Addressing Safe Opioid Monitoring Practices Using an Interprofessional Approach

Durham, Marianne L.; Egan, Ann Marie; Jankiewicz, Ann; Murphy, Marcia Pencak; Nedved, Patricia; Luvich, Renee; Goh, Ann; Fogg, Louis

doi:10.1097/nna.0000000000000540

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Hospitals should consider policies that do not allow for transfer of patients during medication peak times or to provide resources such as trained staff in monitoring for opioid-induced sedation during transfer. Hospital leaders should consider monitoring for opioid practices and develop QI projects to drive changes in patient outcomes (Durham et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Pasero Opioid-Induced Sedation Scale in a Pediatric Surgical Ward: A Quality Improvement Project

Garcia

McMullan

2019

Journal of Pediatric Surgical Nursing

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Pediatric patients are at risk for adverse events associated with opioid medication. Sedation scales enable nurses to reach knowledgeable decisions maximizing patient safety during opioid administration. Adult literature has focused on the Pasero Opioid-Induced Sedation Scale (POSS) to address this risk in the adult population; however, literature in the pediatric setting is limited. Purpose The purpose of this quality improvement project was to implement the POSS tool in a pediatric setting and reduce adverse outcomes because of opioid oversedation and respiratory depression. Methods Two patient cohorts were recruited and evaluated to compare the number of medical emergency team calls, supplemental oxygen use, and length of stay. Bedside nurses received education on opioid-induced sedation and use of the POSS tool. Pretest and posttest surveys were conducted to acquire nurse perceptions of the POSS tool in pediatric postsurgical patients. Results No medical emergency team calls occurred in the preintervention and postintervention patient cohorts. Eight percent of the preintervention patient cohort required supplemental oxygen in comparison with no oxygen need in the postintervention group. In the postintervention patient cohort, length of stay averages were 185.85 hours (SD = 325.6) in comparison with 89.09 hours (SD = 76.6) in the preintervention group. Nursing survey results improved in nurses' confidence, usage, and assessment using the POSS tool. This project led to widespread use of POSS in the facility. Conclusions POSS is an appropriate tool to assess pediatric patients in acute care units. The POSS tool assists nurses in accurate assessments and reduces adverse events related to opioid-induced sedation.

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Section: Discussionmentioning

confidence: 99%

Pasero Opioid-Induced Sedation Scale in a Pediatric Surgical Ward: A Quality Improvement Project

Garcia

McMullan

2019

Journal of Pediatric Surgical Nursing

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“…This facilitated the noticeable development of the initial identified factors and barriers of PSP management that inspired the eight surgical wards to pursue these pain management improvement initiative strategies. For sustainability and further nursing initiative interventional strategies, these wards intended to introduce phase two of this pain management creativities and strategies that needed to address the approvals to have clinical pathways for PSP management and utilizing additional resources through a collaborative interprofessional patient pain management approach [41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge

Tashkandi¹,

Taylor²,

Kolobe³

et al. 2022

AJNS

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Context: There is a surplus of contemporary scientific evidence-based indicated numerous precarious positions with inadequate post-surgical pain management in adult surgical patients. The most important barrier in this context was suboptimal postsurgical pain interventions. Aim: This nursing improvement initiative aimed to optimize post-surgical pain nursing interventions in adult surgical patients by training surgical nurses the strategies to enhance their pain management competencies in one teaching hospital in Saudi Arabia. Materials and methods: A descriptive, cross-sectional pain prevalence survey was conducted quarterly in all eight adult surgical inpatients wards to determine and assess if their pain was controlled to a satisfactory level of less than moderate pain. Secondly, pre-and post-test surgical nurses' knowledge assessment surveys were conducted. Descriptive statistics were used to analyze and interpret and present the data. Results: The outcomes demonstrated that through the improvement nursing initiative strategies implemented, the pain prevalence survey in February 2020 improved by more than 9% with an average of 93.4% (n=142; N=152) of patients with pain intensity less than moderate pain, while in September after omitting quarter three due to Covid-19 surge, all eight surgical wards achieved an average of 88% (n=152; N=173), thus improved by 3,6% compared to the results of November 2019. The average pretest pain knowledge assessment survey taken in January 2020 by 103 surgical nurses in all eight surgical wards was 71%. In October 2020, 114 surgical nurses participated in the post-test and achieved 83%, demonstrated an increase of more than 12% from all 20 questions. Conclusion: The eight surgical wards substantially achieved more than 80% of patients with controlled postsurgical pain levels of less than moderate pain during the last two prevalence cycles, and the posttest revealed pain management knowledge acquisition from the baseline of the pretest conducted. It is therefore postulated that it is essential to monitor the pain management quality of delivered patient nursing care interventions based on the type of pain and consider the provision of refresher training sessions to influence practical skills of pain management competencies.

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“…Although the Richmond Agitation Sedation Scale (RASS) is an accurate assessment tool for sedation, it is not the appropriate tool for assessment of a patient who has been taking opioids. The RASS was developed for use in the intensive care unit during purposeful sedation (Durham et al, 2017). Whereas, the Pasero Opioid-Induced Sedation Scale (POSS) was designed specifically for monitoring sedation during opioid administration (Nisbet & Mooney Cotter, 2009).…”

Section: Sedation Assessmentmentioning

confidence: 99%

“…These events can increase hospital length of stay by 55%, healthcare costs by 47%, 30-day readmission rates by 36%, and risk of inpatient mortality by 3.4 times the normal rate (Jungquist et al, 2017). However, opioid-associated adverse events, such as respiratory depression, are preventable (Durham et al, 2017). It has been demonstrated that sedation occurs along a continuum and is preceded by respiratory depression (Nisbet & Mooney-Cotter, 2009; Smith et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Nurses' Ability to Recognize and Prevent Opioid-Induced Respiratory Depression

McNaughton

Lundberg

Schenian

et al. 2021

Orthopaedic Nursing

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Addressing Safe Opioid Monitoring Practices Using an Interprofessional Approach

Abstract: Clinicians demonstrated increased knowledge about newly adopted sedation and monitoring practices targeted to prevent opioid-induced respiratory depression.

Cited by 4 publications

References 16 publications

Pasero Opioid-Induced Sedation Scale in a Pediatric Surgical Ward: A Quality Improvement Project

Pasero Opioid-Induced Sedation Scale in a Pediatric Surgical Ward: A Quality Improvement Project

Optimizing Post-Surgical Pain Management in Adult Surgical Patients: Effects of Training Interventions on Surgical Nurses’ Knowledge

Nurses' Ability to Recognize and Prevent Opioid-Induced Respiratory Depression

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