Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julianne Ossege

Clinical Mentor

Dr. Jo Singleton

Committee Member

Dr. Elizabeth Tovar


PURPOSE: The purpose of this research study was to evaluate the use of the CRAFFT tool within a pediatric primary care setting. The specific objective was to assess the frequency of documentation of substance use screening, counseling, and/or intervention before and after the implementation of the CRAFFT tool.

METHOD: The practice site chose to implement an evidence based adolescent substance use screening tool (CRAFFT Tool) to improve practice. This practice improvement project utilized a descriptive design with a review of electronic medical records before and after a substance use screening tool was implemented. Two hundred medical records were reviewed, 100 in the pre-phase of the study and 100 in the post-phase of the study. The electronic medical record was reviewed to assess frequency of adolescent substance use documentation before and after the tool was introduced.

RESULTS: Prior to implementation of the CRAFFT tool, substance use screening rates were 10% and documented as “no risk factors” in the narrative note. After the CRAFFT implementation, screening rates were 31%. Documentation included the use of the CRAFFT tool (10%, n=10) and as no “risk factors” for substance use and 20% (n=19). The mean CRAFFT score was 0. Chi square analysis revealed a statistically significant difference (p

CONCLUSION: Overall, screening improved after the clinic implemented the CRAFFT tool, but standardized documentation continues to be a problem. Additional research and suggested practice implications may aid in the continued improvement of adolescent substance use screening.