Date of Graduation

Summer 8-17-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Dr. Alexa Colgrove Curtis

Second Advisor

Dr. Elena Capella


Background: The opioid epidemic escalated in the United States due to the availability of prescription opioids, heroin, and synthetic opioids like fentanyl. Unfortunately, access to treatment is not always accessible, especially in rural communities with limited resources.

Local Problem: Tehama County is a rural county in northern California with limited access to treatment for opioid use disorder. The local Emergency Department (ED) and primary care-based Medication-Assisted Treatment (MAT) clinic collaborated to increase access. However, services remain under-actualized due to limited understanding of MAT best practices, stigma related to substance use within the ED culture, and poor articulation between the ED and primary care setting.

Methods: This evidence-based change of practice project was guided by the Theory of Planned Behavior to assess the culture of the ED, guide education to enhance understanding of treatment for OUD, and optimize patient-centered MAT care in the local ED.

Interventions: Education was administered to ED staff via an online learning platform regarding MAT in the ED, the transition to the primary care setting, and biases that may hinder care. A tool was created to assist patients transitioning from ED to primary care, and provider responses were assessed via pre-and post-intervention surveys.

Results: ED practitioners’ self-reported knowledge regarding OUD and MAT was increased, as well as confidence in transitioning patients to primary care. Awareness of strategies to avoid stigma increased, but acceptance of MAT practice was less influenced. ED staff moderately accepted the patient tool, but more work is needed to determine patient response.

Conclusions: Increasing ED practitioner knowledge and addressing stigma are steps toward improving access to OUD treatment, but bias in the ED culture may persist and limit acceptance of MAT. Future efforts to expand awareness of MAT offerings should move beyond the ED setting.

Included in

Nursing Commons