Perceptions of Emergency Department nurses regarding take-home naloxone intervention in patients with opioid addiction: A systematic review

Background: In recent years, there has been an increase in mortality from opioid overdose worldwide. Naloxone is a suitable drug for its treatment. It is a specialized opioid antagonist that acts within minutes and is a safe drug with a low risk of serious adverse effects. The prevention intervention, by distributing a box of inhaled naloxone for home use, to every patient entering the ED with a history of overdose is in line with the WHO guidelines for dealing with the opioid crisis. After receiving a brief training, attendants will be able to administer naloxone in a possible future episode. Aim: The aim of the present study was to investigate the beliefs of nurses regarding the intervention with the administration of naloxone at home.

Material and Method: A mixed method synthesis of studies from a systematic review was performed. Quantitative, qualitative and mixed method studies were retrieved from Google Scholar and PubMed databases. According to the criteria, the studies had to be written in English and published in the last decade. A total of 9 articles were found. Their quality was checked through the Critical Appraisal Skills Program (CASP).

Results: Emergency department nurses positively assessed the adoption of the role of naloxone provider for patients at risk, as well as the responsibility of educating patients and their families. However, obstacles to its implementation were recorded, such as insufficient training, lack of staff, lack of nurses' job descriptions and legal coverage related to the intervention, lack of funding, as well as the reproduction of the social stigma of addiction.

Conclusions: Nurses appear to view their role as a naloxone provider positively. Informed addiction education in all undergraduate nursing programs may contribute to nurses' readiness to respond to the needs of this population.

Keywords: take-home naloxone, perception, attitude, Nurses, emergency department