Introduction
Substance use disorder during pregnancy is a significant public health concern that puts mothers’ and infants’ lives and well-being at risk. According to Peltier et al. (2022), women with previous mental health issues are at a higher risk of experiencing substance use disorder. Therefore, healthcare professionals should implement evidence-based interventions to minimize the prevalence of substance use disorder in this population. The plan proposed in this presentation seeks to enhance the quality of substance use disorder management in pregnant women by implementing a holistic approach following clinical guidelines.
Intended Change
The quality improvement goal for the proposed intervention with pregnant women with substance use disorder is to reduce the frequency of substance intake by the target audience by 10% within six months. To measure the change in the population, a self-reported survey will be conducted before and after the intervention with pregnant patients with substance use disorder to compare the change in the reported frequency of substance use. In addition, self-reflection on the intervention’s effectiveness over the implementation period will be conducted to collect qualitative measurements of the change.
A List of Required Outcomes
To achieve the quality improvement goal of the whole intervention, the following list of outcomes should be followed. Firstly, among the whole population of patients, the ones with substance use disorder should be identified through assessment and monitoring (Queensland Clinical Guidelines, 2021). Secondly, since women with substance use disorder are commonly triggered to abuse substances due to a history of previous mental illness, such underlying mental illnesses should be diagnosed (Peltier et al., 2022). Thirdly, the identified underlying mental illnesses should be treated; fourthly, patients with substance use disorder should be educated and counseled on the implications of their addiction (Queensland Clinical Guidelines, 2021). Finally, it is necessary to provide patients with community support through the establishment of proper collaborations.
Team Members’ Responsibilities
The responsible stakeholders for the presented intended outcomes include the nursing staff, therapists, and community-based non-profit facilities for substance use disorder treatment. In particular, the nursing staff will be responsible for patient assessment, mental illness diagnosis, and referral to therapy (Volkow, 2020). Therapists will be responsible for mental illness treatment, patient education, and disorder management skills development (Magill et al., 2019). Finally, the engaged community-based non-profit organization will be responsible for establishing community support, empowerment of patients, and the provision of resources for disorder management (Alsuhaibani et al., 2021).
Required Actions for Outcomes
In particular, the nurses will prepare communication strategies and plan the monitoring process to identify pregnant patients with substance use disorder. The nurses will formulate assessment strategies to diagnose underlying mental illnesses and develop a test for SUD diagnosis. Furthermore, nurses should research appropriate pharmacology and contact therapists to treat underlying mental illnesses. To educate and counsel patients on SUD implications, therapists will develop educational materials and schedule group and individual therapy sessions. Finally, to provide patients with community support, the project manager will contact community non-profits and arrange to fund the project.
To ensure that the project outcomes are achieved in a timely and appropriate manner, specific milestones should be established. In particular, it is planned that the results of the task achievement will be checked once a month, as well as the reports on the completed tasks will be submitted by the team members on a weekly and monthly basis according to the agreed schedule of the project. As for the supplies and equipment required for the project implementation, they will include computers and software for medical record processing, educational materials handouts, and survey sheets.
Project Time Frame
The overall duration of the planned quality improvement plan is six months, during which the patients will undergo educational and therapy-based interventions to eliminate substance use disorder via mental health treatment. During month 1, patient enrollment should be completed; a setback that might complicate this stage is the lack of individuals consenting to participate. During months 1 and 2, the diagnosis and assessment of the mental health of the patients with substance abuse will be conducted. The setback at this stage might be related to the complexity of mental health cases. During months 3 and 4, patient education and therapy sessions will take place. The setbacks at this stage might be related to patient withdrawal or internal disruption of the project plan. During month 5, community-based support groups will be initiated; during month 6, the team will conduct evaluation and reflection.
Risk Management Plan
The risks that the project team might face when implementing the intervention include internal and external ones. In particular, the lack of funds might be addressed via additional fundraising campaigns. The lack of participating patients at the intended hospital will be addressed by broadening the scope of patients to include additional medical facilities for pregnant. Finally, in the case of the disruption of stakeholder cooperation, new entities will be engaged to complete the project.
Budget and Roles
The planned project entails a budget of approximately $16,000, which entails personnel $12,000 and equipment $4,000. The roles distributed among the team members will include the following. Nurses will perform as educators and facilitators; therapists will perform as treatment specialists and educators; community counsels will be support group managers.
Progress Tracking
To monitor the completion of tasks according to the schedule, an electronic record will be created to enable team members to see the online schedule of the project and send their weekly and monthly reports on time. Twice a month, the project team will meet to discuss the success and drawbacks of the project to make adjustments. In case of challenges and possible difficulties, the issues will be addressed individually through team cooperation.
Evidence-Based Model
The evidence-based model selected as the core of the intervention is cognitive-behavioral therapy (CBT). According to Vujanovic et al. (2020), CBT is one of the most effective approaches to the treatment of substance abuse in combination with mental health issues. For that matter, the model will be used as the educational framework and therapy interventions to help pregnant women with substance use disorder acquire effective coping skills and behavioral patterns to reduce addiction.
Conclusion
The evaluation plan for the project involves the submission of team members’ qualitative and quantitative data provided at specific times. In particular, patient data on enrollment should be provided by nurses by the end of month 1. The formative assessment of therapy sessions will be conducted by therapists every week. The summative assessment of therapy will be conducted upon completion of the project. Support group feedback will be submitted by group facilitators every week. Finally, the patient data post-intervention will be submitted by nurses by the end of month 6.
References
Alsuhaibani, R., Smith, D. C., Lowrie, R., Aljhani, S., & Paudyal, V. (2021). Scope, quality and inclusivity of international clinical guidelines on mental health and substance abuse in relation to dual diagnosis, social and community outcomes: a systematic review. BMC Psychiatry, 21(1), 1-23.
Magill, M., Ray, L., Kiluk, B., Hoadley, A., Bernstein, M., Tonigan, J. S., & Carroll, K. (2019). A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition. Journal of Consulting and Clinical Psychology, 87(12), 1-25.
Peltier, M. R., Roberts, W., Verplaetse, T. L., Burke, C., Zakiniaeiz, Y., Moore, K., & McKee, S. A. (2022). Licit and illicit drug use across trimesters in pregnant women endorsing past-year substance use: Results from National Survey on Drug Use and Health (2009–2019). Archives of Women’s Mental Health, 25(4), 819-827.
Volkow, N. D. (2020). Personalizing the treatment of substance use disorders. American Journal of Psychiatry, 177(2), 113-116.
Vujanovic, A. A., Smith, L. J., Green, C., Lane, S. D., & Schmitz, J. M. (2020). Mindfulness as a predictor of cognitive-behavioral therapy outcomes in inner-city adults with posttraumatic stress and substance dependence. Addictive Behaviors, 104, 106283.
Queensland Clinical Guidelines. (2021). Perinatal substance use: Maternal. Web.