Other Titles

Opioid Overdose: Is Your Clinic Prepared? [Title Slide]

Abstract

In 2023, the National Institute of Health reported 79,358 U.S. overdose deaths caused by opioids. This value is 166% higher than data from 2017, with an opioid-induced death toll of 47,600.1 The rising rates of overdose require clinics to be prepared to respond to overdose emergencies.2 Literature analysis revealed gaps in provider response capability for opioid overdose in healthcare outpatient settings.3, 4, 5, 6 Thus, there is a need to address the gaps in emergency preparedness for an opioid overdose through simulation training of outpatient staff. The purpose of the pilot study is to develop a simulation to educate healthcare providers, nurses, and staff in outpatient settings on the correct opioid overdose responses.

A de-identified pre-survey was given to assess participants knowledge of opioid overdose response. A review of signs of overdose and recovery positioning was given. A low-fidelity simulation provided naloxone administration practice to mannequins. Next, participants moved to a high-fidelity simulation. Six roles were assigned: primary nurse, nursing assistant, desk clerk, security officer, communicator to EMS, and bystanders. Participants were provided a patient chart review and initial vital signs. Participants were required to demonstrate proficiency in overdose response, communicate effectively with their team, and maintain organization. Following the simulation, a debriefing session addressed participants experience and importance of simulation training. Post-survey measured improvements in overdose response proficiency, confidence and simulation impressions.

This study combined BLS and opioid emergency response with the aim of expanding training to staff across interdisciplinary outpatient clinics. Outcomes showed an improvement in staff knowledge and confidence. Pre-survey participants (n=15) correctly identified 4.2 out of 6 signs of overdose, increasing in the post-survey by 12% (4.93). There was a 20% increase in perceived participant confidence responding to an opioid overdose emergency, as measured on a Likert scale (1-4) from very unsure to very confident. Comfortability administering Narcan improved from 86% to 100%. Comfortability placing a patient in recovery positioning increased from 80% to 100%. Furthermore, 13 of 15 participants felt the simulation was very realistic (9) or somewhat realistic (4). Overdose response training, just like CPR training, has the potential for improving emergency responses through simulation.

Notes


Additional references available in attached slide deck.

References:

1. National Institute on Drug Abuse. (2024, August 21). Drug Overdose Deaths: Facts and Figures; National Institutes of Health. Retrieved from https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

2. 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

3. 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

4. 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

5. 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

6. 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.12473

Description

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

Author Details

Nancy S. Goldstein, DNP, MS, RN, APN-BC, APRN, CNE, RNC; Tyler Langley, MSN, RN; Brooke Van Buskirk, BS (student nurse)

Sigma Membership

Nu Beta at-Large

Lead Author Affiliation

Johns Hopkins University, Baltimore, Maryland, USA

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Experimental

Research Approach

Pilot/Exploratory Study

Keywords:

Continuing Education, Simulation, Interprofessional, Interdisciplinary, Opiate Overdose, Outpatient Service, Rapid Response (Emergency Care), Opiate Overdose--Prevention and Control, Patient Simulation

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

2026-08-04

Click above link to access the slide deck.

Share

COinS
 

Opioid Overdose Education for Outpatient Settings and Simulation Development

Toronto, Ontario, Canada

In 2023, the National Institute of Health reported 79,358 U.S. overdose deaths caused by opioids. This value is 166% higher than data from 2017, with an opioid-induced death toll of 47,600.1 The rising rates of overdose require clinics to be prepared to respond to overdose emergencies.2 Literature analysis revealed gaps in provider response capability for opioid overdose in healthcare outpatient settings.3, 4, 5, 6 Thus, there is a need to address the gaps in emergency preparedness for an opioid overdose through simulation training of outpatient staff. The purpose of the pilot study is to develop a simulation to educate healthcare providers, nurses, and staff in outpatient settings on the correct opioid overdose responses.

A de-identified pre-survey was given to assess participants knowledge of opioid overdose response. A review of signs of overdose and recovery positioning was given. A low-fidelity simulation provided naloxone administration practice to mannequins. Next, participants moved to a high-fidelity simulation. Six roles were assigned: primary nurse, nursing assistant, desk clerk, security officer, communicator to EMS, and bystanders. Participants were provided a patient chart review and initial vital signs. Participants were required to demonstrate proficiency in overdose response, communicate effectively with their team, and maintain organization. Following the simulation, a debriefing session addressed participants experience and importance of simulation training. Post-survey measured improvements in overdose response proficiency, confidence and simulation impressions.

This study combined BLS and opioid emergency response with the aim of expanding training to staff across interdisciplinary outpatient clinics. Outcomes showed an improvement in staff knowledge and confidence. Pre-survey participants (n=15) correctly identified 4.2 out of 6 signs of overdose, increasing in the post-survey by 12% (4.93). There was a 20% increase in perceived participant confidence responding to an opioid overdose emergency, as measured on a Likert scale (1-4) from very unsure to very confident. Comfortability administering Narcan improved from 86% to 100%. Comfortability placing a patient in recovery positioning increased from 80% to 100%. Furthermore, 13 of 15 participants felt the simulation was very realistic (9) or somewhat realistic (4). Overdose response training, just like CPR training, has the potential for improving emergency responses through simulation.