Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Jeffrey Jones Ritzler

Committee Member

Dr. Lynne A. Jensen


Background: In 2014, over two million children between the ages of 12-17 years of age admitted to using illicit drugs (2.3 million) and alcohol (2.9 million) in the past month. The younger a person begins misusing substances the more likely they are to have serious health consequences. It is imperative that we screen, detect, and intervene early to decrease the burden of substance misuse and addiction. Screening Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based strategy used to identify adolescents who misuse substances. The CRAFFT tool is recommended for screening adolescents for substance misuse.

Purpose: The goal of this project was to improve screening and documentation for substance misuse in adolescents between the ages of 12-21 in a rural community hospital emergency department.

Methods: A pre/post-test design was used to examine changes in provider knowledge, self-efficacy, and perceived rate of screening for substance misuse in adolescents using the CRAFFT tool. Providers completed an educational module on the screening portion of SBIRT using the CRAFFT tool. A retrospective/prospective chart review was used to assess the frequency of documentation of substance misuse before/after the CRAFFT education.

Results: There were statistically significant increases in provider knowledge, self-efficacy, and perceived rate of screening (p< .001) following the educational module. Documentation of screening for tobacco, alcohol, and illicit drugs use increased significantly 5.9% to 29.3% (P<.001).

Conclusion: Providers felt more confident in screening for substance abuse in adolescents and had increased knowledge on how to properly screen for substance misuse in this age group. There was increase in documentation of screening for tobacco, alcohol, and illicit substances after the implementation of the CRAFFT tool. It is recommended that providers continue to screen adolescents using the CRAFFT tool and implement strategies to further improve screening rates.