Date of Award

Spring 5-28-2025

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Jacqueline Fawcett

Second Advisor

Ling Shi

Abstract

The emergency department (ED) is where two health crises commonly converge, the opioid crisis and cellulitic infections while simultaneously being the front door to the healthcare system at large. The aim of this dissertation is to fill the gap in knowledge about specific skin and soft tissue injury and severe infection (SSTI) with comorbidity of opioid use disorder (OUD) (OUD SSTI) population and demonstrate inequities as compared to the SSTI and severe infection without OUD comorbidity (non-OUD SSTI) through the lens of the Conceptual Model of Nursology for Enhancing Equity and Quality: Population Health and Health Policy. The Nationwide Emergency Department Sample (NEDS) for 2019 was utilized and a retrospective cross-sectional secondary data analysis was performed. This study findings revealed a 10% increase in likelihood of admission to the hospital for OUD SSTI visits to the ED p< 0.001, the average cost of the ED treatment was $669.67 for OUD SSTI visits and was $565.14 for non-OUD SSTI visits p < 0.001, the average LoS for the OUD admissions was 6 days and 7 days for non-OUD SSTI admissions p< 0.001. This study demonstrated that females were 25% less likely to visit the ED for their SSTI and severe infection as compared to men in the non-OUD SSTI population p< 0.001, while in the OUD SSTI population women seeking care in the ED were 5% less than men p < 0.01. This study emphasizes the need for more robust understanding on the impact of MOUD in conjunction with treatment of infection both within the ED as well as on inpatient floors. This study with the use of the Conceptual Model of Nursology for Enhancing Equity and Quality: Population Health and Health Policy, highlights the need for further studies related to 30-, 60-, 90-day readmission rates to the ED post single dose antibiotic use in tandem with MOUD for all cause visits.

Comments

Free and open access to this Campus Access Thesis is made available to the UMass Boston community by ScholarWorks at UMass Boston. Those not on campus and those without a UMass Boston campus username and password may gain access to this thesis through Interlibrary Loan. If you have a UMass Boston campus username and password and would like to download this work from off-campus, click on the

Download

Share

COinS