Patient Safety Topic: ADE Opioids
April 29, 2022
Wellstar Sylvan Grove Hospital, a 25 bed critical access hospital located in Jackson, GA shared their journey to improved outcomes with adverse drug events – opioids on a recent Patient Safety Network webinar. Erica Fishell, MSN, RN, Director of Clinical Operations discussed the following interventions which have made a positive impact:
- Integration of Prescription Drug Monitoring Programs (PDMP) into Epic
- The physician or nurse can easily click query the PDMP to see a snapshot of where the patient has had a controlled substance like an opioid prescribed, what the opioid is, the quantity filled, and where it was filled
- Common practice with patients with non-acute and chronic complaints
- Checked anytime a provider decides to prescribe an opioid
- FYI notes
- FYI’s are tagged on patients’ charts that are within the Wellstar system and are private notes on the chart that can alert a provider of a potential opioid abuse
- Notes will alert of seeking behavior or patterns of behavior that are concerning for opioid abuse and will recommend using a nonnarcotic means of treating their pain
See screen shots of PDMP:
Other helpful strategies include:
- Not carrying Dilaudid in the Emergency Department
- Recommending follow up with a chronic pain physician
- Recommending utilization of nonnarcotic medications for chronic pain: lidoerm patches, Diclofenac topical ointments, IM or IV Toradol
- Promoting healthier lifestyles with exercise and stretching (one physician actually shows the patient how to exercise and stretch)
- Utilizing the in-patient swing bed unit for rehabilitation for patients with chronic debilitation and chronic pain conditions
Resources shared during the webinar:
- The PEW Charitable Trusts Prescription Drug Monitoring Programs: https://www.pewtrusts.org/~/media/assets/2016/12/prescription_drug_monitoring_programs.pdf
- Substance Abuse and Mental Health Services Administration (SAMHSA) PDMP Guide for Healthcare Providers: https://store.samhsa.gov/product/In-Brief-Prescription-Drug-Monitoring-Programs-A-Guide-for-Healthcare-Providers/SMA16-4997
For more information, view the presentation on the Alliant website.