Substance use risk assessment: assessing the risk of vascular access device tampering in patients with a history of drug use.

Abstract

Aim: Intravenous (IV) drug use is an increasing public health concern impacting the care of hospitalized patients. Identifying patients at risk of nonprescribed use of their vascular access device (VAD) is the first step in providing safe, effective care to these patients. Currently, as indicated by literature review, hospitals do not have a process in place to screen patients for the likelihood of misuse of their VAD. In this article, we focus on developing an assessment and work toward validating the tool.

Methods: A literature review was performed for screening tools that identify patients with history of IV drug use who may be at risk for misuse of their VAD. After identifying a gap in research, key stakeholders collaborated to identify which questions would be necessary to recognize this patient population and developed a Substance Use Risk Assessment (SURA) tool and a Substance Use Risk Reduction Program.

Results/conclusions: The pilot of the assessment and program found successful identification of patients at risk for VAD misuse, and interventions were put in place to decrease risk to the patient and hospital. The SURA tool has attained an acceptable level of content validity; however, reliability was not proven due to limited data availability.