Rangel Teresa, Pham Sydney, Senger Brenda, Daratha Kristopher, Fitzgerald Cynthia, Mallo Rebecca, Daratha Kenneth
Providence Health Care, Professional Development Department, Spokane, Washington.
Providence Sacred Heart Medical Center, Spokane, Washington.
Pain Manag Nurs. 2023 Apr;24(2):222-228. doi: 10.1016/j.pmn.2022.09.003. Epub 2022 Oct 9.
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.
The main objective was to describe changes to inpatient rates of opioid and non-opioid administration following implementation of evidence-based opioid stewardship efforts.
Observational, retrospective, evidence-based practice project.
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.
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.
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.
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.
护士通常会按照“按需”医嘱为因蜂窝织炎等急性疼痛病症住院的患者使用阿片类药物。实践指南建议限制用于急性疼痛管理的阿片类药物使用。在太平洋西北地区的两家医院，成立了一个阿片类药物管理委员会以遵循最佳实践。
主要目标是描述在实施循证阿片类药物管理措施后住院患者阿片类药物和非阿片类药物使用比例的变化。
观察性、回顾性、循证实践项目。
华盛顿州的一家拥有200张床位的医院和一家拥有680张床位的医院。
参与者/受试者：数据来自18岁及以上因蜂窝织炎住院的患者。
在症状管理框架的指导下，从电子健康记录中提取人口统计学和疼痛相关数据（n = 4523次就诊）。描述性地计算在实施循证实践阿片类药物管理干预措施前后接受阿片类药物或非阿片类药物治疗的患者比例。进行逻辑回归分析以测试与阿片类药物使用相关的因素。
在实施阿片类药物管理措施后，接受阿片类药物治疗的患者比例下降，而接受非阿片类镇痛药治疗的患者比例保持稳定。显著影响住院患者阿片类药物使用的因素包括：平均住院疼痛评分、院前阿片类药物处方、住院时间和住院年份。
太平洋西北地区两家医院治疗疼痛性急性蜂窝织炎的镇痛治疗包括阿片类药物和非阿片类药物。遵循最佳实践的阿片类药物管理措施后，接受阿片类药物治疗的患者比例下降。护士可能有机会与医疗服务提供者合作，以改善住院患者的镇痛治疗实践。
