A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge

Waszak, Daria L.; Mitchell, Ann M.; Ren, Dianxu; Fennimore, Laura

doi:10.1016/j.jen.2017.09.010

Cited by 18 publications

(18 citation statements)

References 24 publications

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“…Strategies included educational pamphlets, 320–322 web-based interactive education, 323 and clinician-delivered education. 324,325 All interventions that included knowledge as an outcome demonstrated a significant effect, 320,322,323,325 and many studies observed changes in risky behaviors, such as sharing pills, 320,323 pill storage, 320 saving and disposal of pills, 320,321,323,324 driving, 322 and taking more medication than prescribed. 323…”

Section: Recommendationsmentioning

confidence: 99%

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury

Hsu¹,

Mir

Wally³

et al. 2019

Journal of Orthopaedic Trauma

190

178

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Section: Recommendationsmentioning

confidence: 99%

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury

Hsu¹,

Mir

Wally³

et al. 2019

Journal of Orthopaedic Trauma

190

178

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“…41 Yet, training on non-pharmacological approaches for managing pain and best practices surrounding opioid prescribing could be improved. 42,43 Many studies and interventions have focused on education of physicians and prescribers; 44,45 yet, few have focused on education at the patient level. This study suggests that patient-provider education on opioids may be ineffective from the perspective of the patient.…”

Section: Resultsmentioning

confidence: 99%

<p>Women’s Perspectives On Provider Education Regarding Opioid Use</p>

Kalinowski

Wallace

Williams

et al. 2020

JPR

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Objective: To elucidate women's experiences with opioid medications and their perspectives on provider education regarding opioid use, risks and safety. Methods: Women with a self-reported history of pain who had been prescribed opioids were recruited in 2016 using a convenience sampling approach that included an online social media campaign. Participants (N=154) completed online surveys and open-ended questions regarding their experiences with pain and opioids, and their perspectives on the quality of education they received from their providers. Results: Participants reported receiving insufficient education about opioid-related side effects, as reflected in both ratings for the quantity and quality of education they received from their providers. Non-white participants reported lower quantity and poorer quality of provider education (p<0.05). Themes identified from the qualitative data included frustrations with pain management options, fear of opioids, stigma associated with opioid use, and the need for improved provider education and patient-provider communication. Conclusion: Findings suggest that from a patient's perspective, there is a need for enhanced patient-provider communication and education regarding pain management and potential opioid-related side effects. Improved physician communication and education could promote shared decision-making and result in enhanced satisfaction with care and health outcomes.

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“…The higher knowledge on the need to avoid both sedating medications and acetaminophen are arguably among the more “important” components of the score because coingestion of opioids with both sedating medications and acetaminophen are linked to mortality . Several other recent studies have employed a variety of interventions to achieve knowledge gain about opioids in the ED including nurse‐led teach‐back, medication information sheets, Web‐based education (delivered in the ED), and video discharge instructions . However, the studies have used different knowledge metrics, making it difficult to compare the interventions’ relative strength.…”

Section: Discussionmentioning

confidence: 99%

A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMC² Randomized Controlled Trial

McCarthy

Curtis

Courtney

et al. 2019

Academic Emergency Medicine

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Objectives: Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The study objective was to evaluate the effect of an Electronic Medication Complete Communication (EMC 2 ) Opioid Strategy on patients' safe use of opioids and knowledge about opioids.Methods: This was a three-arm prospective, randomized controlled pragmatic trial with randomization occurring at the physician level. Consecutive discharged patients at an urban academic ED (>88,000 visits) with new hydrocodone-acetaminophen prescriptions received one of three care pathways: 1) usual care, 2) EMC 2 intervention, or 3) EMC 2 + short message service (SMS) text messaging. The ED EMC 2 intervention triggered two patient-facing educational tools (MedSheet, literacy-appropriate prescription wording [Take-Wait-Stop]) and three provider-facing reminders to counsel (directed to ED physician, dispensing pharmacist, follow-up physician). Patients in the EMC 2 + SMS arm additionally received one text message/day for 1 week. Follow-up at 1 to 2 weeks assessed "demonstrated safe use" (primary outcome). Secondary outcomes including patient knowledge and actual safe use (via medication diaries) were assessed 2 to 4 days and 1 month following enrollment.Results: Among the 652 enrolled, 343 completed follow-up (57% women; mean AE SD age = 42 AE 14.0 years).Demonstrated safe opioid use occurred more often in the EMC 2 group (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 1.19 to 5.06), but not the EMC 2 + SMS group (aOR = 1.87, 95% CI = 0.90 to 3.90) compared with usual care. Neither intervention arm improved medication safe use as measured by medication diary data. Medication knowledge, measured by a 10-point composite knowledge score, was greater in the EMC 2 + SMS group (b = 0.57, 95% CI = 0.09 to 1.06) than usual care. Conclusions:The study found that the EMC 2 tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.

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A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge

Cited by 18 publications

References 24 publications

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury

<p>Women’s Perspectives On Provider Education Regarding Opioid Use</p>

A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMC² Randomized Controlled Trial

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A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge

Cited by 18 publications

References 24 publications

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury

Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury

<p>Women’s Perspectives On Provider Education Regarding Opioid Use</p>

A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMC2 Randomized Controlled Trial

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Product

Resources

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A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMC² Randomized Controlled Trial