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Part 1-Introduction and Problem Statement

Part 1-Introduction and Problem Statement

Nurse Education on the Use of the CRAFFT Tool

Substance abuse refers to the hazardous and harmful use of psychoactive substances, including illicit drugs and alcohol. Substance abuse has further been defined as the sporadic or persistent use of drugs that is not in line with or is unrelated to the accepted use of medication (WHO Lexicon). Substance abuse has been on the increase among adolescents and children, with the WHO predicting that the use of tobacco will, by 2030, kill over 500 million persons, making it the single leading cause of mortality (WHO, n.d). Tobacco initiation often occurs in the adolescent stages of life. There is also an increased acceptance of the use of alcohol in social settings. Further, easier access to hard drugs such as opioids is linked to increased use by adolescents; for example, most persons begin using marijuana while they are adolescents, and the trend continues to present (WHO, n.d).

The United Nations Sustainable Development Goals (SDGs) comprise 17 goals formulated by member states and should ideally be achieved by 2030. The third SDG goal asserts in part that the prevention and treatment of substance abuse should be strengthened, and this should include the use of narcotic drugs and alcohol abuse (WHO, n.d). Substance abuse is linked to adverse social, mental, and physical effects for the users and society at large. Substance abuse is associated with reduced life expectancy, suicides, accidents, mental disorders, unemployment, and poor health (Das et al., 2016). Hence, there is a need to take approaches and initiatives that reduce the negative effects and prevalence of substance abuse among these populations.

In this research, the CRAFFT screening tool implementation will be explored. When the CRAFFT tool is implemented effectively in targeting adolescents, it can be used in detecting possible substance abuse. The CRAFFT tool will be used in educating nurses in a rural setting with the aim of increasing their knowledge of the importance and effectiveness of the tool in screening for substance abuse. When the use of the tool is improved among rural nurses, it will become possible to detect substance abuse disorder and, consequently, curtail adolescent poor health outcomes. The research seeks to empower healthcare providers by offering them the skills and knowledge, hence allowing for early detection of problems related to substance abuse. It is important to increase nurses’ capabilities in the identification of substance abuse risk among youth (D’Amico et al., 2016). The rural clinics, though few and scattered, still offer the most ideal and convenient place for adolescents to be screened for substance abuse under the patient-nurse confidentiality ethics and, subsequently, access to counseling services, referrals, and preventive and treatment services. Adopting an early screening strategy among adolescents can aid in reducing the risk of related illnesses and allow for youth to seek mental health services without fear of bias, discrimination, and stigma (D’Amico et al., 2016).

Problem Statement

Substance abuse among adolescents is a major public health concern not only in urban cities but in rural areas as well. Primary care nurses in rural areas lack the skills and knowledge in substance abuse screening (Bolin et al., 2015). Early screening and subsequent detection of the possible use of drugs and alcohol helps in directing patients to access the right healthcare services (Levy & Williams, 2016). Adolescence is a challenging time for most persons in this age category, and this can be further complicated by substance abuse (Radel et al., 2018). When healthcare providers are left to their discretion on screening for substance abuse, they will often fail to do so. Nurses, in particular, are in the best position to screen for substance abuse among adolescents and also to implement strategies to reduce or eliminate the same before it escalates. However, screening does not take place as often as it ought to be done despite the recommendations by professional guidelines for substance abuse screening (D’Amico et al., 2016). In the current research, education for nurses on the use of the CRAFFT screening tool and how the tool is applied in clinical practice for adolescent populations will be the focus. This research has the potential to impact the nursing practice through empowering nurses, as stated earlier. Pre-licensure nurses are inadequately prepared for effective patient substance abuse screening. Most academic programs have a 1–5-hour session of instruction that focuses on substance abuse in patients with infrequent teaching of skills necessary for addressing patient substance abuse (Knopf-Amelung et al., 2018). Therefore, nurses, upon graduating, are ill-equipped, and this calls for research such as this that seeks to empower RNs. When RNs gain important and valuable information and also understand the need and their role to help reduce the frequency of substance abuse among adolescents, then the war against this epidemic will be fast won.

