Other Titles

Opioid Overdose Simulation Training for Outpatient Staff: An Educational Development Project [Poster Title]

Abstract

Outpatient medical facilities have become more likely to encounter in-office emergencies related to opioid overdoses. Literature analysis found gaps in health team response capability in outpatient healthcare settings.1

Our aim was to design and implement an opioid overdose simulation at an outpatient substance use disorder clinic. Literature reviewed found 4 essential themes to guide our curriculum development: simulation training, emergency action protocols, response training and equipment readiness.2,3,4,5 These themes were used to create an algorithm on best-practice for overdose response and guided our simulation development.

A four-step simulation was designed including pre-brief education, low-fidelity mannequin simulation, high-fidelity simulation with a standardized patient, and conclusion debriefing. Participants began with a pre-survey to assess their baseline knowledge. They were educated on signs and symptoms of opioid overdose, recovery positioning, and naloxone administration practice. A standardized patient script included past medical history, patient background, and progression of physiological overdose deterioration. Prior to the simulation, participants were given descriptive role cards for primary nurse, nursing assistant, front desk clerk, security officer, communicator to EMS, and bystander patient. All necessary equipment including bag-valve masks and AEDs were accessible for participants use.

One facilitator assumed the role of standardized patient. The other guided discussion of simulation expectations, interacted during the scenario as needed (patient status change), and monitored the simulation action checklist. Debriefing incorporated strong educational discussion of participants’ questions, take-aways, and impressions. A post-survey showed improvement of staff knowledge and confidence.

Pre-survey participants (n=15) correctly identified 4.2 out of 6 signs of overdose and increased by 12% in the post-survey (4.93). There was 20% increase in perceived participant confidence in responding to an opioid overdose emergency, as measured on a Likert scale (1-4) from very unsure to very confident. Comfort improved for naloxone administration from 86% to 100% and patient recovery positioning from 80% to 100%. Participants (13 of 15) felt the simulation was very realistic (9) or somewhat realistic (4).Through simulation training, opioid overdose response has potential for improving emergency responses and outcomes.

Notes

References:

1. Goldstein, N. S., & Grubb, C. (2025). Original Research: Is Your Outpatient Office Prepared to Manage an Opioid Overdose? AJN American Journal of Nursing, 125(1), 30-36. https://doi.org/10.1097/01.naj.0001094948.23305.58

2. Abulebda, K., Yuknis, M. L., Whitfill, T., Montgomery, E. E., Pearson, K. J., et al. (2021). Improving Pediatric Acute Care Through Simulation (ImPACTS). Preparedness for Pediatric Office Emergencies: A Multicenter, Simulation-Based Study. Pediatrics, 148(3), e2020038463. https://doi.org/10.1542/peds.2020-038463

3. Bansal, V. K., Dobie, K. H., & Brock, E. J. (2019). Emergency Response in the Ambulatory Surgery Center. Anesthesiology clinics, 37(2), 239–250. https://doi.org/10.1016/j.anclin.2019.01.012

4. Spanos S. (2022). Pediatric Office Emergency Preparedness: An Intensive In-Office Training Curriculum. Pediatric emergency care, 38(8), 392–398. https://doi.org/10.1097/PEC.0000000000002702

5. Smereka, J., Aluchna, M., Aluchna, A., & Szarpak, L. (2019). Preparedness and attitudes towards medical emergencies in the dental office among Polish dentists. International Dental Journal, 69(4), 321–328. https://doi.org/10.1111/idj.12473References:

Additional References:

Center for Disease Control and Prevention. (2024, May 7). SUDORS Dashboard: Fatal Drug Overdose Data. Overdose Prevention. https://www.cdc.gov/overdose-prevention/data-research/facts-stats/sudors-dashboard-fatal-overdose-data.html

Zhu, A., Thieme, N., & Gallagher, J. (2024, May 23). Almost 6,000 Dead in 6 Years: How Baltimore Became the U.S. Overdose Capital. The New York Times. https://www.nytimes.com/2024/05/23/us/baltimore-opioid-epidemic-od-deaths.html

Description

The rising rates of opioid overdose require clinics to be prepared to respond to overdose emergencies. Literature analysis revealed gaps in healthcare team response capability for opioid overdose in outpatient settings. An educational simulation was developed and implemented to enhance knowledge of healthcare team on best practices for emergency response. Our educational simulation improved staff knowledge (12%) and confidence (20%) in the outpatient clinic.

Author Details

Brooke Van Buskirk & Tyler Langley MSN Candidates, FULD scholars

Mentor: Nancy S. Goldstein, DNP, ANP-BC, CRNP, CNE

Sigma Membership

Nu Beta at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Teaching and Learning Strategies, Simulation, Curriculum Development, Substance Abuse, Substance Abuse Prevention, Drug Overdose, Opioid Abuse, Simulation Methods in Education, Outpatient Medical Care

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-12

Click on the above link to access the poster.

Additional Files

Fuld_Script.pdf (61 kB)

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Opioid Overdose Simulation Training for Staff: An Educational Development Project

Toronto, Ontario, Canada

Outpatient medical facilities have become more likely to encounter in-office emergencies related to opioid overdoses. Literature analysis found gaps in health team response capability in outpatient healthcare settings.1

Our aim was to design and implement an opioid overdose simulation at an outpatient substance use disorder clinic. Literature reviewed found 4 essential themes to guide our curriculum development: simulation training, emergency action protocols, response training and equipment readiness.2,3,4,5 These themes were used to create an algorithm on best-practice for overdose response and guided our simulation development.

A four-step simulation was designed including pre-brief education, low-fidelity mannequin simulation, high-fidelity simulation with a standardized patient, and conclusion debriefing. Participants began with a pre-survey to assess their baseline knowledge. They were educated on signs and symptoms of opioid overdose, recovery positioning, and naloxone administration practice. A standardized patient script included past medical history, patient background, and progression of physiological overdose deterioration. Prior to the simulation, participants were given descriptive role cards for primary nurse, nursing assistant, front desk clerk, security officer, communicator to EMS, and bystander patient. All necessary equipment including bag-valve masks and AEDs were accessible for participants use.

One facilitator assumed the role of standardized patient. The other guided discussion of simulation expectations, interacted during the scenario as needed (patient status change), and monitored the simulation action checklist. Debriefing incorporated strong educational discussion of participants’ questions, take-aways, and impressions. A post-survey showed improvement of staff knowledge and confidence.

Pre-survey participants (n=15) correctly identified 4.2 out of 6 signs of overdose and increased by 12% in the post-survey (4.93). There was 20% increase in perceived participant confidence in responding to an opioid overdose emergency, as measured on a Likert scale (1-4) from very unsure to very confident. Comfort improved for naloxone administration from 86% to 100% and patient recovery positioning from 80% to 100%. Participants (13 of 15) felt the simulation was very realistic (9) or somewhat realistic (4).Through simulation training, opioid overdose response has potential for improving emergency responses and outcomes.