Quality Improvement Project: Discharge Opioid Prescribing Guideline for the Urologic Surgery Patient Population

Christopher Acebedo, DNP, ACNP-BC, CCRN; Nancy Hung, PharmD; Cameron Heshmati


Urol Nurs. 2020;40(1):23-30. 

In This Article

Outcome Measurement

The decrease in opioids prescribed at discharge and the adequacy of the post-discharge pain control were the project's outcome measures. Pain control adequacy was measured by the rate of prescription refill, patients' self-report of the adequacy of pain control experience using a 4-point scale, the number of readmissions for acute pain episode, and the surplus of opioids at home 5 days after discharge.

Data on pain control adequacy after discharge were collected using an electronic survey generated through Research Electronic Data Capture (RedCap) system. Survey data were extracted from RedCap and imported to a separate Microsoft Office Excel 2017 spreadsheet for MME calculation. Data were uploaded to Statistical Package for Social Sciences (SPSS) software version 25 for statistical analysis at the end of the implementation phase. The data on post-implementation refills were collected by performing a Controlled Substance Utilization Review and Evaluation System (CURES) database search for each patient. CURES is the PDMP in the State of California.

Descriptive statistics on the pre-and post-implementation groups were generated. The difference in demographic characteristics, in-patient opioid requirement, and discharge opioid prescription rate between the pre- and post-implementation groups was compared using independent samples t test. Chi-square test was used to determine the between-group difference in the proportion of opioid refill. The percent distribution of the post-discharge opioid surplus and self-reported pain control adequacy was calculated. Readmission rate for acute pain episode among the post-implementation group was also reported.