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Running Head: STRATEGIES TO REDUCE READMISSION TO DRUG DETOXIFICATION 1

STRATEGIES TO REDUCE READMISSION TO DRUG DETOXIFICATION 3

Strategies to reduce readmission to drug detoxification Student’s name Institutional affiliation
Date: 23/01/2021	EBP Question: What are strategies to reducing frequent readmission to drug detoxification?
Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
1	Childress, Hole, Ehrman, Robbins, McLellan, & O’Brien. 1993	Mixed method study	· N/A	Based on this study, healthcare sectors are responsible for establishing programs that reduce patients' readmission beyond demographics and effort documentation. Nurses are supposed to replicate the initial treatment method through NIDA programs.	Nurses should ensure the comprehensive growth of drug testing.	Lack variety of recommendations that is applicable across the globe.	Level 5 Quality B
2	Bear, Anderson, Manson, Shore, Prochazka, & Novins. 2014	Single research study.	The study took place in Alaska Native for readmission of patients affected by alcoholism. The sample involved 383 adults in Alaska.	Within a year, Forty-two percent of 383 patients were readmitted to the hospital. The challenges of finance and family instabilities also contributed to patients' readmission.	Nurses should be an integral part of the assessment of standard behavior health. The rate of readmission to people can be also be reduced by developing clinical protocols that facilitate detoxification aftercare and treatment and adaptive functioning.	The mostly involves reliability depending on the researchers' interpretation and not mostly from the research method.	Level 5 Quality A
3	Rachlis, Kerr, Montane & Wood. 2009	Single research study.	N/A	The study was based on individuals who inject drugs (IDU) and fail to adhere to medical advice (AMA). There is active drug use in hospitals that leads to a high rate of ignoring AMA. The research shows that people who inject drugs are additive and need to provide education programs on adhering to medical treatments.	Individuals unable to abstain should not be reprimanded but rather supported through education programs.	Small size sample	Level 3 Quality B
4	Peterson, Liu, Xu, Nataraj, Zhang & Mikosz. 2019	Systematic Literature review.	A sample size of 1,658 affected by opioid overdose	The study focused on readmission of patients affected by opioid overdose with ninety days. More than a quarter of patients diagnosed with a high overdose on opioids are readmitted with the first ninety days of their first treatment.	To emphasize strategies to address mental health conditions and comorbid physical.	Lack variety of recommendations that is applicable across the globe.	Level 5 Quality A
5	Reif, Acevedo, Garnick, & Fullerton. 2017	Single research method.	A sample of 30,439 was used between eighteen and sixty-four years.	More than sixty-seven percent of substance use disorder patients lack medication-assisted treatment (MAT) follows up after fourteen days of treatment. Additionally, thirty-nine percent of patients are readmitted for primary negative health conditions after ninety days of receiving medications.	Healthcare facilities should ensure provision for Medication-assisted treatment (MAT). The study indicates that the Medicaid program should be restructured to reduce barriers to MAT and prevent patients' readmission due to health admissions.	The mostly involves reliability depending on the researchers' interpretation and not mostly from the research method.	Level 3 Quality A
6	Spear 2014	Mixed method study	A sample size of 18,278 among thirty-two counties in California.	The study's finding is that efficient networks between the healthcare facility and the patient lead to a low readmission rate. Additionally, detox's continuity of care services also leads to a low readmission rate. High costs associated with continuous and constant care treatment prevented most patients from seeking medication. A person's health continues to worsen until visiting a health facility is not an option.	Establish an affordable healthcare insurance policy to ensure each individual can afford care services.	The study at the end invites other researchers to come up with more findings for patients' readmission. The process means the researchers in this study might bias the population in the size sample used.	Level 3 Quality B
7	Regenstein & Andres. 2014	Systematic literature review	Study on the effects of Medicare on readmission. No sample size	Many proliferation measures have been put in place to reduce readmission of patients in the United Stated through Medicare. Although patients covered under Medicare also experience hospital readmission due to social several social-economic statuses. The study indicates that substance abuse comorbidities, postdischarge care environments, and medical non-compliance is the main reason for readmission of patients.	More measures with the Medicare program should be included, such as funding for follow up measures o patients addicted to drugs use.	The study's main limitation only focused on patients prone to hospital readmission and covered by Medicare in the United States.	Level 5 Quality A
8	Marks, L. R., Munigala, Warren, Liss, Liang Schwarz & Durkin. 2020	Mixed method study	220 admission of individuals with opioid use disorder (OUD) and analysis of Medication for opioid use disorder (MOUD)	Sixty-four percent of the MOUDs were involved with a high parenteral antimicrobial therapy rate. The involvement of treatment without medication continuation on discharge does not reduce readmission among OUD patients. Additionally, methadone for detoxification also does not eradicate readmission of patients.	Care treatments among OUD patients should continue after and before discharge.	Small sample size	Level 5 Quality A
9	Van den Berg, Van den Brink, Kist, Hermes & Kok. 2015	Single method research	132 elders who are alcohol-dependent	Sixty-seven of the sample size was readmitted within the first year of receiving treatment. Lectures and education programs predicted a low rate of readmission. The study shows that alcohol-addicted patients among the older population are highly prone to readmission.	More education and lectures addressing the effects of alcoholism should establish and embrace in any society across the globe.	Small sample size.	Level 3 Quality A
10	Sufrin, Sutherland, Beal, Terplan, Latkin & Clarke. 2020	Single method research	The setting is in the United States. 22 prisoners in six county jails.	Twenty-six percent of women all the women jailed in the United States, according to the study, inject drugs OUD. Abuse of drugs in jails in the United States is controlled through withdrawal. Individuals, particularly the pregnant, are discontinued from receiving treatments at postpartum. Additionally, withdrawal to control patients with an opioid is against the medical guidelines.	People jailed in the United States receive essentially denied access to medication or receive less quality care, leading to a high readmission rate. United States government should establish hospitals in jails to enhance prisoners' care delivery.	Small sample size and lack of recommendation.	Level 5 Quality A

