A nurse in an outpatient women's surgery center developed guidelines for postoperative opioid use as part of her doctor of nursing practice clinical scholarship project, according to the University of Missouri-St. Louis.
Five notes:
1. Monica Kistler, DNP, developed guidelines to determine how many pills should ideally be prescribed after hysteroscopy dilation and curettage, laparoscopy, and uterine ablation, the center's three most common procedures.
2. Based on a survey of all patients treated at the ASC in the third quarter of 2018, Ms. Kistler determined how many pills were taken after each surgery on average, as well as the maximum number of pills taken.
3. Dr. Kistler made posters based on those guidelines and displayed them in the surgery center for three months.
4. During that time, opioid prescriptions dropped 6.9 percent for hysteroscopy dilation and curettage, 19 percent for uterine ablations, and 14 percent for laparoscopy.
"We've changed the habits of prescribers," Dr. Kistler said. "I think just giving them information has changed their practice. One thing I learned was that if you want to see something change, you have to keep it at the forefront of people's minds. You have to be a little bit persistent, and you have to spend a lot of time on it."
5. Dr. Kistler plans to use the project template to inform future quality initiatives.