Implementation of a Perinatal Substance Use Screening Protocol in the Outpatient Setting

Objective

To implement the 5Ps Screen for Alcohol/Substance Use tool and the screening, brief intervention, and referral to treatment (SBIRT) process into clinical practice to determine if enhanced training would improve perinatal providers’ adherence to universal screening.

Design

A quality improvement project using a pre- and postintervention design.

Setting/Local Problem

Three community-based, outpatient obstetrics and gynecology clinics in southeastern Massachusetts. The local problem identified was that no validated screening tool was being used for universal screening of substance use in pregnancy.

Interventions/Measurements

Training consisted of two phases that reviewed the SBIRT process, the 5Ps screening tool, brief intervention conversations, and the process for referral to treatment. Pre- and postimplementation screening rates were compared and analyzed using descriptive statistics and chi-square tests of independence.

Results

Preimplementation screening rates were 14.4%. Screening rates measured 1 month after implementation were 44.6% (p < .001). Universal screening was not achieved.

Conclusion

Short-term improvement in screening for perinatal substance use was observed. Whether these results are sustainable beyond the project time frame is unknown. Future work should examine longer-term outcomes and continued barriers to universal uptake of the screening protocol.