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Demonstrating Effective Leadership

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School of Nursing and Health Sciences, Capella University

NHS8002: Collaboration, Communication, and Case Analysis for Doctoral Learners

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August, 2020 Commented [IP1]: [1] Review this Capella required format for the cover page as illustrated here: Full Title of Your Paper Learner’s Full Name (no credentials) School, Capella University Course Number: Course Name Instructor Name Month, Year

Demonstrating Effective Leadership

According to the Centers for Disease Control and Prevention (2019a), deaths due to

opioid overdose have increased almost six-fold in the last 10 years. Opioid overdose is also

responsible for an average of 130 deaths in the United States every day. Although there is a lot of

scholarly literature available on evidence-based approaches to tackle the problem of addiction,

prevention and treatment interventions require effective interprofessional collaboration. The

following assessment focuses on addressing the issue of opioid addiction in Charleston, West

Virginia, through the formation of interprofessional coalition teams. The paper also focuses on

strategies, best practices, and ethical standards that the coalition team should consider to ensure

that it achieves its goal.

Contributing Factors to Opioid Addiction

According to a report by the National Institute on Drug Abuse (2019), West Virginia

reported the highest number of deaths due to opioid overdose. In 2017, about 833 deaths were

reported in West Virginia, with a prevalence rate of about 49.6 deaths for every 100,000 people.

This rate was three times the national rate of 14.6 deaths per 100,000 persons (National Institute

on Drug Abuse, 2019).

There are many factors that contribute to opioid abuse and addiction. Childhood trauma is

related to substance use disorder in adulthood. Another contributor to the increase of opioid

addiction is the overprescribing of opioid painkillers. According to Anderson and McNair

(2018), individuals seeking treatment for opioid addiction are often in despairing social,

financial, and health conditions. These factors result in the widespread use of opioids and the

expansion of opioid availability, which act as major barriers for individuals seeking treatment for

opioid addiction. Poor financial statuses, a lack of positive relationships, peer pressure, limited

Commented [IP2]: [2] A paper should begin with an introduction, placing the paper’s topic in context, e.g., acknowledge key findings, a general idea of the purpose of the paper, then narrowing the focus to the main thesis idea.

coverage of insurance facilities, and habitancy in rural areas also act as barriers for seeking and

accessing quality treatment services.

Interprofessional Coalition Team to Prevent Opioid Addiction

To combat opioid addiction in Charleston, West Virginia, a coalition team is being

formed and a community readiness survey will be developed based on the inclusion criteria for

coalition members. Trudeau (2015), in a study conducted to address the misuse of prescription

opioids, included the following inclusion criteria: An enrolee must be a current member of an

antidrug community coalition, must have substantial experience of at least a year with the

antidrug coalition, must be 18 years old, must be willing to provide informed consent, and must

speak English.

The team will be comprised of eight members as listed in the following table; through

their expertise, the team members will work toward preventing opioid addiction in Charleston,

West Virginia.

Table 1

Coalition Team Members and Their Contribution

Coalition team members

Contribution

Dr. R. S., a senior psychiatrist certified by the American Board of Psychiatry and Neurology and the Head of Department of Psychiatry at D. S. Hospital, West Virginia

Analyze the root causes of opioid addiction and determine the most effective treatment and preventive strategies to combat opioid addiction.

Dr. N. F., an addiction psychiatrist at D. S. Hospital who is certified by the American Society of Addiction Medicine

Analyze the root causes of opioid addiction and determine the most effective treatment and preventive strategies to combat opioid addiction.

M. T., president of the West Virginia Pharmacists Association Provide the data required to track the supply of opioids and spread awareness on Medication Assisted Treatment MAT to combat opioid addiction.

A. K., a member of the Substance Abuse Mental Health Services Administration, U.S. Department of Health and Human Services

Work to ensure a reduction in the impact of substance abuse and mental illness.

Commented [IP3]: [3] Good work in identifying the potential contributing factors, including thinking about this from a system’s or a macro perspective and in noting these social determinants and factors related to the community and addiction

Commented [IP4]: [4] Good use of the literature to establish criteria for membership in developing a community readiness survey. How does this align with the selected case scenario, the community factors and the development of an interprofessional collaborative team that might include community stakeholders?

