دورية أكاديمية
أعرض في EDS

Alternatives to opioids for pain management in the emergency department decreases opioid usage and maintains patient satisfaction.

التفاصيل البيبلوغرافية
العنوان: Alternatives to opioids for pain management in the emergency department decreases opioid usage and maintains patient satisfaction.
المؤلفون: Duncan RW; Swedish Medical Center, 501 E Hampden Ave, Englewood, CO 80113, United States. Electronic address: rachael.duncan@healthonecares.com., Smith KL; Rueckert-Hartman College for Health Professions, Regis University, 3333 Regis Blvd., Denver, CO 80221, United States. Electronic address: ksmith003@regis.edu., Maguire M; Swedish Medical Center, 501 E Hampden Ave, Englewood, CO 80113, United States. Electronic address: mmaguire9@mgh.harvard.edu., Stader DE 3rd; Swedish Medical Center, 501 E Hampden Ave, Englewood, CO 80113, United States. Electronic address: dstader@carepointhc.com.
المصدر: The American journal of emergency medicine [Am J Emerg Med] 2019 Jan; Vol. 37 (1), pp. 38-44. Date of Electronic Publication: 2018 Apr 22.
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: W B Saunders Country of Publication: United States NLM ID: 8309942 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8171 (Electronic) Linking ISSN: 07356757 NLM ISO Abbreviation: Am J Emerg Med Subsets: MEDLINE
أسماء مطبوعة: Publication: 1983- : Philadelphia, PA : W B Saunders
Original Publication: [Philadelphia, PA. : Centrum Philadelphia, c1983]-
مواضيع طبية MeSH: Analgesics, Opioid*/adverse effects , Emergency Service, Hospital*/organization & administration, Analgesics/*therapeutic use , Opioid-Related Disorders/*prevention & control , Pain/*drug therapy , Pain Management/*methods , Patient Satisfaction/*statistics & numerical data, Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; United States/epidemiology ; Young Adult
مستخلص: Objective: The objective of this study was to assess opioid use in an emergency department following the development and implementation of an alternative to opioids (ALTO)-first approach to pain management. The study also assessed how implementation affected patient satisfaction scores.
Methods: This study compared data collected from October to December of 2015 (prior to implementation) to data collected between October and December of 2016 (after the intervention had been implemented). Emergency department visits during the study timeframe were included. Opioid reduction was measured in morphine equivalents (ME) administered per visit. Secondary outcomes on patient satisfaction were gathered using the Press Ganey survey.
Results: Intravenous (IV) opioid administration during the study period decreased by >20%. The predicted mean ME use in 2016 was 0.25 ME less when compared to 2015 (95% CI -0.27 to -0.23). Estimated use for patients in the pre-implementation period was 1.45 ME mgs (SD 0.88), and 1.13 ME mg (SD 0.69) for patients in the post-implementation period. Patient satisfaction scores using the Press Ganey Scale also were assessed. There was no significant difference in the scores between 2015 and 2016 when patients were asked "How well was you pain controlled?" (-0.94, 95% CI -5.29 to 3.4) and "How likely are you to recommend this emergency department?" (-1.55, 95% CI -5.26 to 2.14).
Conclusion: In conclusion, by using an ALTO-first, multimodal treatment approach to pain management, participating clinicians were able to significantly decrease the use of IV opioids in the emergency department. Patient satisfaction scores remained unchanged following implementation.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Emergency department; Opioid; Pain; Patient satisfaction
المشرفين على المادة: 0 (Analgesics)
0 (Analgesics, Opioid)
تواريخ الأحداث: Date Created: 20180501 Date Completed: 20191023 Latest Revision: 20191023
رمز التحديث: 20231215
DOI: 10.1016/j.ajem.2018.04.043
PMID: 29709398
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8171
DOI:10.1016/j.ajem.2018.04.043