Acute pain management: Impact of opioid tolerance leveling on patient, provider, and system outcomes
Abstract
Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015:
The human and economic burden related to ineffective pain management is well documented. Factors influencing ineffective acute pain management are multi-factorial and include failure of healthcare professionals to accurately and reliably assess and meet patient's individual pain management requirements. The discipline has been absent an approach and tools enabling reliable, safe, patient-centric assessment and management of pain. Historically, acute pain treatment is focused on the primary admitting condition, which can inadvertently exacerbate existing addiction and improperly manage the patient pain needs. This further potentiates provider biases that conflict with evidence-based pain management strategies. To address these concerns, an interprofessional team was assembled including direct care nurses, clinical nurse specialists, chemical dependency consultants, educators, pharmacists, physicians and hospital leadership. A system pilot was designed with a four prong approach: education of the provider of opioid selection and utilization, tiered approach for assessment of patient experience and tolerance with opioids, consistent and reliable evidenced based selection and administration of opioids, structure and processes enabling surveillance and escalation of pain management. Tiers are assigned based on patients' daily use of opioids. The program uses a systematic, reliable, evidence-based approach to expedite treatment options and interprofessional consultation to design a plan customized to the patient's needs through clearly defined orders. Information system tools were developed to aid transparency and access to data that supports evidence based pain management. An escalation process was created to identify variances and build a robust learning cycle for enhanced program reliability. Program evaluation measures include the following: patient experience (harm composite and satisfaction scores), provider (rate of adoption and nursing knowledge). Preliminary results (n=400) reveal high provider satisfaction, wide-spread adoption, and most importantly improved patient experience including a zero percentage harm composite. Clinical scholarship aligning and integrating implementation science and innovation has the capacity to advance the practice of nursing, patient care delivery, and most importantly exceed the needs of those we are privileged to serve. Additionally, providers can customize standardized pain pathways with less bias while maintaining autonomy in practice and promoting a consistent plan of care across the continuum.
Sigma Membership
Lambda Epsilon
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Translational Research, Pain, Safety
Recommended Citation
Payne, Jill S., "Acute pain management: Impact of opioid tolerance leveling on patient, provider, and system outcomes" (2016). Convention. 360.
https://www.sigmarepository.org/convention/2015/posters_2015/360
Conference Name
43rd Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Las Vegas, Nevada, USA
Conference Year
2015
Rights Holder
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Acquisition
Proxy-submission
Acute pain management: Impact of opioid tolerance leveling on patient, provider, and system outcomes
Las Vegas, Nevada, USA
Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015:
The human and economic burden related to ineffective pain management is well documented. Factors influencing ineffective acute pain management are multi-factorial and include failure of healthcare professionals to accurately and reliably assess and meet patient's individual pain management requirements. The discipline has been absent an approach and tools enabling reliable, safe, patient-centric assessment and management of pain. Historically, acute pain treatment is focused on the primary admitting condition, which can inadvertently exacerbate existing addiction and improperly manage the patient pain needs. This further potentiates provider biases that conflict with evidence-based pain management strategies. To address these concerns, an interprofessional team was assembled including direct care nurses, clinical nurse specialists, chemical dependency consultants, educators, pharmacists, physicians and hospital leadership. A system pilot was designed with a four prong approach: education of the provider of opioid selection and utilization, tiered approach for assessment of patient experience and tolerance with opioids, consistent and reliable evidenced based selection and administration of opioids, structure and processes enabling surveillance and escalation of pain management. Tiers are assigned based on patients' daily use of opioids. The program uses a systematic, reliable, evidence-based approach to expedite treatment options and interprofessional consultation to design a plan customized to the patient's needs through clearly defined orders. Information system tools were developed to aid transparency and access to data that supports evidence based pain management. An escalation process was created to identify variances and build a robust learning cycle for enhanced program reliability. Program evaluation measures include the following: patient experience (harm composite and satisfaction scores), provider (rate of adoption and nursing knowledge). Preliminary results (n=400) reveal high provider satisfaction, wide-spread adoption, and most importantly improved patient experience including a zero percentage harm composite. Clinical scholarship aligning and integrating implementation science and innovation has the capacity to advance the practice of nursing, patient care delivery, and most importantly exceed the needs of those we are privileged to serve. Additionally, providers can customize standardized pain pathways with less bias while maintaining autonomy in practice and promoting a consistent plan of care across the continuum.
Description
43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.