Kelly Samolis
Champlain Valley Physicians Hospital, USA
Title: An epidemic: Pain management in patients with opiate use disorder
Biography
Biography: Kelly Samolis
Abstract
Purpose: An evidence-based practice project was undertaken to investigate the clinical practice questions: What are the best practices in treating acute pain during hospitalization in adults with a history of opiate use disorder?
Rationale and significance: Opiate addiction is a current national epidemic, with evidence to suggest that patients with opiate use disorder do not receive proper pain management in the acute healthcare setting. In 2013, 2 million Americans were found to have abused or are currently addicted to opiates. Substance abuse and mental health services administration found in 2015, 14% of hospital admissions were related to patients with drug abuse problems. Healthcare professionals typically lack the needed education and confidence to treat these patients, resulting in improper pain management.
Methodology: An extensive literature search was completed utilizing CINHAL, PebMed, Up to Date, EBSCO databases. The search was limited to studies within the last 10 years, with the exception of two journal articles that were relevant to current best practices. The search term utilized were: competence, pain assessment, drug monitoring, and opiate administration, opiate use disorder, opiate addiction, opiate dependence, acute pain, inpatient practices, and pain assessment. Articles fitting inclusion criteria were then systematically appraised utilization of The John Hopkins Evidence Appraisal Tool.
Findings: 17 journal articles were critically appraised. The seven common themes found in the evidence-based research appraised were increased nursing education, more research indicated, changing staff perception, use and education of motivational interviewing, better focused nursing assessment, substance abuse team, and better pain management regimens.
Conclusion: Based on findings, increased nursing education was found to be the most identified theme, with the goal of increased nursing education to improve pain assessments and decrease stigmatization of these patients to result in better pain management. Literature was somewhat limited in due to the ethical limitation of studying pain in this patient population.
Recommendations for future study: Next steps include continued presentations to increase awareness in these findings. Educate nursing staff annually on pain assessment, motivational interviewing, and opiate use disorder. Lastly publish a professional nursing journal article to nationally educate nurses and healthcare professionals on these evidences-based suggestions.