by Amy Smalarz, PhD, President and Co-Founder, Strategic Market Insight
July 8, 2014

Although opioids may be used as the “standard of care” or “common practice” for postsurgical pain management, it is important to understand the impact of their use as it’s directly related to the Triple Aims.

It has been documented that opioids can cause adverse events while in the hospital and potentially lead to opioid addiction after discharge but to what degree are nurses aware of the potential safety, clinical and economic implications of using opioids for postsurgical pain management?

At this year’s Association of PeriOperative Registered Nurses (AORN) Annual Conference, a recently conducted survey assessed nurses’ levels of awareness of these areas.

The survey was well received as 146 nurses took the time to respond. Of the nurses who responded, approximately 34% work in Magnet Hospitals (recognized by the American Nurses Credentialing Center after demonstrating excellence in patient care). Approximately 69% work in not-for-profit institutions, over 80% work in community and urban areas, and approximately 70% have 20+ years’ experience (69%).

Notable findings from this survey include:

Awareness

1. Almost all of the nurses (97%) knew that people who have an opioid-related adverse event are at 3-times higher risk of inpatient mortality
2. A majority (75%) knew that the number of drug overdose deaths for opioids was greater than heroin, cocaine and benzodiazepines combined (25% responded “False”).

Learning Opportunities

3. While it has been reported that 90-99% of patients who undergo common surgical procedures receive opioids only 37% of nurses were aware of this level of opioid use, i.e., almost two-thirds of the nurses under-estimated the percentage of people receiving opioids
4. Less than a third (26%) of nurses knew that approximately 20% of inpatient adverse drug reactions are attributable to opioids; 74% of nurses under-estimated the percentage of adverse events caused by opioids
5. A majority (52%) of survey respondents under-estimated the percentage of older adults that are more likely to become long-term opioid users after receiving prescribed opioids for the first time within 7 days of ambulatory surgery (which is approximately 44%).

The results of this survey demonstrate that while nurses are aware of some safety concerns and issues regarding opioid use, an opportunity exists to educate nurses about opioid adverse events, potential unnecessary use as well as opioid long-term use and potential addiction.

Therefore, the next steps include:

• expanding the audience of the survey and including more nurses who work in the post-anesthesia care units (PACU)
• surveying nurses to ask about the impact of postsurgical pain management medication choices on their workflow, burden of documentation, communication with other clinicians and patients as well as satisfaction.

Stay tuned for updated information regarding the dissemination of this and future nursing studies!

• Opioid Safety
• Respiratory Compromise