Application of a Secondary Opioid Risk Tool in the Management of Patients on Opioids in the Adult Pain Management Clinic: A Quality Improvement Project
Doctor of Nursing Practice
Dorothy Esposito, DNP MSN/ed, APRN, FNP-BC
Emily Mihailescu, MSN, FNP, APRN, NP-C
Introduction—Significance and Background: Aggressive opioid prescription practices play the biggest role in opioid-related behaviors and contribute to an epidemic of abuse. If started on long-term opioid therapy without screening, patients who are high risk for opioid abuse could overdose on their prescribed opioids. Current practice does not follow guidelines on monitoring opioid misuse behaviors utilizing a secondary screening tool for patients on long-term therapy.
Purpose: The purpose of this project is to help clinicians identify whether a patient, currently on long-term opioid therapy, may be exhibiting aberrant behaviors associated with misuse of opioid medications, using the Current Opioid Misuse Measure (COMM™).
Interventions and Setting: The project took place in a Pain Management Clinic, located in New Haven County. The population of focus was adult patients on long-term opioid therapy. Educational seminars were provided for the clinicians on utilizing the COMM™. The COMM™ was given to the clinicians to distribute to all eligible patients over a 12-week period. Each month the number of eligible patients were recorded as well as completed forms, total scores, and number of patients identified as high risk.
Evaluation: During 12-weeks of implementation, there were 75 patients out of 855 eligible patients that were screened. Out of the 75 patients screened, 7 (10%) were found to have positive screenings.
Discussion: The results identified 10% of patients that screened positive for the COMM™ tool. Since the COMM™ examines concurrent misuse, it is ideal for helping clinicians monitor patients’ aberrant medication-related behaviors over the course of treatment with opioids.
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Kastanaras, M. (2023). Application of a secondary opioid risk tool in the management of patients on opioids in the adult pain management clinic: A quality improvement project [Unpublished DNP project]. Sacred Heart University.
Available for download on Saturday, February 03, 2024
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.
Date on project is 2022; however, the date of acceptance is April 2023.