Commented [IP5]: [5] Good work in presenting the rationale for the selection of this interprofessional team. What are your thoughts in terms of local community representation or someone who has experienced addiction as a member to the group? How might someone with knowledge regarding the local community, the culture, etc., be a valuable member to this group?

Commented [IP6]: [6] Good work identifying root causes. Dr. R. S. and Dr. N.F. have the same rationale for inclusion. Might it be advantageous to include team members with differing skill sets to address the identified issues?

R. K., a member of the Centers for Disease Control and Prevention

Provide scientific expertise on the data and tools required by health care providers to curb opioid addiction.

H. M., a member of the Community Anti-Drug Coalitions of America

Works to make West Virginia safe, healthy, and drug-free.

M. S., a member of the Boys and Girls Scouts of America Ensure that awareness of opioid addiction is spread across the youth groups of West Virginia.

F. S., a member of the West Virginia Department of Health and Human Resources

Extends support required to prevent opioid addiction, especially in individuals who do not have any funds for treatment and are not eligible to qualify for Medicaid

Issues Affecting Interprofessional Collaboration

The following are potential issues that affect interprofessional collaboration in the team:

• Organizations being hesitant about sharing their work, their target populations, and the

funding allocated to their organization

• Unpleasant history with fellow team members

• Differences due to hierarchy of authority

• The inability to establish effective communication between the coalition team and the

community

• The lack of organizational capacity and funding

• The inability to establish effective leadership among the coalition team (“Center for

Community Health and Development,” n.d.)

Strategies to Optimize Interprofessional Collaboration

The following strategies will help optimize interprofessional collaboration in the coalition

team:

• Effective communication among the coalition team

• Active participation of all members of the coalition team

Commented [IP7]: [7] Good work in thinking about youth and prevention. Based on the statistics presented in the beginning of the analysis, who might be at most risk? What did the literature report about vulnerable populations for opioid addiction? Based on this information, perhaps homeless shelters, food security resources, and a former addict might be included as potential members?

Commented [IP8]: [8] There are important factors to consider when working with an interprofessional team. How might these be applied to this specific interprofessional team within the framework of this community and opioid addiction in Charleston, West Virginia? This type of analysis and application to the case scenario would move the criteria from proficient to distinguished.

• Active networking through meetings with all members of the coalition team

• The setting of attainable goals to achieve success

• Honest and realistic attitudes among all members of the coalition team

• Recognition of all members by respecting the diversity of the coalition team (“Center for

Community Health and Development,” n.d.)

• Diffusion leadership responsibilities between all team members without any bias to promote

a sense of ownership and shared vision

• Shared decision-making and critical interprofessional communication to combine resources

and the development of common goals to improve staff satisfaction and service outcomes

Ethical Issues to be Considered in the Prevention of Opioid Addiction

Anderson and McNair (2018) state that the prevalence of psychiatric comorbidities with

opioid addiction and the dependence on opioid painkillers for chronic pain make treatment

challenging. The treatment of opioid addiction requires further research, which can be facilitated

by conducting clinical trials. On a micro level, the ethical issues associated with such research

can be observed when obtaining consent forms for research from individuals who may not be

competent enough to make decisions for themselves. The decision-making capacity of

individuals under the influence of drugs or experiencing withdrawal is questionable. The

coalition team will adhere to guidelines by the National Advisory Council on Drug Abuse that

emphasize research on the administration of drugs to human subjects who are at the brink of

developing addiction and those undergoing withdrawal. The basic principles of these guidelines

include respect for persons, beneficence, and justice. Respect for persons includes the

participants’ right to know what changes they would undergo during the course of the research.

Beneficence helps prevent potential harm and maximizes the potential benefits of the research to

Commented [IP9]: [9] Good work in addressing the potential challenges and road blocks in working with an interprofessional group. How might this be applied to this specific community and the selected population health issue for this interdisciplinary group? What do you anticipate might be areas of challenge and strategies for best practices for this team in Charleston ? What might be an example or two?

participants by assessing the risks and benefits associated with the research. Justice represents

equality and fairness, which must be considered when distributing the benefits and burdens of

the research.

