Implementing the Clinical Opiate Withdrawal Scale in a Mental Health Crisis Unit:

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Introduction: Dual-diagnosis patients frequent the mental health crisis units across Alabama. Opioid abuse, if left untreated, can lead to opiate withdrawal due to opioid dependence. Without prompt initiation of treatment, opiate withdrawals can precipitate life threatening conditions. The Clinical Opiate Withdrawal Scale (COWS) tool allows providers to track early withdrawal symptoms, determine the severity of opiate withdrawal, and guide the treatment plan. Administering COWS is a nurse's intervention that requires education, skills, and confidence due to the ability to trigger opiate withdrawals when initiating the intervention too soon. Purpose: To provide nursing education, improve assessment skills in utilizing COWS, and promote confidence in providing clinical assessment data to the provider. Methods: This quality improvement project used a pre and post education survey study design to assess nurses' baseline knowledge of COWS assessment before and post-education, including evaluating confidence in utilizing the tool and communicating withdrawal symptoms to the provider. Nursing competency and confidence in COWS was assessed using a 4-point Likert scale from Schollaert- Culwell (2020). Nurses provided education via power point presentation. Results: Quantitative surveys were analyzed via descriptive statistics to summarize the characteristics of the data set. Data was collected to determine the tool's usage post COWS education at weeks three, four, and five. Discussion: Post test survey revealed increase in nursing confidence in assessing via COWS after formal education. Notable improvement in the usage of COWS tool after education.

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