Date Approved

4-27-2026

Graduate Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Shelby Fredricks, DNP, APRN, CPNP-PC, CHSE, PMHS

Second Advisor

Dave Vander Ark, DNP, MSN, RN, PMH-BC

Academic Year

2025/2026

Abstract

Background: Adolescent substance use disorders (SUDs) require early identification in inpatient psychiatric settings, but inconsistent screening workflows limit systematic detection.

Aims: This quality improvement project evaluated implementation of the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) 2.1 screening tool to improve identification of adolescents at risk for SUDs and support multidisciplinary communication.

Methods: CRAFFT 2.1 screening was embedded into admission workflows for adolescents admitted to two inpatient psychiatric units. Admission nurses distributed self-administered forms during admission. Completed screenings were scored and entered into the electronic medical record. Scores were categorized as low (0), medium (1), or high (≥2). High-risk results were communicated to the charge nurse and relayed to the multidisciplinary team during daily huddles. Measures included completion rate, risk distribution, and communication of high-risk results. This project was determined to be non–human subjects research by the university Institutional Review Board.

Results: Over 2.5 weeks, 95 adolescents were admitted; 31 screenings were returned. After exclusions, 29 were analyzed (30.5% completion rate). Of those, 18 (58%) were low risk, 3 (10%) medium risk, and 8 (26%) high risk. One high-risk screening lacked an identifier. Of identifiable high-risk cases, 7/8 (88%) were communicated to the treatment team.

Conclusions: Implementation of the CRAFFT screening tool supported identification and communication of adolescents at risk for SUDs. Low completion rates reflected workflow barriers, but the intervention demonstrated feasibility in inpatient psychiatric settings.

Keywords: adolescent substance use, CRAFFT 2.1, quality improvement, inpatient psychiatry

Download

Share

COinS