A Narrative Review of Nurse-Led Addiction Models of Care: Informing the Foundations for International Nursing

Substance-use has been linked to several physical and psychological issues that impact on an individual's quality of life, which, when left without intervention, can have detrimental effects. Nursing is a diverse profession, the practical activities of which are underpinned by theory, with nursing models representing conceptualisations about the profession, nursing practice, and how care can be organised and provided. Nursing-models provide a framework to direct the nurse's role and practice and identify the required knowledge and skills nurses need to deliver care to individuals.

This review aimed to identify and compare the core elements of addiction nurse-led models implemented across various countries to inform the development of effective, globally relevant approaches. The objectives were to determine facilitators and barriers that were encountered, and to explore the impact, if any, of addiction nurse-led models of care on substance-use for individuals and the wider community. This was a narrative review with a systematic approach. A narrative synthesis of findings was compiled. Full texts were reviewed by two authors with the search yielding 23 articles for analysis.

A systematic search was undertaken using index terms and keywords formulated in liaison with a subject librarian in May 2022. These were used in association with Boolean operators across five databases: CINHAL Ultimate, Web of Science, Psych Info, Embase, and Medline. Two overarching concepts were included in the search: Nursing-led initiatives and models, and Addiction and Substance abuse.

This narrative review identified key elements for an effective addiction nurse-led model of care: an integrated and individual-focused approach, nurses with specialized training and education, and structured protocols to guide their work. Incorporating these commonalities will contribute to the development of a robust and successful model. To promote recovery and ensure accessibility, these models should foster a judgment-free, stigma-free environment where individuals feel safe and supported throughout their journey.

This narrative review has formed the foundations to develop an addiction nurse-led model of care that can be implemented internationally in various healthcare settings, that is nurse-led and grounded in individual's needs.