OBJECTIVE: To evaluate a newly implemented universal screening process for substance use on a labor and delivery (L&D) unit. DESIGN: Focused program evaluation using the Centers for Disease Control and Prevention Framework for Program Evaluation in Public Health. SETTING/LOCAL PROBLEM: An L&D unit in a community hospital that was part of a larger health system located in rural Pennsylvania with higher than state average rates of perinatal substance and opioid use. PARTICIPANTS: Women (n = 570) admitted to the L&D unit between July 2021 and July 2022 and the maternity care providers (i.e., nurses, certified nurse-midwives, and physicians
n = 22) on the L&D unit. INTERVENTION/MEASUREMENTS: We analyzed screening rates
provider follow-up rates for at-risk screens
and staff perception of acceptability, appropriateness, and feasibility of the National Institute on Drug Abuse Quick Screen and the modified Alcohol, Smoking, and Substance Involvement Screening Test (NIDA Quick Screen/ASSIST). We also collected staff feedback with open-ended questions in the survey. RESULTS: The screening rate on the L&D unit during the study period was 89%. Maternity care providers ordered the appropriate follow-up on at-risk screens 88% of the time. Nurses and providers found the NIDA Quick Screen/ASSIST to be an acceptable, appropriate, and feasible screening tool for identifying substance use risk. CONCLUSION: The screening rate on the L&D unit was greater than the health system goal of 80%, whereas the provider follow-up rate was less than the goal of 100%. In open-ended feedback, staff identified ways to streamline the screening process
improve nurse, provider, and patient education
and enhance patient follow-up.