Addressing Safe Opioid Monitoring Practices Using an Interprofessional Approach

J Nurs Adm. 2017 Nov;47(11):537-544. doi: 10.1097/NNA.0000000000000540.

Abstract

Objective: The aims of the project are to increase knowledge related to opioids and improve adherence to evidence-based interventions for sedation monitoring and assessment in adult inpatients receiving opioids for pain through delivery of an interprofessional online program.

Background: Preventable opioid-induced respiratory depression is a patient safety risk in hospitals. Sedation and respiratory assessment and monitoring guidelines and tools are available to improve practice.

Methods: An interprofessional team identified organization-specific drivers of opioid-induced sedation and respiratory depression using process improvement methodology, developed interventions, and evaluated clinician opioid knowledge and documentation practice.

Results: Opioid knowledge survey responses improved after the interventions. Audits showing improved appropriate documentation by RNs of the correct sedation scale were performed over 2 separate 3-month periods.

Conclusions: Clinicians demonstrated increased knowledge about newly adopted sedation and monitoring practices targeted to prevent opioid-induced respiratory depression.

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Analgesics, Opioid / standards
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interprofessional Relations
  • Monitoring, Physiologic / methods
  • Monitoring, Physiologic / nursing*
  • Nursing Staff, Hospital / education*
  • Nursing Staff, Hospital / standards
  • Organizational Case Studies
  • Pain Management / methods
  • Pain Management / nursing*
  • Patient Safety / standards*
  • Respiratory Insufficiency / chemically induced*
  • Respiratory Insufficiency / nursing
  • Respiratory Insufficiency / prevention & control
  • Risk Assessment / methods

Substances

  • Analgesics, Opioid