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A review of opioid use for pain in adult patients with traumatic injuries
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Durling-Grover, Renay. A review of opioid use for pain in adult patients with traumatic injuries. Retrieved from https://doi.org/doi:10.7282/t3-bfmz-eh86

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TitleA review of opioid use for pain in adult patients with traumatic injuries
NameDurling-Grover, Renay (author); Kamienski, Mary (chair); Forrester, D. Anthony (internal member); Rutgers University; School of Nursing - RBHS
Date Created2020
Other Date2020-05 (degree)
SubjectOpioids, Family Nurse Practitioner in Emergency Care
Extent1 online resource (74 pages) : illustrations
DescriptionPurpose: To evaluate the impact and effectiveness of New Jersey (NJ) Senate Bill 3 in reducing the use of opioids in the treatment of pain for the trauma patient in the inpatient setting. The goal of this project was to examine the prescribing practices of practitioners and the patients use of opioid pain medications in the hospital setting prior to, and after the enactment of Senate Bill 3.

Methodology: This project was a single center retrospective review which took place at an American College of Surgeons verified Level I Trauma Center in NJ. In all, a total of 2,043 patient charts for calendar years 2016 and 2018 were reviewed. Injury Severity Score (ISS) and Morphine Milligram Equivalents (MME) were recorded by patient and the data between the two years was compared to ascertain opioid consumption pre and post the Senate Bill enactment. Patients prescribe opioid drips, methadone, or fentanyl patches were excluded because the data available did not allow for accurate conversion to MME. After applying these exclusion criteria, a total of 1,688 patients charts remained.

Results: The average daily MME consumption dropped from 14.1±0.48 MME/day in 2016 to 8.78±0.33 MME/day in 2018. This represents a 38% decrease with p<0.001 in inpatient opioid use over a similar length of stay (LOS, 4.34±0.14 versus 4.41±0.13 days) of patients in both years. The total MME consumed per person decreased form 77.0 MME/stay to 44.8 MME/stay, a nearly 42% decrease in opioid consumption during inpatient treatment. While the injury severity score (ISS) of patients was higher in 2018 than in 2016 (10.6±0.21 vs. 9.09±0.19, p<0.001) still less opioid was used in 2018. Also, trauma patients in 2018 were approximately 4.2 years older than in 2016 (59.9±0.69 years in 2018 vs. 55.7 ±0.71 years in 2016, p<0.001).

Implications for Practice: This retrospective review demonstrated that one single entity cannot correct a multi-tiered societal problem. Medical professionals, legislators, community leaders, and the community itself must work in a collaborative fashion to employ meaningful and multifaceted solutions to solve the opioid crisis.
NoteDNP
NoteIncludes bibliographical references
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/t3-bfmz-eh86
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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