The clinical change proposal

 

The clinical change proposal revolves around proper pain management, patient preferences, and reducing the impact on the nation’s current opioid crisis. The plan behind this is educating the patient on the causes behind the opioid crisis, as well as discussing pain management and pain management preferences with the patient before surgery. Nurses, anesthesiologists, and surgeons will work together to create a proper protocol for administering medications, writing prescriptions, and deciding on postoperative pain medication in the post-anesthesia care unit.

The initial proposal intervention was based around discharge teaching to reduce narcotic abuse, improper usage, overdose, medication diversion, and the proper storage and disposal of these medications (Hah, Bateman, Ratliff, Curtin, & Sun, 2017). However, through the research of the project it has come to my attention that patients should also be asked about their medication preferences in the post-operative period before surgery begins, this includes educating patients on the medications available based on levels of pain, as well as the patients preference to either receive narcotic medications or if the patient would prefer non-opioid methods of medication instead.

Through observation of the unit, I have also decided that the nursing staff should have frequent in-service teachings regarding medications and the center’s protocol for medications. As it stands, patients report pain and the nurse administers the medications prescribed by anesthesia without much discussion or patient input into the medications or the dosages they are receiving. Because patients are under anesthesia, they are by law, advised to avoid making important decisions, such as the types of medications they prefer to use or avoid. Therefore, the patient should state these preferences before surgery. It is also noted that some of the nurses in the unit tend to be heavy-handed with medication administration and provide little interventions into further assessing the patient. This has also led me into independent studies for each of the pain medications the unit currently utilizes, both narcotics and non-opioid options. This review will be used during the nursing in-service and will include the medications onset time, average peak of effect, and duration of effectiveness. Additionally, a chart of medication strength in comparison to one milligram of morphine, so that nursing staff has a strong understanding of the potency of the medications being used. These are the ways in which my research and the protocol have changed over the last six weeks.

References

Hah, J. M., Bateman, B. T., Ratliff, J., Curtin, C., & Sun, E. (2017, November). Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic. Retrieved November 1, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119469/.

 

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