Document Type
DNP Project
Publication Date
2026
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Kerry A. Milner, DNSc, APRN, FNP-BC, EBP-C
Abstract
Opioid use disorder (OUD) remains a driver of emergency department (ED) utilization and preventable overdoses among high-risk patient at the transition clinic currently treated with medication assisted therapies such as methadone and sublingual buprenorphine. Barriers to daily methadone and sublingual buprenorphine-naloxone films are often declined due to patient preference, stigma, concerns about daily adherence, diversion risk, or medication fatigue. Hence, the need for a new clinic policy that would offer options for a longer-term, patient-centered pharmacologic option that reduces daily treatment burden, improves adherence, and mitigates overdose risk.
The goal is to develop and implement an evidence-based clinical policy for prescribing and administering SublocadeÒ in the Transitions Clinic, thereby increasing patient engagement in OUD treatment by offering a long-acting, monthly medication option aligned with patient preferences, and reduce opioid-related ED visits and overdose events among Transitions Clinic patients.
Two patients were started on sublingual buprenorphine to reach a stabilized dosage which made them eligible to transition to the injectable buprenorphine. They were monitored, observed for side effects, and injection site discomfort and necessary changes were made to the implementation process.
The results showed that implementing long-acting injectable buprenorphine to high-risk illicit opioid users at the transition clinic prevented ED visits, operational workflow transition was feasible to the new policy, and patient cravings and desire to illicit drug use decreased.
The continual provision of long-acting monthly injectable buprenorphine (Sublocade) to these high -risk patients, the need to avoid illicit opioid drug use and overdoses, and the frequency of emergency room visits along with patient adherence, support and counselling can help these patients achieve better outcomes such as remission and opioid recovery.
Creative Commons License
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Recommended Citation
Quarm, G. (2026). Implementation and early evaluation of long-acting buprenorphine therapy at a Federally qualified health center setting: A quality improvement project [Unpublished DNP project]. Sacred Heart University.
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.