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Eliminating extended-release opioids from a postoperative pain protocol for total knee replacement patients
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Kalachian, Anoush. Eliminating extended-release opioids from a postoperative pain protocol for total knee replacement patients. Retrieved from https://doi.org/doi:10.7282/t3-zyf4-k410

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TitleEliminating extended-release opioids from a postoperative pain protocol for total knee replacement patients
NameKalachian, Anoush (author); Barberio, Judith (chair); Cox, Jill (member); Rutgers University; RBHS School of Nursing
Date Created2022
Other Date2022-05 (degree)
SubjectPharmacology, Nursing, Gerontology, Arthroplasty, Extended-release opioids, Opioids, Orthopedics, Postoperative pain, Total knee replacement
Extent79 pages : illustrations
DescriptionPurpose of Project: The purpose of this project is to determine whether the elimination of ER opioids in the multimodal medication regimen of TKR patients resulted in improved patient outcomes.

Methodology: This project utilizes a retrospective chart review to evaluate an institution’s current postoperative pain protocol. The outcomes of interest include mean hospital length of stay, discharge disposition, mean pain score, antiemetic use, mean opioid dose used, and number of opioid discharge prescriptions.

Results: Most of the patients reviewed (N = 60) were female (56%, n = 20) with a mean age around 70 years for both the pre-protocol (n = 36) and post-protocol groups (n = 34). Analysis of results revealed an increase in opioid administration, t(174) = -1.4, p = .17. There was a reduction in mean pain score, t(199) = 0.8, p = .445. Additionally there was a reduction in both antiemetic use, t(59) = 2.2, p = .03 and length of stay, t(58) = 1.0, p = .33, and more discharges to home than rehab, x² = 60, p < .001. All patients received 30 tablets of only one opioid prescription upon discharge with no refill, either oxycodone-IR (82%, n = 49), hydromorphone (5%, n = 3), or tramadol (12%, n = 7).

Implications for Practice: This project, aimed to reduce opioid overprescription and overconsumption has the potential to improve prescribing practices, improving patient safety and healthcare quality by supporting the current guidelines that recommend against using ER opioids for this population.
NoteD.N.P.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-zyf4-k410
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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