US nurses ‘live’ mapping opioid overdoses to inform practice

Based on their findings, they said nurse practitioners and nursing students could use local, real-time maps of opioid overdoses to inform their clinical work with adolescents in community health settings.

“Analysing community maps with data from emergency response teams can help us to design interventions”

Donna Hallas

The US is currently in the grip of a well publicised opioid crisis that has devastated communities across the country, but researchers noted that overdoses varied by region and neighbourhood.

For instance, they highlighted that opioid overdoses in the Bronx area were concentrated in the South, while the northern part of the borough had seen relatively few overdoses.

The study, carried out by a team from New York University’s Rory Meyers College of Nursing and published in the Journal of Pediatric Health Care, used data that was already being collected.

The New York fire department and its emergency medical services collect data that generate geospatial information system (GIS) maps for New York City’s five boroughs, noted the researchers.

The real-time maps enable these services to identify locations of street-level drug use that may lead to lethal outcomes and to plan their daily strategies in the fight against opioid overdoses.

For the new study, researchers used the GIS maps to develop an educational programme for nurse practitioner preceptors who provide educational experiences for nursing practitioner students.

The preceptors were educated on a variety of facets of the opioid crisis, including reviewing opioid-prescribing practices in community-based centres and recommendations for changing prescribing practices to control pain using alternative medications.

The preceptors were also introduced to state health department opioid data, which provide an overview of trends including overdose rates, naloxone administrations, and emergency room visits.

The state-level data was compared with the GIS maps, which contained a finer level of detail, including the number of opioid overdoses as well as other drug and alcohol incidents, with heat maps showing locations and concentrations of incidents.

The researchers focused on maps of the Bronx and Brooklyn, where students were working in primary care settings, including school-based health centres, community-based clinics and hospitals.

“Interventions can be designed, evaluated, and changed quickly”

Donna Hallas

They found the use of GIS maps helped inform the care preceptors provided and the discussions about the opioid crisis they had with students, as measured by reviewing weekly clinical notes.

In addition, the analysis of the maps led to consistent screenings for risk-taking behaviours in the adolescent and young adult populations, thanks to students’ awareness of community abuse issues.

These screenings resulted in an increase in interventions by students, including motivational interviewing, brief intervention and referral to substance use treatment.

Lead study author and nurse Dr Donna Hallas said: “Analysing community maps with data from emergency response teams can help us to design interventions that have the potential to change the trajectory of the current opioid crisis.

“The importance of local GIS maps is that this information is available in real time so that interventions can be designed, evaluated, and changed quickly to meet the immediate needs of the community,” she said.

“Traditional and non-traditional healthcare professionals have a unique opportunity to use visual technologies, such as GIS mapping, to identify hot spots early and then assess, diagnose, and treat those for whom opioid use, overdoses, and deaths are major problems,” she added.