On a meso level, the coalition team must consider ethical issues such as the unprejudiced

recruitment of participants in trials, payment to the participants, and the prevalence of

preexisting diseases such as diabetes mellitus and hypertension in the participants. The coalition

team must discuss the benefits and risks associated with the prevention of opioid addiction

(Anderson & McNair 2018). At a community level, this can take the form of providing treatment

facilities to all individuals seeking treatment for opioid addiction irrespective of their gender,

race, economic status, political inclination, and religious beliefs. The guidelines also emphasize

the importance of obtaining informed consent from participants and the careful selection of

participants (especially those who have never used drugs and those who are frequent drug users).

The guidelines also apply to those who have comorbid psychiatric conditions and women with

childbearing potential (National Institute on Drug Abuse, 2019).

Interprofessional Collaboration, Diversity, and Inclusion

Inspired by the Joint Statement of Principles followed by the Coalition for Diversity and

Inclusion in Scholarly Communications, the coalition team will establish a culture of respect,

inclusion, and value in the team by removing barriers to participation and providing equal

opportunities to all team members. Maintaining an environment that promotes and respects

diversity among all team members through effective communication will enable the active

participation of all team members in major decision-making tasks involving the goal of

preventing opioid addiction (“Joint Statement of Principles,” n.d.). Further, creating an inclusive

workplace despite racial, religious, cultural, or gender diversity helps improve collaboration and

Commented [IP10]: [10] Good work in not only identifying these core ethical principles but their application to research, clinical trials and informed consent.

Commented [IP11]: [11] Good work in noting these ethical issues. How might these be addressed via the collaborative team and its work? How can the team engage the trust of the community for recruitment, education, and treatment?

Commented [IP12]: [12] Good identification of these vulnerable groups. Is there a broader perspective in terms of ethical issues, e.g., more than research and clinical trials? For example, how might one’s code of ethics be useful in preparing team members to address potential ethical issues and challenges related to prevention, treatment, and education with regard to opioid use/abuse?

develop a feeling of belonging in an organization. This, in turn, results in improved staff

satisfaction and an environment that is conducive to the development of innovative intervention

strategies to battle opioid addiction. Additionally, developing a workplace culture that celebrates

diversity and inclusiveness promotes communality, which is fundamental for community

engagement and improved patient outcomes.

Community-level interventions can be implemented in the form of public education,

health care provider-patient interactions, and community-based medication disposal programs.

Educating communities on utilizing naloxone (which is used to treat emergency cases of opioid

overdose) and Medication Assisted Treatment (MAT) to reverse opioid overdose in a language

layman can easily understand is pivotal. It is also important that physicians and other health care

professionals alert patients about the risks associated with the overdose of prescription opioids.

Encouraging communities to install drop boxes and set up collection sites for the collective

disposal of unused opioids will also help prevent opioid addiction.

Literature Review on Prevention of Opioid Addiction

The Centers for Disease Control and Prevention (2019b) has recommended best practices

for the prevention of opioid addiction. These practices are based on thorough reviews of the

latest scientific research and expert opinions on aiding addicts and those at potential risk for

addiction. Naloxone helps in overdose reversal and distributing naloxone across communities

can have lifesaving effects. Academic detailing, which includes educating physicians on best

practices, is said to improve physician practices. Research shows that MAT improves quality of

life in addicts. Eliminating prior authorization for prescribing medication for opioid use disorder

enables physicians to prescribe MAT without the need for approval from insurance providers.

Commented [IP13]: [13] Good work in noting the role of diversity and inclusion and how this supports the mission objective of the interprofessional team. What might be an example of “best practices” to address this per the case scenario?

Commented [IP14]: [14] Good strategies to address this at the community level. What role might cultural factors play per the community demographics? How might the community stakeholders play an active role in this process at the community level working with the interdisciplinary team?

Commented [IP15]: [15] Might it be beneficial from a population health perspective to educate other health care professionals and community stakeholders?

Commented [IP16]: [16] Great point here in assessing the other stakeholders who play a role in this case scenario

Screening for fentanyl will help determine a patient’s level of abuse and also help track the

supply of fentanyl among the local drug supply.

Syringe services programs are interventions that provide clean syringes in exchange for

used ones. Patients with opioid use disorder are encouraged to take up treatment and counselling

when they enter syringe services programs (Carroll et al., 2018). The coalition team and the

community can partner to develop a syringe services program for patients with opioid addiction

and connect them with treatment and counselling programs.

