Evaluation of Patient's Understanding of Opioid Instruction Post Nursing Education Intervention

Purpose: Prescription drug abuse-related emergency department visits and treatment admissions have risen significantly in recent years. Research indicates that many of these patients do not have a good understanding of their medications at the time of discharge from the hospital. The knowledge deficit present at discharge leaves patients at high risk for medication errors, adverse drug reactions, and readmission. Data was collected on 586 patients who had been sent home on opioid analgesics after having undergone a urological procedure. Researchers found that of those with leftover medication, 89% kept the medication at home, 6% threw it in the trash, 2% flushed it down the toilet, and <1% returned it to the pharmacy This inappropriate storage and disposal of opioids lends itself to a number of other problems such as patients storing up opioids and self-medicating, continuing to take opioids for non medical purposes and use by persons for whom the medication was not prescribed. Among persons aged 12 or older in 2012-2013 who used pain relievers nonmedically in 2013, 67.6 percent received the pain relievers they most recently used from a friend or relative, either for free, purchase, or through theft, and 23.8 percent received them through a physician prescription. Consensus among patients is that they are not sufficiently prepared for their discharge from the hospital, reporting uncertainty about both their discharge diagnosis and medication changes.  Researchers have indicated there is a relationship between discharge instructions and hospital readmission rates (Hunter, Nelson & Birmingham, 2013). To prevent complications from misuse or abuse of opioids by the patient or others, the quality and quantity of discharge teaching must be improved so that patients have an understanding of safe use, storage, and disposal of opioids. Nurses play a key role in providing this patient education at the point of care when the patient receives the opioid prescription.  This study will explore if a nursing education intervention improved nurse’s knowledge of safe opioid use for patients who are discharged from the hospital with a prescription for an opioid following a surgical procedure. The researchers will also analyze nonequivalent groups of patients regarding the specific instruction they received from the nurse at time of discharge about the safe use of opioids to determine if the education of nurses not only increased nurse’s knowledge of opioids but was measureable in terms of patient’s instruction as reported by patients.

Methods: This is a quasi-experimental pretest/post-test design. We anticipate approximately 100 nurses and 200 patients will participate in the study.

Baseline data will be collected via phone calls to patients who were discharged from an inpatient surgical unit with an opioid prescription following a surgical procedure.  

Following the baseline patient data collection, nurses on the patient surgical unit will be provided with education on the safe use of opioids including: instruction on safe use, storage and disposal of opioids. Nurses will receive a pretest and a post test to measure effectiveness of intervention.

Following the nursing education, data will be collected on a group of patients who were discharged from the hospital with an opioid prescription by the nurses who had received the nursing education to determine if patients were instructed on the safe use, storage and disposal of opioids. Data will be analyzed using SPSS

Results: Estimated date of completion, May 2015.

Conclusion: Nurses often perform the discharge medication instruction and are frequently the last professional to provide medication education to patients. However research indicates that nurses often do not have adequate knowledge of opioids to provide patients with this sufficient instruction necessary for safe home medication management. Education for nurses regarding the safe use, storage and disposal of opioids is of urgent need at this time so that nurses may better provide patients with an accurate understanding for the safe management of opioids. This study seeks to determine if a nursing education intervention improves nurse’s knowledge of safe opioid use for patients who are discharged from the hospital with a prescription for an opioid following a surgical procedure. The researchers will also analyze nonequivalent groups of patients regarding the specific instruction they received from the nurse at time of discharge about the safe use of opioids to determine if the education influenced a change in patient discharge education practice.