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Health Policy Brief-Revising the Opiate Withdraw Order Set
Christan Mulder
Western Washington University

Statement of the Issue

With antibiotic resistance becoming more and more common especially among intravenous drug users it’s . Joseph Medical Center (SJMC) nurses must be equipped with the best available resources and tools to assist in treating and further preventing the heroin epidemic in our community. The Center for Disease Control and Prevention states that heroin use and heroin related deaths have nearly quadrupled between the years 2002 and 2013 and that improvement strategies must be implemented at every system level (CDC. Amendment of the opiate withdrawal protocol would expand drug abuse treatment for the hospitalized patient and will encompass multiple factors that affect the addicted patient during and after hospitalization. Developing a treatment plan for these patients goes above and beyond the care of the physician. To provide medical care in a way that is consistent with the PHMC’s mission and values we must work together to improve substance abuse care. The current opiate withdrawal protocol utilized by PHMC follows a fairly narrow approach and is in need of a revision and update in order to facilitate and increase patient success rates. the new order set addresses a multitude of factors that emotionally and physically promote good health. Issue and Background The care of the substance abuse patients is a complex process that includes ongoing assessments. The nursing staff caring for these individuals using the current order set often feel limited with treatment options available therefore causing negative feelings and low levels of professional satisfaction relating to limitations of care being provided. Our hospital must face this epidemic with a comprehensive approach and will begin by evaluating and revising the care provided to substance abuse patients. The new order set provides options for managing the symptoms of withdrawal but also provides treatment options for ongoing maintenance therapy or even just stabilization during their hospital stay. PeaceHealth St. Not every patient admitted to the hospital is ready for detox. The Registred Nurse caring for these individuals must be equipped with the best possible medications and treatments available. 2015).2 The Whatcom County Health Department reports that opiate abuse has risen dramatically over the last several years and as of 2009 Whatcom County ranked 3rd in the state from overall negative impacts from Heroin abuse. treatment of possible intoxication/withdrawal symptoms and treatment of cooccurring psychiatric diagnoses. As the current opiate withdrawal order set addresses simply only withdrawal.

The care that an RN provides for a substance abuse patient during hospitalization is not limited to ongoing assessments. and coordinating a discharge plan with the possibility of the patient to enter into recovery. psychosocial support. Benefits  The revised Opiate and Narcotic Withdrawal order set enhances workflow for all providers and nurses and reduces the unintentional oversight and Eliminating variability  Reducing unnecessary calls to medical providers. Provider’s resistance to change and personal judgements by all staff involved in the patients care are possible barriers to utilization and implementation of the new order set.  Provide ongoing support of the drug addicted patient by allowing maintance therapy options within PHMC and enable success of staying clean from drugs at discharge  Familiarize nurses. doctors and patients with medications being administered and available to be ordered for patients experiencing withdrawals. Educational sessions and practice updates are available in order to facilitate the change process. treatment planning. PHMC’s new opiate withdrawal order set allows for a more comprehensive approach to care. the symptoms of withdrawal and the benefits of the new opiate withdrawal order set. advocating. vison and mission. By providing additional pharmacological therapies to manage the symptoms of withdrawal or enabling and supporting a patient in ongoing treatment options we will begin to see a decrease in the number of patients who leave against medical advice or leave simply prior to finishing antibiotic therapy. Recommendations  Revision of PHMC Opiate and Narcotic Withdrawal Order set to reflect the hospitals goals.3 important that all patients finish the prescribed antibiotic treatment.  Formulate and provide educational opportunities for providers and nursing staff on the detoxing patient. Position on the Issue The floor nurses providing direct care for these patients.  Enhanced Workflow and Flexibility for Providers  Increased patient/staff satisfaction References . medication administration and monitoring. coordinating and evaluating care must be equipped with a better set of tools.

us/documentcenter/view/1738 .4 Center for Disease Control and Prevention. Vital signs: Today’s Heroin Epidemic.cdc.whatcomcounty. Retrieved from http://www. Opiate Addiction Fact Sheet. (2015. January) Increases in Drug and Opioid Overdose Deaths — United States. Retrieved from http://www.htm Whatcom County Public Health Department. Retrieved from http://www.cdc.gov/vitalsigns/heroin/index.html Center for Disease Control and Prevention.gov/mmwr/preview/mmwrhtml/mm6450a3. July). (2014). (2016. 2000–2014.