Rangel T, Pham S, Senger B, Daratha K, Fitzgerald C, Mallo R, Daratha K. Pharmacologic Pain Management Trends among Adults Hospitalized with Cellulitis: An Evidence-Based Practice Project.
Pain Manag Nurs 2022;
24:222-228. [PMID:
36220690 DOI:
10.1016/j.pmn.2022.09.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 08/15/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND
Nurses commonly administer opioids, following "as needed" order sets, to patients hospitalized for acute pain conditions like cellulitis. Practice guidelines recommend limiting opioid administration for acute pain management. At two hospitals in the Pacific Northwest, an opioid stewardship committee was formed to align with best practice.
AIMS
The main objective was to describe changes to inpatient rates of opioid and non-opioid administration following implementation of evidence-based opioid stewardship efforts.
DESIGN
Observational, retrospective, evidence-based practice project.
SETTINGS
One 200-bed and one 680-bed hospital in Washington State.
PARTICIPANTS/SUBJECTS
Data were included from patients aged 18 years or older hospitalized for cellulitis.
METHODS
Demographic and pain-related data were extracted from the electronic health record (n = 4,523 encounters) guided by the symptom management framework. The proportion of patients receiving opioid or non-opioid medications before and after implementation of evidence-based practice opioid stewardship interventions was calculated descriptively. A logistic regression tested factors related to administration of an opioid medication.
RESULTS
The proportion of patients receiving an opioid decreased following opioid stewardship efforts while those receiving non-opioid analgesics remained stable. Factors significantly influencing inpatient opioid administration were: average inpatient pain score, pre-hospital opioid prescription, length of stay, and year of hospitalization.
CONCLUSIONS
Analgesic administration treating painful, acute cellulitis at two hospitals in the Pacific Northwest included opioid and non-opioid medications. The proportion of patients receiving opioids decreased following best practice opioid stewardship actions. Opportunities may exist for nurses to collaborate with providers to improve inpatient analgesic administration practices.
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