Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Nursing

Supervisor

Forchuk, Cheryl

Abstract

Health care providers have described inadequate knowledge to fully care for people who use unregulated psychoactive substances during hospitalization. Literature has revealed gaps in understanding health care providers’ perspectives of harm reduction and substance use education in hospital. Through an interpretive lens, this secondary analysis explores gaps which exist in current education and related factors needing to be addressed in hospital settings. This study was conducted across three hospitals in one city in southwestern Ontario with a sample size of 31. Using an ethnographic method of analysis themes emerged including the interconnection between the health care providers’ perspectives of the current state and desired state. Themes which emerged in both states include: (a) insufficient education, (b) lack of resources, (c) inconsistent policy, (d) culture of stigma and suboptimal care, (e) enhanced education, (f) resources, (g) policy change, (h) culture shift and optimal care. The findings of this study demonstrate the need for supportive policy, resources and enhanced harm reduction and substance use education to shift the current culture of care in hospital to better inform policy, practice, education, and future research.

Summary for Lay Audience

There are increasing numbers of people who use unregulated psychoactive substances worldwide, year to year. Premature death and significant medical complications have been associated with unregulated substance use. HIV, hepatitis, skin or soft tissue infections, abscesses, and endocarditis are common complications often requiring medical attention. People who use unregulated substances requiring medical care, present to hospital settings at an increased frequency due to the complexity of medical conditions associated with unregulated substance use. Health care providers working in hospital settings describe being inadequately trained to fully care for people using unregulated substances. People who use unregulated substances frequently describe stigmatization in hospitals, a lack of knowledge or attention to withdrawal from health care staff and policies that prevent them from seeking medical care. This presents significant barriers for people who use unregulated psychoactive substances to accessing hospital care. Harm reduction is a practice that offers evidence based, barrier and judgment free services to people who use unregulated substances aimed at reducing harm while promoting informed substance use. In this study we explored health care providers’ perspectives on education of substance use and harm reduction in hospital settings to better understand how to address insufficient knowledge.

Health care provider participants described current education as insufficient, however, tied this to additional contributing factors such as inconsistent policies and lack of resources in hospital. Health care provider participants acknowledged the marginalization of people who use unregulated substances and attributed this to insufficient education, inconsistent policies, and lack of resources. To improve culture of care in hospital, health care providers perceived education, supportive policy, and resources such as experts in addiction in hospital settings, to be imperative to facilitate change. This interconnection of factors involved with health care providers’ perspective of harm reduction and substance use education is extremely important to understanding ways in which policy creators, hospital institutions, educators, and post-secondary institutions can address the current gaps in education. Addressing educational gaps may help to build trust with people who use unregulated substances in hospitals and facilitate optimal care of this population.

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Available for download on Tuesday, September 10, 2024

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