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


Table 3 details the pain, age, and LOS of participants included in the pre- and post-implementation groups. Both groups were similar in age and median pain score. The mean LOS among the pre-implementation group was statistically significantly higher, 1.8 days versus 1.32 days for the post-implementation group (see Table 4). Excluding patients who underwent laparoscopic procedures; the pre- and post-implementation groups had similar inpatient MME (see Table 5).

The amount of discharge opioid MME was significantly lower among the post-implementation group across all procedure types (see Table 6). Fifteen of 285 patients in the pre-implementation group and one of 177 patients in the post-implementation group had missing data for refill comparison. The number of opioid refills was significantly higher among the post-implementation group. Eight patients in the post-implementation group versus one in the pre-implementation group required refills (see Table 7).

Seventy of the 176 patients responded to the post-discharge survey. Response rate was 39.77%. Table 8 shows that 40% reported adequate post-discharge pain control, while 50% endorsed excellent pain control. Only 15.7% of respondents reported taking all prescribed opioid agents after discharge, leaving 84.3% with a surplus of opioids and 47% taking none of the opioids prescribed (see Table 9). None of the patients in the post-implementation group were readmitted due to acute pain episode.