Dissertation
Implementation of a Screening Process for Opioid Tolerant Patients
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Patients who are opioid tolerant present a significant clinical challenge to anesthesia providers, experiencing increased risk for opioid withdrawal, inadequate postoperative pain management, and adverse effects of opioids. Despite these concerns, there is a lack in formal processes of preoperative screening and management for opioid tolerant patients.Purpose: The initial project aim was to create a preoperative screening and referral process for implementation by the surgical service. Secondary aims included the creation of a reference tool for anesthesia providers.Methods: A screening and referral process was created for the surgical service at the preoperative clinic appointment. Barriers encountered in the clinic-based implementation resulted in a shifted focus to anesthesia providers. After a pre-survey to assess preoperative screening practices and resource awareness, a reference tool was subsequently disseminated. A post-survey measured changes in screening practices, awareness of resource availability, and helpfulness of the resource in opioid tolerant patient management. Data was analyzed using descriptive statistics and Chi-square tests. Findings: The pre-survey of anesthesia providers (n=114) revealed limited awareness of institutional resources, with 64% of responses reporting none known. The post-survey (n=61) showed improvement after implementation, with 45.7% of responses identifying the created tool as an available resource, and 90% of providers stating it was helpful in opioid tolerant patient management. While only two survey items demonstrated statistically significant (p <0.001) improvement, all items showed clinically meaningful improvements. Discussion: The creation of a reference tool improved provider preoperative screening practices and was identified as a valuable resource. Future directions include continued attempts to extend screening to surgical clinics and promote interdisciplinary collaboration to ensure comprehensive pain management planning.
Details
- Title: Subtitle
- Implementation of a Screening Process for Opioid Tolerant Patients
- Creators
- Kiana Stender - University of Iowa
- Contributors
- Cormac O'Sullivan (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Nurse Anesthesia
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Kiana Stender
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841035102771
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