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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Article info
Publication history
Published online: October 09, 2022
Accepted:
September 7,
2022
Received in revised form:
August 15,
2022
Received:
September 7,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
