A Quality Improvement Project to Standardize Opioid Analgesic Pain Management for Carpal Tunnel Release Surgical Patients by Implementation of a Pre-op Evidence-Based Educational Session

Abstract

In recent years, opioid consumption patterns have exponentially grown, arguably contributing to the consequences seen with the opioid epidemic (Morone & Weiner, 2013). Evidence in literature suggests pre-operative pain management education results in reduction of consumed opioid pills and patient-reported pain, when compared to a control group (Alter & Ilyas, 2017; Kol, Alpar, & Erdoğan, 2014; Makki, Alameddine, Khateeb & Packer, 2011; Pepe et al., 2017; van Dijk et al., 2015). The purpose of this project was to standardize opioid analgesic pain management for carpal tunnel release surgical patients by implementation of a pre-op evidence-based pain management educational session as evidenced by tracking opioid usage and pain rating based on the Numerical (pain) Rating Scale (NRS) score. The Plan-Do-Study-Act (PDSA) model was used for structured data collection and quality improvement implementation (Langley et al., 1996). Specific criteria established within a clinical practice guideline was used as the material for the educational session presented to patients (Chou et al., 2016). Results were statistically analyzed utilizing frequencies and run charts. These frequencies revealed an average reduction in opioid consumption with the educational session implementation. All conclusions drawn from results of data analysis were used for quality improvement revisions and project findings dissemination and sustainability.