This research seeks to fill the gap created by practice settings in rural areas where adolescent patients are not screened for substance abuse because of the nurses’ failure to do so. Several factors have been identified as contributing to the existence of this gap, and these include lack of referral places; inadequate training; refusing or assuming to discuss the issue of substance abuse, that is, denial of its existence; and time constraints, among others (D’Amico et al., 2016). When nurses lack the necessary training on substance abuse, their understanding and confidence are greatly hindered as to how they can integrate into their daily practice drug and alcohol abuse screening (KnopfAmelung et al., 2018).

The PICOT question that guides the research is: Among rural nurses (P), does the implementation of the CRAFFT tool (I) at a rural health care setting, compared to prior to the implementation of the tool (C), improve the nurses’ knowledge (O) as well as increase screening efficiency among adolescents over a six-month period (T)?


Substance abuse among adolescents is an issue of concern that needs to be addressed. One such way of addressing the issue is through screening patients. However, screening can only occur when nurses are aware of the need to do so and the impact that non-screening can have on the population’s health. This research aims to educate rural healthcare setting nurses on using the CRAFFT screening tool and consequently increasing the frequency of screening among adolescents in the said area.


Bolin, J. N., Bellamy, G. R., Ferdinand, A. O., Vuong, A. M., Kash, B. A., Schulze, A., & Helduser, J. W. (2015). Rural healthy people 2020: New decade, same challenges. The Journal of Rural Health31(3), 326-333.

D’Amico, E. J., Parast, L., Meredith, L. S., Ewing, B. A., Shadel, W. G., & Stein, B. D. (2016). Screening in primary care: what is the best way to identify at-risk youth for substance use?. Pediatrics138(6).

Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. (2016). Interventions for adolescent substance abuse: An overview of systematic reviews. Journal of Adolescent Health59(4), S61-S75.

Knopf-Amelung, S., Gotham, H., Kuofie, A., Young, P., Stinson, R. M., Lynn, J., … & Hildreth, J. (2018). Comparison of instructional methods for screening, brief intervention, and referral to treatment for substance use in nursing education. Nurse Educator43(3), 123.

Levy, S. J., & Williams, J. F. (2016). Substance use screening, brief intervention, and referral to treatment. Pediatrics138(1).

Radel, L., Baldwin, M., Crouse, G., Ghertner, R., & Waters, A. (2018). Substance use, the opioid epidemic, and the child welfare system: Key findings from a mixed methods study. Office of the Assistant Secretary for Planning and Evaluation, 1-9.

WHO Lexicon of alcohol and drug terms. Geneva: World Health Organization; 1994

World Health Organization (n.d). Health Topics; Sustainable Development Goals (SDGs). (


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Part 1-Introduction and Problem Statement

Introduction and Problem Statement

The purpose of assignments Part 1 – Part 3 is to gradually guide the student in developing the signature assignment. The idea is for the student to take a stepwise approach to completing the signature assignment.

The signature assignment will be broken up into three steps: Part 1 – Introduction and Overview of the Problem; Part 2 – Project Purpose Statement, Background & Significance and PICOt Formatted Clinical Project Question; and Part 3 – Literature Review and Critical Appraisal of the Literature. The three steps, when completed, will be combined in the final Signature Assignment formal paper in Week 8.

This week’s assignment is Part 1 – Introduction and Problem Statement.

First, the student will use the previously approved PICOT question.

Part 1-Introduction and Problem Statement

Part 1-Introduction and Problem Statement

Next, the student will use the outline below and submit via a Word doc to the assignment link.

  1. Provide a title that conveys or describes the assignment–not just “Part 1”, or “Introduction and Problem Statement”.
  2. Introduction – Provide an introduction to your topic or project. The introduction gives the reader an accurate, concrete understanding what the project will cover and what can be gained from implementation of this project.
  3. Overview of the Problem – Provide a synopsis of the problem and some indication of why the problem is worth exploring or what contribution the proposed project is apt to make to practice.
  4. Conclusion
  5. References – Cite references using APA 7th ed. Manual.

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