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Christiana Prucnal, MD, ScM, RN




Clinical Fellow




Emergency Medicine Resident


Emergency Medicine


Christiana K. Prucnal MD ScM RN, Margaret Samuels-Kalow MD MPhil MSHP, Kristina Monteiro PhD, Dawn Williamson DNP RN PMHCNS-BC CARN-AP, Elizabeth A. Samuels MD MPH MHS

Emergency Department Nurses' Knowledge an Attitudes Regarding Opioid Use Disorder and Treatment in the Emergency Department

I was fortunate to work as a registered nurse for a number of years first on a cardiac step-down unit and then in the emergency department before starting my training as an emergency medicine resident. My interests include improving outcomes for marginalized, vulnerable populations, health equity, interdisciplinary dynamics, and critical care. Creating dedicated space to foster and amplify minority and women voices in medicine creates a richer more complete training environment and affords better care for patients. Institutional support for inclusive scholarship, with opportunities like the Women in Medicine and Science Symposium, is part of why I chose this program.


Many patients with opioid use disorder (OUD) do not receive emergency department (ED) treatment and harm mitigation services. While prior study examined contributing provider factors, little is known of nursing factors. We describe ED nurse knowledge and attitudes regarding OUD and evidence-based resources.


Anonymous email surveys based on The Theory of Planned Behavior Framework were distributed to ED nurses at an urban, tertiary-care hospital. Analyses used Chi-Square and independent samples t-tests.


More than one thirdof nurses completed the questionnaire (39%, 85/218). Most showed willingness and confidence screening for substance use. Confidence providing buprenorphine and take-home naloxone was significantly associated with having worked fewer years. Confidence administering buprenorphine was significantly associated with receiving in-service training. Staff with knowledge of take-home naloxone, positive attitudes toward syringe service programs, and a belief in a biopsychosocial basis of addiction were significantly younger and had worked significantly fewer years.


Younger age and fewer years worked were significantly associated with positive attitudes towards recovery science. Fewer years worked was significantly associated with confidence performing treatment and harm mitigation. In-service training was significantly associated with confidence administering buprenorphine. Further study should support generalizability and determine which staff development measures generate improved outcomes.