Restricting supply, influencing prescribing practices, reducing demand, and reducing

harm are strategies that help prevent opioid addiction. The supply of opioids can be restricted by

improving access to drug take-back programs, where patients are instructed to return excess

drugs to any pharmacy after completing the course of medication. Prescribing practices can be

improvised by providing essential curricula on pharmacological and nonpharmacological

treatments for opioid addiction to health care providers. Developing reimbursement plans for

nonopioid pain medications will help patients switch from opioids and reduce opioid addiction.

Improving accessibility to prescription drug monitoring data will enable health care providers to

track the number of patients on prescription drugs and provide effective treatment. The demand

for drugs can be reduced by expanding treatment options by increasing access to MAT,

improving techniques on educating health care providers on the treatment of opioid use disorder,

and enabling full coverage of the medications approved by the U.S. Food and Drug

Administration. Opioid addiction can be reduced by allowing pharmacists to distribute naloxone

to individuals with opioid addiction; the pharmacists should not fear criminal prosecution for

distributing naloxone or participating with syringe programs and sales. The coalition team can

Commented [IP17]: [17] Good point here; how might the interprofessional team or the community stakeholders play a role here?

Commented [IP18]: [18] Great example of the interprofessional team working collaboratively with community organizations.

implement the aforementioned evidence-based strategies to promote the prevention of opioid

addiction.

Conclusion

The increasing prevalence of opioid addiction is a global problem that calls for a

prevention intervention. Forming interprofessional coalition teams in every community can help

prevent opioid addiction. Optimizing interprofessional collaboration among these coalitions is

pivotal for preventing opioid addiction. The treatment of opioid use disorder is challenging

because of factors such as the comorbidity of other psychiatric illnesses and dependence on

opioid painkillers. The treatment of opioid use disorder requires further research. Coalition teams

must consider an ethical code of conduct when working toward implementing interventions to

prevent opioid addiction. Effective communication, the elimination of barriers by promoting

diversity in teams, and effective leadership are some best practices for interprofessional

collaboration that will help teams. Literature reviews demonstrate evidence-based practices such

as educating communities, physicians, and health care providers on opioid addiction treatment,

improving access to MAT, and revising insurance policies on access to drugs recommended by

the U.S. Food and Drug Administration. The goal of preventing opioid addiction can be achieved

by collective emphasis on prevention, treatment, and rehabilitation of patients with opioid use

disorder and those who are at a potential risk for addiction.

Commented [IP19]: [19] Fine work in thinking about interventions, prevention, and strategies for best practices from a population health perspective. Do the members of the team you selected align with these objectives? How does this connect with being a scholar practitioner?

References

Anderson, E., & McNair, L. (2018). Ethical issues in research involving participants with opioid

use disorder. Therapeutic Innovation & Regulatory Science, 52(3), 280–284.

https://doi.org/10.1177%2F2168479018771682

Carroll, J. J., Green, C. T., & Noonan, K. (2018). Evidence-based strategies for preventing

opioid overdose: What’s working in the United States.

https://cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf

Center for Community Health and Development. (n.d.). Coalition building I: Starting a

coalition. https://ctb.ku.edu/en/table-of-contents/assessment/promotion-strategies/start-a-

coaltion/main

Centers for Disease Control and Prevention. (2019a). America’s drug overdose epidemic: Data

to action. https://www.cdc.gov/injury/features/prescription-drug-overdose/index.html

Centers for Disease Control and Prevention. (2019b). Heroin overdose data.

https://cdc.gov/drugoverdose/data/heroin.html

National Institute on Drug Abuse. (2019). West Virginia opioid summary.

https://drugabuse.gov/opioid-summaries-by-state/west-virginia-opioid-summary

Trudeau K. J. (2015). Development of a community readiness survey for coalitions to address

prescription opioid misuse. Journal of Alcohol and Drug Education, 59(3), 67–90.

https://www.ncbi.nlm.nih.gov/pubmed/27516644

https://doi.org/10.1177%2F2168479018771682

https://cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf

https://ctb.ku.edu/en/table-of-contents/assessment/promotion-strategies/start-a-coaltion/main

https://www.cdc.gov/injury/features/prescription-drug-overdose/index.html

https://cdc.gov/drugoverdose/data/heroin.html

https://drugabuse.gov/opioid-summaries-by-state/west-virginia-opioid-summary

https://www.ncbi.nlm.nih.gov/pubmed/27516644

Demonstrating Effective Leadership
Demonstrating Effective Leadership