TACKLING OPIOID OVERDOSE SITUATIONS WITH SIMULATION-BASED LEARNING

Opioid abuse has reached staggering levels globally. In Canada, opioid abuse is our single most significant emerging public health crisis. Currently, Canada is the second largest consumer of prescription opioids (INCB, 2013; CIHI, 2016), with a 203% increase in usage between 2000 and 2010 (INCB, 2011; NACPDM, 2013). From 2008-2014, there has been a 62% increase nationally in opioid overdose hospitalization rates for people aged 15-24 (UN, 2016). In response to this crisis, the Canadian government has moved to make naloxone, the medication used to treat opioid overdoses, available without a prescription and without cost. Not only will healthcare providers in all settings be required to know how and when to treat a person using a naloxone overdose kit, increasingly members of the public will be required to possess this skill set. Within this changing landscape, it is essential to appreciate that nurses practice not only in institutional type settings, but also out in the community in every conceivable setting. Nurses are ideally positioned to have a positive impact on this critical public health crisis, both through their direct intervention and through the health teaching they can provide to citizens who may be required to intervene. Ensuring that our nursing program graduates are able to demonstrate the knowledge, skill, and judgment necessary to engage effectively within this rapidly changing health crisis requires innovative educational approaches. Simulation-based learning holds the potential to aid learners not only to develop knowledge, but also to experience situations in such a way that they develop practice skills in a safe environment (Cant & Cooper, 2010). Additionally, simulation-based learning provides the perfect venue for students to be supported to reflect, both in the moment and after the moment (Schön, 1983) on their experience. In so doing, simulation-based learning promotes the transformational potential of a learning experience, addressing not only the cognitive and behavioural domains, but equally important the attitudes and perceptions of the learner. This presentation describes a project in which a high stakes, low frequency event involving acute opioid overdose in a community setting (e.g., on a street corner) was developed and evaluated.

References:
[1] Canadian Institute for Health Information, Canadian Centre on Substance Abuse. Hospitalizations and Emergency Department Visits Due to Opioid Poisoning in Canada. Ottawa, ON: CIHI; 2016.
[2] Cant, R. P., & Cooper, S. J. (2010). Simulation-based learning in nurse education: Systematic review. Journal of Advanced Nursing, 66(1), 3-15. DOI: 10.1111/j.1365-2648.2009.05240.x
[3] International Narcotics Control Board. (2013). Narcotics Drugs: Estimated World Requirements for 2013; Statistics for 2011. New York: United Nations.
[4] International Narcotics Control Board. (2011). Narcotics Drugs: Estimated World Requirements for 2012; Statistics for 2010. New York: United Nations.
[5] National Advisory Committee on Prescription Drug Misuse. (2013). First do no harm: Responding to Canada’s prescription drug crisis. Ottawa: Canadian Centre on Substance Abuse.
[6] Schön, D. A. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books.
United Nations Office on Drugs and Crime. (2016). World Drug Report 2016, United Nations publication, Sales No. E.16.XI.7.