For a study, a standardized universal drug screening approach was implemented in an outpatient prenatal clinic in an urban tertiary care hospital. Researchers implemented universal drug use screening for pregnant patients utilizing a modified 5Ps screening tool employing a quality-improvement approach that included process modeling, stakeholder analysis, and plan-do-study-act cycles (Parents, Peers, Partner, Past, Present). The SBIRT (Screening, Brief Intervention, Referral to Treatment) paradigm was used to implement an operational process. The major end measure was the percentage of patients checked for drug use, intending to screen 90% of patients. The proportion of people who screened positive and the portion of the time a positive screen resulted in recording a short intervention by a health care practitioner were secondary outcome variables. Seven hundred thirty-three patient contacts were sampled across a 19-month deployment period. In 618 cases, a drug abuse screening was performed (84%). For the final six months of data collection, they exceeded the target of screening 90% of eligible patients. About 124 (or 20%) of the 618 completed screenings tested positive. Documentation of harsh treatments for patients with a positive screen by health care practitioners reached 80% in the last phase of implementation but subsequently dropped to 50% by the end of the research period.
A sustainable and generalizable procedure for conducting drug use screening within a large prenatal practice. It aided in identifying patients who were not previously identified as at risk. Further efforts were needed to investigate ways to preserve health care practitioner recording intervention in response to positive screenings.