Attach a reference list with full citations of articles reviewed for this EBP question

Bear, U. R., Anderson, H., Manson, S. M., Shore, J. H., Prochazka, A. V., & Novins, D. K. (2014). Impact of adaptive functioning on readmission to alcohol detoxification among Alaska Native People. Drug and alcohol dependence, 140, 168-174.

Childress, A. R., Hole, A. V., Ehrman, R. N., Robbins, S. J., McLellan, A. T., & O’Brien, C. P. (1993). Cue reactivity and cue reactivity interventions in drug dependence. NIDA research monograph, 137, 73-73.

Marks, L. R., Munigala, S., Warren, D. K., Liss, D. B., Liang, S. Y., Schwarz, E. S., & Durkin, M. J. (2020). A comparison of medication for opioid use disorder treatment strategies for persons who inject drugs with invasive bacterial and fungal infections—the Journal of infectious diseases, 222(Supplement_5), S513-S520.

Peterson, C., Liu, Y., Xu, L., Nataraj, N., Zhang, K., & Mikosz, C. A. (2019). US national 90-day readmissions after opioid overdose discharge. American journal of preventive medicine, 56(6), 875-881.

Rachlis, B. S., Kerr, T., Montaner, J. S., & Wood, E. (2009). Harm reduction in hospitals: is it time?. Harm Reduction Journal, 6(1), 19.

Regenstein, M., & Andres, E. (2014). Reducing hospital readmissions among Medicaid patients: a review of the literature. Quality Management in Healthcare, 23(4), 203-225.

Reif, S., Acevedo, A., Garnick, D. W., & Fullerton, C. A. (2017). Reducing behavioral health inpatient readmissions for people with substance use disorders: do follow-up services matter?. Psychiatric Services, 68(8), 810-818.

Spear, S. E. (2014). Reducing readmissions to detoxification: an inter-organizational network perspective. Drug and alcohol dependence, 137, 76-82.

Sufrin, C., Sutherland, L., Beal, L., Terplan, M., Latkin, C., & Clarke, J. G. (2020). Opioid use disorder incidence and treatment among incarcerated pregnant women in the United States: results from a national surveillance study. Addiction, 115(11), 2057-2065.

Van den Berg, J. F., Van den Brink, W., Kist, N., Hermes, J. S., & Kok, R. M. (2015). Social factors and readmission after inpatient detoxification in older alcohol‐dependent patients. The American journal on addictions, 24(7), 661-666.