ABSTRACT Background: Outpatient facilities, such as family and adult practice offices, psychiatric offices, and substance use treatment centers, should be equipped to manage medical emergencies and facilitate hospital transfers. Clinics that treat patients with opioid use disorder must be especially prepared to address respiratory arrest due to opioid overdose. Purpose: The objective of this integrative review was to identify emergency response initiatives already investigated or developed that could be adapted to address opioid-related medical emergencies in the outpatient adult treatment setting. Methods: Initial and updated literature searches were conducted using MEDLINE and PubMed. These searches yielded 207 and 60 articles of interest, respectively, and a total of 6 and 18 were selected for retrieval. Of these, 5 and 8, for a total of 13, met the inclusion criteria. Results: We found few publications in the mental health literature to inform or guide outpatient practitioners in preparing their offices for emergencies. This integrative review draws from all areas of the medical literature to identify emergency response strategies that have been developed for outpatient settings. We identified 4 major themes in office emergency preparedness: simulation training, response team organization, equipment readiness, and emergency action protocols. Conclusion: These 4 themes can provide guidance for improving readiness in medical offices, and in ambulatory mental health and substance use clinics. Researchers will need to develop emergency response algorithms that address these themes and assess patient outcomes.

Nancy S Goldstein

Claire Grubb

AJN American Journal of Nursing

The American Journal of Nursing is the oldest and most honored broad-based nursing journal in the world. Peer reviewed and evidence-based, it is considered the profession’s premier journal. AJN adheres to journalistic standards that require transparency of real and potential conflicts of interests that authors,editors and reviewers may have. It follows publishing standards set by the International Committee of Medical Journal Editors (ICMJE; www.icmje.org), the World Association of Medical Editors (WAME; www.wame.org), and the Committee on Publication Ethics (COPE; http://publicationethics.org/).

AJN welcomes submissions of evidence-based clinical application papers and descriptions of best clinical practices, original research and QI reports, case studies, narratives, commentaries, and other manuscripts on a variety of clinical and professional topics. The journal also welcomes submissions for its various departments and columns, including artwork and poetry that is relevant to nursing or health care. Guidelines on writing for specific departments—Art of Nursing, Viewpoint, Policy and Politics, and Reflections—are available at http://AJN.edmgr.com.

AJN's mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.

The American Journal of Nursing is the oldest and most respected broad-based nursing journal in the world. Peer-reviewed and evidence-based, it is regarded as the premier journal in the nursing profession. AJN adheres to journalistic standards that require transparency regarding real and potential conflicts of interest that authors, editors, and reviewers may have. It follows the publishing standards set by the International Committee of Medical Journal Editors (ICMJE), the World Association of Medical Editors (WAME), and the Committee on Publication Ethics (COPE).

AJN welcomes submissions of evidence-based clinical application papers, descriptions of best clinical practices, original research and quality improvement reports, case studies, narratives, commentaries, and other manuscripts on a variety of clinical and professional topics. The journal also invites submissions for its various departments and columns, including artwork and poetry relevant to nursing or health care. Guidelines for writing for specific departments—Art of Nursing, Viewpoint, Policy and Politics, and Reflections—are available at http://AJN.edmgr.com.

AJN's mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and the promotion of nursing perspectives to the health care community and the public.

《American Journal of Nursing》是世界上历史最悠久、最受尊敬的综合护理期刊。该期刊经过同行评审，基于证据，被视为护理专业的首要期刊。AJN遵循新闻标准，要求作者、编辑和审稿人公开真实和潜在的利益冲突。它遵循国际医学期刊编辑委员会（ICMJE）、世界医学编辑协会（WAME）和出版伦理委员会（COPE）设定的出版标准。

AJN欢迎提交基于证据的临床应用论文和最佳临床实践的描述、原创研究和质量改进报告、案例研究、叙述、评论以及其他关于各种临床和专业主题的手稿。该期刊还欢迎与护理或医疗保健相关的艺术作品和诗歌的投稿。关于特定部门的写作指南，包括护理艺术、观点、政策与政治以及反思，可以在http://AJN.edmgr.com找到。

AJN的使命是通过传播基于证据的、经过同行评审的临床信息和原创研究，讨论相关和有争议的专业问题，遵循新闻诚信和卓越的标准，以及向医疗保健社区和公众推广护理视角，来促进护理和医疗保健的卓越。

Category	Quartile
医学	4
医学, 护理	4

Is Your Outpatient Office Prepared to Manage an Opioid Overdose?

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