Proactively assessing practices and processes that involve high-alert medications such as anticoagulants, insulin, and opioids can enable hospitals to identify the weaknesses that exist within their medication-use systems. As a part of the Pennsylvania Hospital Engagement Network adverse drug event collaboration, a 45-item organization assessment tool was developed to assess the safety of opioid practices in hospitals, identify opportunities for improvement, and enable participating hospitals to compare their results with the aggregate results of all participating hospitals in Pennsylvania. Almost 60% (n = 17) of participating hospitals in the project completed the assessment. The highest-scoring items in the assessment were the use of standardized pain scales, the use of commercially available or pharmacy-prepared opioid solutions, and the availability of standardized preprinted order forms or computerized prescriber order entry (CPOE) order sets for patient-controlled analgesia therapy. The lowest-scoring items were inclusion of the mg/kg or mcg/kg dose along with the calculated patient-specific doses for pediatric parenteral opioid orders, pharmacists' ability to easily access the patient's opioid status, and restriction of the use of long-acting opioids to opioid-tolerant patients. Findings from the assessment revealed opportunities to improve medication safety and established a baseline of current practices regarding opioid use that can be used to evaluate ongoing improvement.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)