Addiction or substance use disorder (SUD) is growing rapidly throughout the nation and is considered a public health crisis that has generated a great deal of public attention. From 2000 to 2014 nearly half a million people in the United States died from drug overdoses; many of them from prescribed or illicit opioids (Centers for Disease Control and Prevention, 2016). Opiate abuse has been rapidly increasing throughout the country. In the United States, “opioid death rates increased by 15.6% from 2014 to 2015” (Rudd, Seth, David, & Scholl, 2016).
In a 2013 national survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), it is reported that 6.5 million Americans aged 12 years or older (or 2.5 percent) used prescription drugs in the past month for a non-medical reason (National Institute on Drug Abuse, 2015). This unauthorized access and inappropriate use of opioids outside the context of supervised medical use is a major contributor to the problem of SUD and overdose deaths (Compton, Jones, & Baldwin, 2016; Rudd, et al., 2016). The lack of awareness of the proper disposal of unused prescription medications in the home poses a serious public health problem (National Association of Drug Diversion Investigators, 2017). This paucity of education for the safe use, secure storage and safe disposal of opioids is a preventable health risk that all health care providers must be aware of and take an active role to educate patients in order to help stop the spread of opioid use disorder (OUD) and SUD.
Effective January 1, 2018, The Joint Commission new pain standards went into effect, calling for improved opioid safety. Among these new standards is the requirement to educate patients and their families who are discharged with opioid prescriptions on their safe use, secure storage and proper disposal (The Joint Commission, 2017). These new national standards place more responsibility on nurses to assure that patients have been educated regarding strategies that minimize the risk of misuse and potential overdose related to prescription opioids; however, many clinicians are unaware of these new standards and may not appreciate the importance of educating patients regarding opioid safety, storage and proper disposal.
Purpose and Goals:
The purpose of this scholarly project was to increase the knowledge of staff nurses to effectively educate patients being discharged regarding the safe use, secure storage and proper disposal of opioids when prescribed. The aims of the study were to: (1) identify knowledge gaps of registered nurses regarding patient education concerning the safe use, storage, and safe disposal of opioids; (2) develop and implement an educational program for registered nurses regarding current requirements for opioid education incorporating essential opioid safety strategies needing to be documented and taught to patients; and (3) measure the outcomes and knowledge acquired from the educational intervention by developing and implementing a pre and post-educational survey for participants.
Methodology:
A convenience sample comprised of sixty registered nurses working on a thirty-six bed orthopaedic/ urology surgical unit at Massachusetts General Hospital was recruited to participate in an investigator developed pre and post web-based survey designed to measure baseline knowledge and assess the effects of an educational program based on The Joint Commission standards regarding opioid patient education. Educational sessions were held on various dates and times for a one month period on the study unit. Inclusion criteria included all English-speaking registered nurses in staff nurse positions on the chosen study unit, with access to hospital email, able to read, computer literate, and were able to attend a ten minute educational session with up to ten minutes allowed for questions to be answered. Exclusion criteria included nurses who were not in staff nurse positions on the study unit.
Results (in progress):
Preliminary data are currently being reviewed. Descriptive and comparative statistics are utilized to analyze data.
Implications for Future:
Inadequate education about opioids is a barrier to safe, effective use of these beneficial but potentially dangerous medications. Knowledge regarding opioid safety is needed to assist in the prevention of opioid use disorder to improve patient safety and outcomes. Nurses are in a critical position to use their knowledge and expertise to educate patients and family members about opioids and help prevent unnecessary harms related to misuse, improper storage and disposal of opioids.
Key Words:
Opioid education, opioid safety, substance use disorder.