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Screening for Opioid Use Disorder Risk in Orthopedic Spine Surgery Patients and Educating on Opioid Safe Post-Operative Pain Management
Dissertation

Screening for Opioid Use Disorder Risk in Orthopedic Spine Surgery Patients and Educating on Opioid Safe Post-Operative Pain Management

Ellie Rouse
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
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Abstract

Background: Despite regular opioid prescribing for postoperative pain in an orthopedic spine surgery clinic, standardized, evidence based processes for opioid risk assessment and education are lacking, constituting a critical gap in perioperative care. Purpose: This evidence-based practice project will determine feasibility of implementing routine pre-operative screening for Opioid Use Disorder risk using the Opioid Risk Tool—Opioid Use Disorder (ORT-OUD) and implementing standardized pre-operative education on safe and effective opioid use for adult orthopedic spine patients. Methods: Adults (>18 years) requiring spine surgery and clinic nurses are the populations studied. ORT-OUD surveys were administered to pre-op patients and they received an educational handout on opioid safety and completed a pre-post self-reported knowledge survey. Clinic nurses completed an educational intervention with a pre-post-test evaluation of knowledge and safety opioid use for pain. Descriptive and inferential statistics was used for analysis. Open-ended responses were qualitatively analyzed. Findings: Patients (n=134) completed ORT-OUD screens and 27.4% were high risk for developing OUD. There was a 32% increase in nurses’ mean post-education knowledge scores and reported learning new information applicable to their practice. Patients in the education group acknowledge a greater number of safety precautions than those receiving no education. In response to the question, “List one opioid safety precaution you are already know,” the most frequent responses were: “Taking as Prescribed” and “No Driving/Heavy Machinery”. Conclusion: ORT-OUD screening can be successfully implemented pre-operatively and opioid safety education can be achieved in clinic. Spine surgery patients demonstrated high risk for OUD. Nurse-implemented education on opioid safety led to clinically significant increase in nursing knowledge, and improved patient knowledge.
 post-op opioid use opioid risk screening spine surgery opioid safety education multimodal analgesia ORT-OUD

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