Publication
Improving Safe Opioid Prescribing for Pediatric Hospice and Palliative Care Patients
Johansen W, Massmann C, Bray J, Daut E · Journal of Pain and Symptom Management · 2024
Outcomes: 1. Utilizing a quality improvement-approach, participants will self-report the ability to assess the implementation of several opioid safety components (i.e. opioid safety contract, open-ended question, and mental health screener) and how they may improve safety regarding opioid prescribing in pediatric hospice/palliative care patients. 2. Utilizing a quality improvement-approach, participants will self-report the ability to learn skills relating to discussing safe opioid prescribing with pediatric hospice/palliative care patients and their families. Key Message: The global aim of this QI project is to improve the safety of prescribing controlled substances in pediatric hospice/palliative care patients. The SMART aim of this QI project is to increase the percentage of opioid safety components completed on eligible pediatric hospice/palliative care patients from 0 to 80% from 10/31/22 to 2/28/23. Introduction/Context: Opiates can provide substantial improvement in quality of life for pediatric hospice/palliative care patients; however, misuse/abuse of these drugs can cause a direct threat to the safety of these patients and their families. Improving safe opioid practices would benefit the safety of patients being prescribed controlled substances which is a specific strategic goal of Saint Louis Children's Hospital. Method(s): After reviewing the current literature, we defined several safe opioid practices through the creation of several opioid safety components: opioid safety contract, mental health screener (PHQ-2 and GAD-2), and open-ended questions relating to opioid prescribing. Following a needs assessment, we created a high-level process map and Pareto chart reflecting potential barriers to utilization of opioid safety components. A key driver diagram was created and several PDSA cycles were completed with cumulative data being collected and displayed on a time-series chart for each of the opioid safety components. Pre/Post surveys were also created to assess family's perception relating to opioid prescribing, administration, and education. Result(s): The process measures were the cumulative proportions of eligible patients which had an opioid safety component recorded in the electronic medical record. Those proportions are as follows: 69% for opioid contract, 42% for mental health screener, and 46% for open-ended question. We had 2 outcomes measures: 1)pre/post surveys sent to both our team as well as families assessing project impact and 2)days between non-compliance related to signed opioid safety contracts (displayed on a T-chart). Conclusion(s): We have adopted the opioid safety contract into our daily practice and abandoned the mental health screener and open-ended questions. We are investigating ways to increase days between non-compliant events regarding the opioid safety contract. We are hopeful to spread this opioid safety contract other departments at Saint Louis Children's Hospital. Keywords: Quality Improvement /Advocacy / Policy/ RegulationsCopyright © 2024
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.