Date on Paper


Document Type

Doctoral Paper

Degree Name


Committee Chair

Galloway, Lynette

Committee Member

Riff, Diane

Author's Keywords

Southeastern Kentucky; MAT; Random Urine Drug Screening; Policy



Background: Medication-Assisted Treatment (MAT) is one of the most effective pharmacological therapies for opioid dependence. Regular urine drug screening to include random urine drug screens at least once a month is a key factor in improving quality care for those receiving treatment in an outpatient MAT clinic.

Problem: A rural outpatient MAT clinic has a current random urine policy that is not being utilized when treating clients with Opioid Use Disorder (OUD). This increases the risk of diversion and misuse of buprenorphine/naloxone (Suboxone), thus increasing the risk of overdose and death for OUD patients.

Environment: This project was implemented in a rural outpatient MAT clinic in southeastern Kentucky that serves residents in three surrounding counties.

Purpose: The QI project uses a Plan-Study-Do-Act framework to evaluate staff response to education on a current Random urine drug screening policy and implementation of the policy.

Procedures: A formal, in person education was provided to providers and staff on the clinics current Random Urine Drug Screening Policy. Pre and Post education surveys were conducted to compare the knowledge base of the policy before and after education was provided. The number of random urine evaluations were collected weekly over a four-week period after intervention. Descriptive statistics, a Likert ordinal scale, and paired T-tests were employed for data analysis.

Results: Random urine drug screenings increased from 0% pre intervention to 87.5% post intervention. The participants knowledge base of random urine screenings increased as well as their level of confidence when utilizing the policy when comparing pre and post intervention surveys.

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