Impact of the COVID-19 Pandemic on Functions of Nursing Professionals in the Care of Opioid Use Disorder: Systematic Review.

Kate G Brown, Carina Y Chen, Deanna Dong, Kimberly J Lake, Eduardo R Butelman
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Abstract

Background: Nursing professionals are vitally involved in the cascade of care for opioid use disorders (OUDs). The global spread of COVID-19 has had complex effects on public health aspects of major diseases, including OUDs. There are limited data on the major ways in which the COVID-19 pandemic has affected the functions of nursing professionals in the care of OUDs.

Method: This systematic review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and examined published data for trends in OUD care during the first 2 years of the COVID-19 pandemic, focusing on nursing functions. The National Library of Medicine PubMed database and the EMBASE database were examined for peer-reviewed studies with primary data published between January 1, 2020, and December 31, 2021.

Review findings and conclusions: Rapid changes were observed in numerous aspects of OUDs during the early pandemic stage, as well as its care by nursing and other health professionals. These changes include increased overdoses (primarily from synthetic opioids such as fentanyl) and emergency department visits. These trends varied considerably across U.S. jurisdictions, underscoring the importance of region-specific examinations for public health policy and intervention. Out of necessity, healthcare systems and nursing professionals adapted to the challenges of OUD care in the pandemic. These adaptations included increases in telehealth services, increases in take-home doses of methadone or buprenorphine/naloxone, and expansion of layperson training in the use of naloxone for overdose reversal. It is likely that some of these adaptations will result in long-term changes in standards of care practices for OUDs by nursing professionals.

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COVID-19 大流行对护理专业人员在阿片类药物使用障碍护理中的职能的影响:系统回顾。
背景:护理专业人员在阿片类药物使用失调症(OUDs)的一系列护理过程中发挥着至关重要的作用。COVID-19 在全球的传播对包括 OUDs 在内的主要疾病的公共卫生方面产生了复杂的影响。关于 COVID-19 大流行对护理专业人员在 OUDs 护理中的职能产生影响的主要方式的数据十分有限:本系统性综述遵循《系统性综述和元分析的首选报告项目》指南,研究了 COVID-19 大流行头两年 OUD 护理趋势的已发表数据,重点关注护理职能。研究人员在美国国家医学图书馆PubMed数据库和EMBASE数据库中检索了2020年1月1日至2021年12月31日期间发表的主要数据的同行评审研究:在大流行初期,OUDs 的许多方面以及护理和其他医疗专业人员对其的护理都发生了快速变化。这些变化包括过量用药(主要来自合成类阿片,如芬太尼)和急诊就诊人数的增加。这些趋势在美国各辖区之间存在很大差异,凸显了针对具体地区的检查对于公共卫生政策和干预的重要性。出于必要,医疗保健系统和护理专业人员对大流行中的 OUD 护理挑战进行了调整。这些调整包括增加远程医疗服务、增加美沙酮或丁丙诺啡/纳洛酮的带回家剂量,以及扩大对非专业人员使用纳洛酮逆转用药过量的培训。其中一些调整可能会导致护理专业人员对 OUD 的护理实践标准发生长期变化。
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