Reducing opioid utilization after appendectomy: A lesson in implementation of a multidisciplinary quality improvement project.
Surg Open Sci
; 2(1): 27-33, 2020 Jan.
Article
de En
| MEDLINE
| ID: mdl-32754705
ABSTRACT
BACKGROUND:
Perioperative care after appendectomy may be the first exposure to opioids for many children. A quality improvement project was implemented to assess current practice of prescribing pain medications after a laparoscopic appendectomy to decrease unnecessary opioid use via simple, targeted steps.METHODS:
Three measures were implemented in patients undergoing laparoscopic appendectomy for acute appendicitis (1) ice packs to incision in postanesthesia care unit, (2) standard pain scores within 30â¯minutes of admission to ward postoperatively, and (3) standardized postoperative order set minimizing opioid utilization and limited number of opioids prescribed at discharge. Pre- and postimplementation data were compared with the primary outcome variable opioid utilization during the postoperative period.RESULTS:
There were no statistically significant differences in age or gender between the 814 preimplementation and 263 postimplementation patients. Postimplementation compliance is 66.9% for icepacks, 88% for pain scores, and 94.7% for postoperative order set. There were statistically significant decreases in intravenous and enteral opioids administered, number of opioid doses prescribed at discharge, and patients discharged with an opioid prescription.CONCLUSION:
By using a multidisciplinary assessment of current state, culture, and management of parental, patient, and nursing expectations, our institution was able to reduce overall opioid consumption.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Langue:
En
Journal:
Surg Open Sci
Année:
2020
Type de document:
Article