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A review of opioid use for pain in adult patients with traumatic injuries
Descriptive
TitleInfo
Title
A review of opioid use for pain in adult patients with traumatic injuries
Name
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Durling-Grover
NamePart
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Renay
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Renay Durling-Grover
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author
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(type = personal)
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Kamienski
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Mary
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Mary Kamienski
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Advisory Committee
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chair
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(type = personal)
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(type = family)
Forrester
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D. Anthony
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D. Anthony Forrester
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Advisory Committee
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internal member
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Rutgers University
Role
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degree grantor
Name
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School of Nursing - RBHS
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school
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Text
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theses
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2020
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2020-05
Language
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English
Abstract
(type = abstract)
Purpose: 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.
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.
Subject
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Topic
Opioids
Subject
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Topic
Family Nurse Practitioner in Emergency Care
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Rutgers University Electronic Theses and Dissertations
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ETD_10565
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1 online resource (74 pages) : illustrations
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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doi:10.7282/t3-bfmz-eh86
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ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
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Durling-Grover
GivenName
Renay
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Permission or license
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2020-01-19 09:59:56
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Renay Durling-Grover
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Affiliation
Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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2020-05-31
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2022-05-31
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 31st, 2022.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2020-09-24T16:16:46
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