title: Opioid and Naloxone Training in a Rural School District
Creators: name: Waldron, Allyson
Publisher: name: University of Nevada, Las Vegas
Year: 2021

description: The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used historically in medical settings over the last five decades to reverse an opioid overdose in minutes; today, naloxone is available to anyone using opioids or anyone who thinks they could encounter an opioid overdose. Adults employed in rural public-schools may encounter a drug overdose through their work with adults or adolescents. This possibility compelled the Elko County School District (ECSD) to stock two doses of nasal naloxone (Narcan) in each school; however, a formal naloxone training program was not implemented to educate staff about possible opioid risk or naloxone administration. This educational need for opioid and naloxone training serves as the impetus for this Doctor of Nursing Practice (DNP) project. The purpose of this DNP project was to develop, implement, and evaluate an opioid risk and naloxone training program for the ECSD nurses and school personnel. To achieve this project’s purpose, the National Association of School Nurses (NASN) naloxone toolkit was adapted and utilized to facilitate a voluntary online educational training session for all ECSD school nurses and personnel meeting pre-determined inclusion criteria. This online training module was offered through an e-mail invitation that was extended over approximately six weeks. The training contained material to aid in recognizing opioid overdose, state and countyspecific information about opioid overdose prevention and treatments, and protocols for emergency response, including naloxone administration. A collection of demographic data and a pre-post evaluation design were utilized to assess the knowledge and confidence levels before and after implementing this training intervention. One hundred fifty invitations were sent to participants via e-mail. Seventy-two possible participants responded to the project’s invitation, but 42 did not complete all the project requirements, and two were not working in the ECSD; therefore, 44 were excluded from all analyses. The final sample included 28 (N = 28). The majority of responding participants were female (N=19; 67.9%), mostly schoolteachers (N=12; 42.9%), and nurses (N=10; 36.7%). All participants were full-time employees, and all worked in the ECSD. All participants were fulltime employees, and all worked in the ECSD. The results of the pre-and post-knowledge and confidence assessments indicated a statistically significant improvement in both knowledge and confidence. Self-reports indicated that the participants felt their learning needs were met and felt improved confidence to respond during an overdose situation. These outcomes may also reveal that educational reviews may be beneficial to school nurses and that with training, laypersons can gain essential learning skills that resemble those of health professionals, allowing them to respond effectively during an opioid overdose emergency. Finally, this project may imply that all adults can benefit from this training module, especially those currently using opioids, those who have previously used opioids with continued access to these drugs, or adults around others who could be using these substances.