One Hospital's Initiatives to Encourage Safe Opioid Use

Abstract

Pain is the leading reason people seek health care. In an effort to aggressively manage pain in the hospitalized patient, we have seen an increase in the use of opioids. Unfortunately, there has been a similar increase in the number of opioid-related adverse events. As a result, The Joint Commission issued a Sentinel Event Alert in August 2012 with suggested evidenced-based actions to help avoid these adverse events. This article describes one hospital's initiatives to provide opioids safely.

Reviewing opioid use, monitoring, and legislature: Nursing perspectives

“…Nurses must also be involved in policy and practice initiatives at the institutional level regarding the adoption of pain scales, pain interventions that are culturally and linguistically appropriate [47]. Nurses should maintain a central role as members of the interdisciplinary team regarding pain treatments [13], [47]. They ought to receive in-depth education related to opioid abuse and addiction, and have the capacity and opportunity to consult collegially with prescribers when there are questions regarding opioid orders, and/or when assessment findings show contraindications for further opioid use.…”

“…Upon admission, the conversation should begin referring to the level of opioid tolerance/intolerance. Also on admission, a skin assessment should be done to check for implantable pain devices, transdermal patches, or any other devices used to administer opioid medications [13]. However, a lack of clinical experience or knowledge may inhibit these practices from happening.…”

“…The Decade of Pain Control and Research promoted two goals [6], [9], [13]. The first goal focused on reducing the incidence of suffering associated with pain both acute and chronic (lasting longer than six months).…”

“…The first goal focused on reducing the incidence of suffering associated with pain both acute and chronic (lasting longer than six months). It raised both public and professional attention and awareness regarding a significant and often neglected public concern of under-treated chronic pain [13]. Estimates indicate that over 100 million adults are afflicted with chronic pain in the United States [9].…”