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Session Details

Nurse’s Ability to Recognize, Prevent and Treat Opioid Induced Respiratory Depression (OIRD), An EBP Project

Track: Podium: Clinical Practice

Session Number: S404
Date: Tue, Jun 2nd, 2020
Time: 10:15 AM - 11:15 AM

Description:

Educate on OIRD and risk factors.
• Age
• Sedation Level & the difference between sleepy, drowsy, somnolent
• Respiratory status
• Functional status
• Tolerance
• Drug-drug interactions
• Reaction or response to prior opioid treatment
• Physical and psychiatric comorbidities
• Gastrointestinal and Genitourinary status
• Cardiovascular status
Describe our interdisciplinary evidence-based practice quality improvement project that was implemented to improve the recognition and treatment of OIRD on our orthopedic surgical unit. This includes the identification of the Pasero Opioid-Induced Sedation Scale (POSS) tool as an EBP intervention to identify and treat OIRD after an extensive literature review. This led our team to the development of two clinical questions. The primary Intervention Question: For nurses, who administer opioid medications to postoperative inpatients, how does education on OIRD affect their level of knowledge and self-confidence in determining the risk of OIRD compared to their knowledge and self-confidence prior to education? The secondary Meaning Question: For nurses who assess postoperative inpatients after administration of opioid medications, do they perceive the POSS tool as beneficial in recognizing OIRD?
Describe our team’s objectives for this project.
• Educate nursing staff on orthopedic unit about OIRD through a series of 15-30 minute education sessions.
• Administer a pre and post-assessment of nursing’s knowledge of OIRD and confidence in the ability to assess patients’ level of sedation.
• Establish a nurse’s ability to recognize, prevent and treat OIRD using the POSS.
• Administer a post-assessment of nurse’s perceptions of the feasibility of using POSS in the clinical setting.
5. Describe our team’s methods for this project
• Sample Identification: registered nurses (RNs) who administer opioid medications to postoperative inpatients on a 30-bed orthopedic unit in a 660 bed teaching hospital in a metropolitan area.
• Education Program: Education sessions were held on multiple occasions with the goal of educating 55 nurses. Education sessions began with the administration of the Opioid Knowledge Self-Assessment and a confidence scale. Subject matter experts presented education that included include didactic material and case study discussion. The Opioid Knowledge Self-Assessment and confidence scale were reassessed at the completion of the education session.
• POSS Education: Nurses were then educated on the POSS tool and performed a patient assessment using the tool. They recorded a POSS score for the patient and rated their perception of the feasibility of using the POSS tool in the clinical setting. Their rating was compared to the rating of the subject matter expert.
Data was analyzed and includes the following:
• Descriptive statistics, using percent, describe the characteristics of the nurses completing the knowledge and confidence surveys.
• The analysis of the dependent variables included examining the difference in pre, post, and delayed posttests on knowledge and confidence for OIRD results for the nursing staff participating in the education session.
• The analysis of staff nurse’s perceptions for the use of the POSS assessment in actual practice is conducted one time following the use of the POSS instrument. The perceptions will include a question-by-question analysis and we determined the correlation (reliability) between the assessment conducted by the staff nurse and the expert for using the POSS instrument in practice.
Describe findings from the project, how we disseminated the results and outcomes after interventions.
Sub-Categorization: Complications, Safety, Vulnerable Populations Best Practices
Session Type: Podium

Learner Outcome: Implement the evidence-based strategies to recognize, prevent and treat opioid-induced respiratory depression and improve patient outcomes.
Category: B
Sub-Categorization: Complications, Safety, Vulnerable Populations Best Practices
Session Type: Podium

Learner Outcome: Implement the evidence-based strategies to recognize, prevent and treat opioid-induced respiratory depression and improve patient outcomes.
Category: B

Speakers

Lead Presenter
Molly McNaughton, CNP
Allina Health
Presenter 2
Jamie Lundberg, BSN, RN
Allina Health, Abbott Northwestern Hospital
Presenter 3
Meghan Schenian, RN, BSN
Allina Health

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