Document Type
DNP Project
Publication Date
4-2024
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Dr. Dorothea Esposito, DNP MSN/ed, APRN, FNP-BC
Practice Mentor
Melinda Constantine, MSN, RN, CMSRN, ONC
Abstract
Significance and Background: Opioid related overdoses are considered a public health epidemic and emergency in recent years within the United States. With a staggering number of opioid related deaths which have continued to rise, steps have been taken to decrease risk within local communities through programs including personalized patient education during provider visits, the dispensing of Naloxone with opioid prescriptions and encouraging the use of alternative pain management strategies. Most recently, New York State passed a recommendation encouraging all healthcare providers to prescribe Naloxone with the first opioid prescription of each year for patients deemed high risk for overdose. A policy to encourage appropriate patient education with Naloxone prescriptions was needed within a local community hospital setting. Evidence supported the use of an opioid safety toolkit education within the postoperative population being discharged on opioid pain medications.
Purpose: Deliver opioid safety toolkit education with Naloxone prescription to postoperative patients being discharged with opioid pain medications. Compare patient confidence in Naloxone use within the community post education.
Methods: Plan-Do-Study-Act. Plan: The presence of an opioid safety toolkit education within the outpatient pharmacy of the project hospital which is readily given with Naloxone to postoperative patients going home with opioid prescriptions. Do: Outpatient pharmacy staff introduced the opioid safety toolkit into their normal workflow, including education regarding Naloxone use, alternatives to opioids, proper use, side effects and overdose red flags. Study: Data was gathered on patient self-reported confidence in Naloxone use within the local community post-discharge. Act: Present data to organizational stakeholders.
Outcome: Over the ten-week data collection period which was divided into five-week trials, there were a total of 155 opioid prescriptions and 79 Naloxone co-prescriptions (a co-prescription rate of 50.96%). In the second and more successful trial, there were 95 opioid prescriptions and 68 Naloxone co-prescriptions (a co-prescription rate of 71.6%). All patients, with the exception of two reported high confidence in Naloxone use post-discharge in an emergency situation (97.4% reported confidence). Only two patients declined the prescription due to high copayment costs, but a copayment assistance program was adopted from a state-funded resource to address and eliminate this burden (97.5% accepted the co-prescribed Naloxone). Naloxone prescriptions increased substantially during this period, and education was provided to every patient that was given a Naloxone prescription.
Discussion: The implementation of the opioid safety toolkit education program increased patient confidence in Naloxone use post-discharge within the community setting and increased Naloxone prescriptions within the project hospital. Education focused on providing patients with practical knowledge on Naloxone as well as information regarding proper opioid use, side effects to be aware of and signs of overdose which may otherwise be overlooked.
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Recommended Citation
Aziz, A. (2024). Postoperative discharge opioid education including narcan kit access to prevent overdose: A quality improvement project [Unpublished DNP project]. Sacred Heart University.
Comments
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.