Abstract
ObjectivesIn May 2018, St. Paul’s Hospital (SPH) in Vancouver (Canada) opened an outdoor peer-led overdose prevention site (OPS) operated in partnership with Vancouver Coastal Health and RainCity Housing. At the end of 2020, the partnered OPS moved to a new location, which created a gap in service for SPH inpatients and outpatients. To address this gap, which was magnified by the COVID-19 pandemic, SPH opened a nurse-led OPS in February 2021. This paper describes the steps leading to the implementation of the nurse-led OPS, its impact, and lessons learned.MethodsFour steps paved the way for the opening of the OPS: (1) identifying the problem, (2) seeking ethics guidance, (3) adapting policies and practices, and (4) supporting and training staff.ResultsThe OPS is open between 10:00 and 20:00 and staffed by two nurses per shift. It is accessible to all patients including inpatients, patients in the Emergency Department, and patients attending outpatient services. Between February 1, 2021 and October 23, 2021, the OPS recorded 1612 visits for the purpose of injection, for an average weekly visit number of 42. A total of 46 overdoses were recorded in that 9-month period. Thirty-seven (80%) required administration of naloxone and 12 (26%) required a code blue response.ConclusionsDue to the unique nature of our OPS, we learned many important lessons in the process leading to the opening of the site and the months that followed. We conclude the paper with lessons learned grouped into six main categories, namely engagement, communication, access, staff education and support, data collection, and safety.
Highlights
Canada is in the midst of an ongoing overdose crisis
A total of 46 overdoses were recorded in that 9-month period
Due to the unique nature of our overdose prevention sites (OPS), we learned many important lessons in the process leading to the opening of the site and the months that followed
Summary
Canada is in the midst of an ongoing overdose crisis. Between January 2016 and March 2021, more than 22,000 people died from an overdose [1]. The number of supervised consumption services in British Columbia has gone from two to approximately thirty This rapid scale-up was made possible by grassroots efforts which led to the opening of “pop-up” overdose prevention sites (OPS) and compelled the Minister of Health to issue a ministerial order allowing overdose prevention sites to be opened (and integrated into existing services) without completing the traditional application process with Health Canada to be formally recognized supervised consumption sites. In British Columbia, OPS are typically staffed by peers with lived and living experience of substance use who provide first-aid interventions to prevent and respond to overdoses. They act as a point of contact to connect clients with services and care
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