Decreasing Opioid Utilization in Rehabilitation Patients Using a Clinical Nurse Specialist Pain Consultant Program

Urton, Michael; Rohlik, Elaine; Farrell, Meagan T.; Ng, Wing; Woodard, Elizabeth K.

doi:10.1016/j.apmr.2017.05.026

Cited by 7 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A few published quality improvement projects have shown a reduction in opioid prescribing with efforts to standardize and monitor prescribing patterns involving either a single clinical area [22][23][24][25] or broadly throughout a health system. 26,27 In general, these efforts involve adoption of guidelines and monitoring of adherence with data collection.…”

Section: Contextmentioning

confidence: 99%

Assessment of Opioid Prescribing Practices Before and After Implementation of a Health System Intervention to Reduce Opioid Overprescribing

et al. 2018

View full text Add to dashboard Cite

Key Points Question Can a series of focused interventions targeting different aspects of opioid overprescribing reduce opioid overprescribing within a health system? Findings This quality improvement study found postintervention reductions in opioid prescribing occurred at a statistically significantly faster pace than a preintervention downward trend. Overall reductions for key measures were 58% for morphine milligram equivalents per clinical encounter per month, 34% for morphine milligram equivalents per opioid prescription, and 38% for opioid prescriptions per encounter. Meaning Overprescribing can be reduced in different clinical departments using tools available to most health systems.

show abstract

Section: Contextmentioning

confidence: 99%

Assessment of Opioid Prescribing Practices Before and After Implementation of a Health System Intervention to Reduce Opioid Overprescribing

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In the initial week of rehabilitation, the intensification of physical activity is believed to impact pain increment. Mismanaged pain can reduce the effectiveness of the treatments, extend the length of stay, and decrease satisfaction with the provided care [34]. Various pharmacological and non-pharmacological treatments can reduce not only pain but also anxiety, depression, and fatigue and improve muscle strength and range of motion [32,33,35].…”

Section: Discussionmentioning

confidence: 99%

Healthcare Experience of People with Acute Spinal Cord Injury: A Phenomenological Study

Sousa,

Andrade,

Fernandes

et al. 2023

Nursing Reports

View full text Add to dashboard Cite

Living with spinal cord injury (SCI) is a challenge that begins in the acute phase, when the disease, the limitations, and the treatments fill the days at the hospital. This study aims to understand the healthcare experience of the person with SCI in the acute phase, based on the Activities of Living Nursing Model (ALNM). It is a qualitative and phenomenological study based on the Standards for Reporting Qualitative Research. Data were collected via semi-structured interviews. Content analysis was performed using the ATLAS.ti software and Bardin’s methodology. The article was written following the COREQ guidelines. The categories were defined using the Roper–Logan–Tierney Model for Nursing. The sample included 16 people with incomplete SCI, different etiology, and neurological levels. Eleven of the twelve ALNM emerged from the interviews. The activities of mobilizing, eliminating, maintaining a safe environment, and communicating were emphasized the most. Controlling body temperature was not relevant. Mobility deficits and pain increased dependence. Feelings of motivation, encouragement, and frustration were highlighted. Professional expertise, rehabilitation resources, and support equipment promoted independence. The results in this sample revealed that people with SCI in the acute phase have complex challenges related to dependence awareness and treatments, but they always keep recovery expectations in mind.

show abstract

“…A retrospective chart review demonstrated that access to a clinical nurse specialist with pain management expertise allowed for a significantly faster reduction in opioid use in an inpatient rehab hospital, compared to standard pain management from a medical team. 17 The role of pharmacists in promoting opioid stewardship in inpatient rehabilitation settings has not been described.…”

Section: Introductionmentioning

confidence: 99%

Opioid Utilization and Management in the Setting of Stewardship During Inpatient Rehab Care

Murphy¹,

Leblanc²,

Badr³

et al. 2022

DHPS

View full text Add to dashboard Cite

Background Opioid utilization and management in an inpatient rehabilitation setting have not been widely described, despite the unique opportunities that exist in this setting to support opioid stewardship across transitions in care. We aimed to characterize opioid utilization and management by interprofessional teams across a large, inpatient rehabilitation setting after incorporation of opioid stewardship principles by pharmacists as part of their daily practice. Patients and methods This was a retrospective chart review at Toronto Rehab, University Health Network, Toronto, Canada. Patients with admission orders for any opioid from November 2017 to February 2018 were included. Complex continuing care and palliative care patients were excluded. Descriptive statistics were primarily used to describe the data as well as univariate linear regression to compare associations with milligram morphine equivalent (MME) reduction. Results A total of 448 patients were included. A reduction in total daily MME was seen in 49% (n=219) of the patients during their inpatient stay, with 73% (n=159) of these patients having a reduction of ≥50%. Sixty-nine percent (n=311) of the patients received an opioid prescription at discharge, with most scheduled (90%, n=98) with a supply of less than 30 days. Rehabilitation length of stay was correlated with a MME decrease during rehab (p<0.01), suggesting that longer lengths of stay contributed to a greater reduction in MME. Patients with chronic opioid use prior to acute care admission (p=0.01), and those who started extended-release opioids during acute care (p=0.02) were significantly less likely to discontinue opioids during rehab stay. Conclusion Opioid utilization and management in the setting of opioid stewardship across inpatient rehab and transitions of care were characterized. Opportunities exist for further quality improvement initiatives within inpatient rehabilitation and acute care settings to identify and support patients with complex pain management needs.

show abstract

Decreasing Opioid Utilization in Rehabilitation Patients Using a Clinical Nurse Specialist Pain Consultant Program

Cited by 7 publications

References 14 publications

Assessment of Opioid Prescribing Practices Before and After Implementation of a Health System Intervention to Reduce Opioid Overprescribing

Assessment of Opioid Prescribing Practices Before and After Implementation of a Health System Intervention to Reduce Opioid Overprescribing

Healthcare Experience of People with Acute Spinal Cord Injury: A Phenomenological Study

Opioid Utilization and Management in the Setting of Stewardship During Inpatient Rehab Care

Contact Info

Product

Resources

About