Perception and Practice Among Emergency Medicine Health Care Providers Regarding Discharging Patients After Opioid Administration
| Autor: | Alexandra Amaducci, Ryan M. Surmaitis, Marna Rayl Greenberg, Kenneth D. Katz, Lindsay J. Houck, Sandra J. Sabbatini, Kathryn A. Henry, Hope Kincaid, Michael Jong, Emily A. Kiernan |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Health Personnel Vital signs 03 medical and health sciences Young Adult 0302 clinical medicine Interquartile range Surveys and Questionnaires Health care Medicine Humans Hydromorphone Pharmacology (medical) 030212 general & internal medicine Practice Patterns Physicians' Pharmacology Morphine business.industry 030208 emergency & critical care medicine Emergency department Guideline Middle Aged Patient Discharge Analgesics Opioid Cross-Sectional Studies Opioid Emergency medicine Emergency Medicine Female Perception Opiate business Emergency Service Hospital medicine.drug |
| Zdroj: | Clinical therapeutics. 40(2) |
| ISSN: | 1879-114X |
| Popis: | Purpose This study aimed to determine the current attitudes, perceptions, and practices of emergency medicine providers and nurses (RNs) regarding the discharge of adult patients from the emergency department (ED) after administration of opioid analgesics. Methods A cross-sectional survey was administered at 3 hospital sites with a combined annual ED census of >180,000 visits per year. All 59 attending emergency physicians (EPs), 233 RNs, and 23 advanced practice clinicians (APCs) who worked at these sites were eligible to participate. Findings Thirty-five EPs (59.3%), 88 RNs (37.8%), and 14 APCs (60.9%) completed the survey for an overall response rate of 51.75%. Most respondents were female (95 [69.9%]). The factor ranked most important to consider when discharging a patient from the ED after administration of opioids was the patient’s functional status and vital signs (median, 2.00; interquartile range, 2.00–3.50). More RNs (84 [96.6%]) than EPs (29 [82.9%]) reported that developing an ED policy or guideline for safe discharge after administration of opioids is important to clinical practice (P = 0.02). Only 8 physicians (23.5%) reported that they did not prescribe intramuscular morphine, and 15 (42.9%) reported that they did not prescribe intramuscular hydromorphone. EPs (7 [20.0%]) and RNs (3 [3.4%]) differed in regard to whether they were aware if any patients to whom they administered an opioid had experienced an adverse drug-related event (P = 0.01). Most EPs (24 [68.6%]) and RNs (54 [61.4%]) believed that the decision for patient discharge should be left to both the emergency medicine provider and the RN. Implications Most study participants believed that developing a policy or guideline for safe discharge after administration opioids in the ED is important to clinical practice. Only a few physicians reported that they did not prescribe intramuscular hydromorphone or morphine. Most participants believed the discharge decision after administration of opioids in the ED should be primarily determined by both the emergency medicine provider and the RN. |
| Databáze: | OpenAIRE |
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