{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:01:21Z","timestamp":1790298081729,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify the training, organizational, attitudinal and competence factors associated with how frequently nurses screen patients for substance use disorder, and to determine which remain associated after demographic and structural characteristics are taken into account.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional online survey of a national sample of licensed nurses in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1365 licensed nurses completed the survey in October 2025. The outcome was self\u2010reported screening frequency over the previous 12\u2009months. Hierarchical regression entered demographic and structural variables, then training and organizational variables, then attitudinal and competence variables, with categorical predictors dummy coded. Findings were confirmed with robust standard errors and an ordinal logistic model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recent continuing education, supportive organizational policy, harm reduction readiness and professional competence each independently predicted more frequent screening. Nurses unsure whether their organization supported screening screened least. Nurses in outpatient, long\u2010term care and other non\u2010hospital settings screened less than hospital\u2010based nurses. Opioid stigma was not independently associated with screening; concern about patient trust and confidentiality was. Role, race, gender and experience showed no independent association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Screening was associated less with who nurses are than with what they had recently learned, how ready and competent they felt and whether their organization clearly expected screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession<\/jats:title>\n                    <jats:p>Pairing recurring education with explicit policy, referral pathways and workflow support is more promising than one\u2010time training or attitude\u2010change efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>The study addressed why screening is inconsistent. Recent education, competence, readiness and clear policy were the operative factors, not stigma. Findings apply to nurses, educators and health system leaders across settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>STROBE checklist for cross\u2010sectional studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70563","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:26:10Z","timestamp":1790295970000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modifiable Factors Associated With Substance Use Disorder Screening by Nurses: A Cross\u2010Sectional Survey"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-5587","authenticated-orcid":false,"given":"Gregory A.","family":"Carter","sequence":"first","affiliation":[{"name":"School of Nursing Indiana University  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1779-7290","authenticated-orcid":false,"given":"Wendy R.","family":"Miller","sequence":"additional","affiliation":[{"name":"School of Nursing Indiana University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_15_2_1","volume-title":"Nursing's Social Policy Statement: The Essence of the Profession","author":"American Nurses Association","year":"2022"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1300\/J465v28n03_03"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20104\u201050"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u20102909.111.3.455"},{"key":"e_1_2_15_7_1","doi-asserted-by":"crossref","DOI":"10.15620\/cdc\/170565","volume-title":"Drug Overdose Deaths in the United States, 2003\u20132023 (NCHS Data Brief No. 522)","author":"Garnett M. 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