Objective: Delayed gastrointestinal (GI) recovery (postoperative ileus) is a risk for patients undergoing bowel resection (BR) and presents clinical challenges including prolonged hospital length of stay (LOS) and increased postoperative morbidity. Alvimopan, an oral, peripherally acting mu-opioid receptor antagonist, is the first therapy approved to accelerate GI recovery after BR. Published data have described alvimopan use in open BR. In contrast, this study focused on laparoscopic BR. Methods: Historic data were retrospectively collected and alvimopan data were prospectively collected from 1 surgeon at our facility. Adults undergoing laparoscopic partial small or large BR with primary anastamosis scheduled to receive intravenous, opioid-based, patient-controlled analgesia were eligible. Pregnancy, opioid analgesic on the home medication reconciliation form, complete bowel obstruction, colostomy or ileostomy creation, and unplanned surgery were exclusion criteria. All patients were uniformly managed with a standardized accelerated postoperative care pathway to facilitate GI recovery. LOS, time to first bowel movement (BM), 30-day readmission rate, and the cost were evaluated. Data were analyzed using Pearson chi-square and independent samples t tests.Results: Thirty-nine alvimopan and 56 historic cohort patients were included. Time to first BM was reduced by 1.2 days and LOS was reduced by 1.1 days (both P , .001) in the alvimopan cohort compared with control. Overall variable cost data were reduced by $1,368 in the alvimopan cohort. Readmission rates were low and comparable. Conclusions: Laparoscopic surgery can decrease LOS compared with open BR; however, alvimopan use at our facility reduced LOS and time to BM while remaining cost-effective in this patient population.

Background: The nation's opioid crisis has caused the nursing profession to examine pain management practices, including assessment of pain, diagnosis, and treatment. Nursing programs have the opportunity to play a vital role in addressing the opioid crisis by enhancing the pain management content in their curriculum. Method: A nursing elective course was designed and implemented that allowed nursing students to examine appropriate pain assessment, the role of the nurse, best practices in pharmaceutical treatment, and attitudes and biases that may exist. The course was designed by a pharmacist and co-taught with a nurse practitioner. Results: The course consisted of 25 nursing students mixed from the baccalaureate nursing (BSN) degree and RN-to-BSN programs. There was a success rate of 100% and an overall satisfaction rate of 97%. Conclusion: This course met several goals: (a) the need for an elective; (b) achievement of two nursing program outcomes; (c) increased nursing student knowledge relating to appropriate pain management using an interdisciplinary approach; and (d) camaraderie created between school programs. [ J Nurs Educ. 2019;58(6):360–363.]