Implementation of a Perinatal Substance Use Screening Protocol in the Outpatient Setting

Area of Science:

• Perinatal healthcare
• Substance use screening
• Quality improvement in obstetrics and gynecology

Background:

• Universal screening for substance use in pregnancy is crucial for early identification and intervention.
• Existing practices lacked a standardized, validated screening tool for perinatal substance use.
• The 5Ps Screen for Alcohol/Substance Use and the screening, brief intervention, and referral to treatment (SBIRT) process were identified as potential solutions.

Purpose of the Study:

• To implement the 5Ps Screen and SBIRT process into clinical practice.
• To evaluate the impact of enhanced training on perinatal providers' adherence to universal screening for alcohol and substance use.
• To assess the feasibility and effectiveness of integrating a standardized screening protocol in community-based obstetrics and gynecology clinics.

Main Methods:

• A quality improvement project utilizing a pre- and postintervention design was conducted.
• Enhanced training on the 5Ps Screen and SBIRT process was provided to perinatal providers in three clinics.
• Screening rates were compared before and after the intervention using descriptive statistics and chi-square tests.

Main Results:

• Preimplementation screening rates were 14.4%.
• Postimplementation screening rates increased significantly to 44.6% (p < .001) one month after the intervention.
• Despite the improvement, universal screening was not achieved during the study period.

Conclusions:

• The enhanced training led to a short-term improvement in perinatal substance use screening.
• The sustainability of these improved screening rates beyond the project's timeframe is undetermined.
• Further research is needed to address barriers to universal screening adoption and examine long-term outcomes.