Description: After a resident in a nursing facility serving veterans experienced an opioid overdose, it highlighted serious deficits in staff training regarding overdose response and naloxone use. In response, the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) partnered with the facility to improve education and resources focused on overdose readiness and response techniques. This partnership involved conducting training sessions for staff, creating easily accessible naloxone reference guides, and advising on tailored storage solutions for the medication.
Case Description: A resident at the nursing facility experienced an opioid overdose, and the staff was unaware of how to locate or administer naloxone. They recognized their lack of training regarding overdose responses. This prompted the facility point of contact to reach out to the COE-NF, saying, “… I knew exactly who to call in order to help get some training for naloxone administration for my staff.”
Unique Challenges: The facility accommodates a significant number of residents who struggle with opioid use disorder (OUD). It provides essential medical care and fosters a supportive environment to help veterans regain control of their lives. The facility’s point of contact reported that staff lacked the specialized training and education needed to address the complexities of addiction and to create personalized treatment plans to meet the unique needs of each veteran.
COE-NF Solution: The COE-NF’s regional behavioral specialist (RBS) recommended a plan to promote education and resources on overdose response strategies. The strategies included understanding how to assess a potential opioid overdose, establishing an opioid overdose response program, developing policies to improve access to naloxone, and understanding how naloxone is administered in an emergency.
The RBS advised that staff participate in the Opioid Overdose & Naloxone Administration COE-NF training. This training enhances staff knowledge and skills in recognizing and responding to opioid overdoses and how to develop an opioid overdose prevention program. The RBS also provided the facility with Using Naloxone to Respond to an Overdose in a Nursing Facility quick reference guides, which can be displayed on employee badges for easy access.
Furthermore, the RBS emphasized the importance of having naloxone readily accessible for residents who are currently prescribed opioids or have a history of OUD, as well as for all staff members. The RBS also shared information regarding specialized storage devices for naloxone, which are designed to ensure its prompt availability and safe storage. This proactive approach is intended to create a safe environment and promote timely intervention in emergencies related to opioid overdoses.
Outcome/Benefits: The facility’s point of contact expressed gratitude for the numerous resources provided by the COE-NF. She began revitalizing the behavioral health services at the facility and recognized the COE-NF as her direct line of support to help initiate this process. Her transparency about the current challenges allowed the COE-NF to brainstorm and identify several interventions to address the issues. She reported that 98% of staff members have participated in the education recommended by the RBS. Additionally, all residents now have a care plan and those at high risk of opioid overdose are prescribed naloxone. Each unit has naloxone available, and the facility is actively implementing emergency naloxone kits to improve safety and readiness for potential overdose situations, marking a significant step toward better support for veterans with OUD. The facility posted the Using Naloxone to Respond to an Overdose in a Nursing Facility and Naloxone in Nursing Facilities: How it Saves Lives fliers on each unit and staff break rooms to increase awareness. The facility is conducting monthly training sessions based on the trainings on the COE-NF website. Further, the corporate headquarters is currently developing a policy and procedure for managing opioid overdoses and naloxone administration.
In addition to these interventions, the facility has demonstrated the following:
- Improved communication with staff
- Increased awareness of residents’ needs
- Adoption of new practices and interventions
- Adaptation of programs, policies, and practices to meet the needs of the residents
