Date of Award

Summer 2023

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chair

Dr. Amanda Bullard

Abstract

Background: The opioid epidemic is a preventable health threat that is a recognized national problem by the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS). The evidence-based Opioid Stewardship (OS) toolkit is essential in the opioid epidemic because it supports identifying patients at risk for opioid aberrancy. However, at the Interventional Pain Management Clinic (IPMC), a chart review on the completion rates of the OS toolkit components for new patients admitted in June 2022 revealed that providers were not consistently completing components of the OS toolkit such as Opioid Risk Tool (ORT), the Morphine Milligram Equivalent (MME), the Prescription Drug Monitoring Program (PDMP), and the urine drug screen (UDS).

Purpose: The project aims to decrease inconsistent UDS in all new patients at the IPMC and increase provider adherence in completing the opioid stewardship (OS) toolkit by implementing a multidisciplinary approach to OS.

Methodology: This quality improvement (QI) project used the plan-do-study-act (PDSA) method and Kotter’s Change Model (KCM) to guide best practices for the multidisciplinary team approach to OS. The QI consists of a formal educational session provided to multidisciplinary team members in the IPMC regarding appropriate opioid prescribing for chronic non-malignant pain (CNMP) patients based on the Centers for Disease Control and Prevention (CDC) Prescribing Opioids for Pain Guidelines and the OS toolkit.

Results: The outcome data from the chart reviews, pre-and post-implementation, reveal that a multidisciplinary team approach to OS did not result in a statistically significant decrease in inconsistent UDS. However, the project did result in a clinically significant in improvement in the completion of the OS toolkit component and inconsistent UDS.

Conclusion: Continually use of the evidence-based intervention at the IPMC can identify patients at risk for opioid aberrancy and improve outcomes.

Included in

Nursing Commons

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