Nurses routinely use evidence to inform health care practice. More and more, nurses also use evidence to inform public policy.
That’s the goal of Andrew Given, a Doctor of Nursing Practice student at the Washington State University College of Nursing in Vancouver. Now Given has become the first nursing student to be awarded a prestigious graduate student fellowship by the Thomas S. Foley Institute for Public Policy and Public Service.
Given, who’s studying to be a psychiatric-mental health nurse practitioner, is researching whether a “patient-centered” approach to addiction treatment can inform statewide policy. Patient-centered care focuses on the unique needs of individual patients versus blanket policies that treat all patients the same.
Given’s project involves patients who are being treated for opioid use disorder and who also misuse alprazolam, a benzodiazepine that’s better known by the brand name Xanax. Using these two substances together greatly increases a person’s risk of death. But many opioid treatment programs discharge patients if they’re using a benzodiazepine, when evidence shows alprazolam is the main danger.
“The No. 1 thing that will decrease the risk for these patients is active time in treatment and engagement about the risk of unintentional overdose and death,” Given said. “Policy should reflect the science; programs should not treat every patient who struggles with benzodiazepine misuse in the same manner. It’s a big issue that many, many opioid treatment programs and institutions that deal with recovery are not necessarily using a patient-centered approach.”
He’s evaluating the success of “low-barrier, high tolerance” treatment programs in helping this subset of patients. Such programs make it easy for people to get in, and don’t employ such a punitive approach to patients who misuse both opioid and non-opioid drugs or who don’t meet immediate abstinence expectations.
Given began his inquiry for the final project required of all DNP students. The Foley fellowship is supporting data collection, travel time, training and consultations.
If he finds that a patient-centered approach is beneficial to this subset of patients, “we want to share it and influence policy,” he said. “The idea is to look at an individual policy intervention and then use it as a bridge to create regional policy change and potentially influence practice across the state.”
Generally, Given said that DNP students’ final projects – which focus on quality improvement, program evaluation or policy change – often have such a ripple effect.
He also said the Pacific Northwest is hospitable to nurses who want to have a voice in politics, policy and practice.
“I’m from Chicago where there’s considerably more opposition to and less integration of nurse practitioners,” Given said. “Out here there’s a lot more opportunity to be involved.”