’
academic
Competence
online surveys
data before
scores of
experimental
training
institutions in
and
on Qualtrics
and after
percentage
methods
program with
both
understanding
before and after
training
knowledge
Assessment of
pre- and post-
undergraduate
of subject
training
increased
self-efficacy
intervention
and
topic
between 1 and
Weaknesses: –
analysis
postgraduate
specifically
7 in the
Small sample
psychology
related to
student groups Limitation to
courses
SBIRT
and self-
two academic
completed the
Self-efficacy-
efficacy
institutions
training
Ability to
scores
Ranking:
conduct
increased
Level 2
SBIRT
between 19.86
Valid yes
independently
and 39.34
Reliable yes
13
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
Measurement
their
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
percent points
Applicable
yes Overall
rank: High
Moberg &
Paltzer (2021)
SBIRT
Quantitative
Random
SUD
Health records
Correlational
Patients in
Strengths: –
research
sample of
diagnosis-
and claims on
analysis and
SBIRT clinics
Large sample
Correlational
14,856
Diagnosis of a
addiction and
cross-
had 42%
Closely
research
working-age
substance or
substance use
tabulation of
greater odds
controlled
design
Medicaid
alcohol use
disorders
data
of SUD
methodology
beneficiaries
disorder
diagnosis.
Correlation
obtained via
according to
analysis
Wisconsin’s
DSM-IV
Weaknesses: –
Initiative to
SBIRT clinic
Reliance on
Promote
participation-
claims and
Healthy
Availability of
encounter data
Lifestyles
clinic-specific
Focus on
SBIRT
Medicaid
patients only
14
Major
Citation
Conceptual
Design/
Sample/
Framework
Method
Setting
Variables
Studied and
their
Measurement
Data
Analysis
Appraisal:
Findings
Worth to
Practice
Definitions
Ranking:
Level 1
Valid yes
Reliable yes
Applicable
yes Overall
rank: High
1
Synthesis of Evidence Substantiating an Intervention
Very nice title page
Marcos J Carvajal Bermejo
School of Nursing and Health Sciences, Capella University
NURS-FPX8045 Doctoral Writing and Professional Practice
Dr. Peggy Soper
October, 2023
2
Synthesis of Evidence Substantiating an Intervention
Drug and substance use disorder treatment is a crucial health resource for communities
that can enhance people’s health outcomes. However, when people deserving in the community
do not access or use these resources, the aim of health improvement is not achieved. A practice
gap identified in Little Havana, Miami, is an underutilization of the community’s drug and
substance treatment resources, as seen by less than 70% utilization (you must use a citation
especially with numbers). An intervention that may be used to cover this gap always be 100%
clear when you are referring to an concept Don’t rename the concept/ explain the concept is
Screening, Brief Intervention, and Referral to Treatment (SBIRT), an intervention for the initial
assessment of patients in primary care to determine the current risk of drug and substance use
disorders. The PICOT question used as guidance for this project especially the literature search
can be stated as: “For the staff caring for patients in the community mental health center (P), how
does training and policy for routine Brief Intervention and Referral to Treatment (SBIRT)
implementation (I) compared to current practice (C) affect the use of substance use treatment
services (O) in twelve weeks (T)?” Can you ask this and say who gets the application of the
tool? The PICOT does not really say who is the receiver of the tool This paper is a critical
review and synthesis of the literature on SBIRT as a solution to the underutilization of drug and
substance treatment resources.
Critical Review of the Literature
The first article considered is by Moulin et al. (2021), and the focus of the researchers
was to evaluate the impact of SBIRT and a dedicated counselor in an emergency department
(ED). This study’s research question was how the SBIRT and referral to the counselor affected
care utilization. The researchers conducted a prospective longitudinal study to answer the
3
research question. The theory of motivational interviewing (MI) was the basis of the intervention
and the researchers sought to determine how MI affected the utilization of substance and drug
use treatment for people experiencing homelessness. Using the “Strength of Recommendations
Table” (SORT) criteria, this study can be ranked as level 1 because it is a prospective study with
good follow-up. The strength of evidence from this study, therefore, is high. The program was
associated with a 67% decrease in average emergency department visits among patients with
substance use disorder. The findings from this study indicate that SBIRT implementation could
lead to a reduction in ED utilization for substance and drug use emergencies.
The second article, McCall et al. (2022), focused on the impact of SBIRT administered
by professional mental health counselors to patients with substance misuse or disorder. The
research question for the study was the impact of SBIRT in in-patient settings on ED visits,
hospitalization, and costs. The researchers used a retrospective review of health records as the
primary methodology for research. The study is based on the Texas Christian University (TCU)
Treatment Model that delineates patient-level and program-level factors of treatment (McCall et
al., 2022). SORT ranks this study as a level I study because it is a retrospective cohort with good
follow-up. SBIRT was associated with a 0.32 (p < .001) odds ratio of ED visits and subsequent
hospitalization, indicating reduced ED visits. These findings can be used to support the need for
SBIRT as a standard practice for substance and drug abuse screening and intervention.
Moreover, Lukowitsky et al. (2022) focused on the impact of SBIRT training on attitudes
and beliefs towards people who use substances. The researchers used a quasi-experimental
approach with a pre-post design. Training was p
