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clinical nurse specialist, naloxone, OEND, opioid overdose and naloxone distribution, program development



  1. Mullennix, Stephanie C. MSN, RN, AGCNS-BC, CEN
  2. Iseler, Jackeline DNP, RN, ACNS-BC, CNE
  3. Kwiatkowski, Gregory M. PharmD, BCPS
  4. McCann-Spry, Lisa MSN, RN, AGCNS-BC, ONC
  5. Skinner, Jeffrey MHA, BSN, RN, CEN
  6. Kuhl, Nicholas MD, FACEP
  7. VanDePol, Eric Keith MD
  8. Poland, Cara Anne MD, MEd


Purpose: This article describes the implementation of a clinical nurse specialist-led emergency department overdose education and naloxone distribution program. The program's purpose is to increase naloxone availability to reduce opiate overdose mortality rates within the local community.


Description of Program: The program distributes naloxone kits to patients in the emergency department after an opioid overdose. The kits are designed to help recipients prevent, recognize, and respond to an opioid overdose.


Outcome: The program, which includes naloxone take-home kits and clinical guidelines outlining a standard of care for naloxone distribution and coprescribing, was successfully implemented across 11 emergency departments within an integrated health system. More than 250 kits were dispensed within the first year of program implementation along with an online patient education video that received more than 1600 views. In 2017, the county reported an opioid-related overdose death rate of 16.5 (per 100 000 residents). From January 2018 to June 2019, the opioid-related death rate per 100 000 residents was reported at 9.6.


Conclusion: Although emergency department naloxone distribution programs are feasible in the acute care setting, it was critical for clinical nurse specialists to enlist an interdisciplinary team and engage executive leadership to ensure program success. For others considering such a program, early consideration should be given to determining financial support and evaluating the compliance and regulatory aspects of dispensing medications from emergency settings.