Nursing Knowledge of the Opioid Epidemic in the Emergency Department

Opioid abuse in society dates back as far as 3400 BC when the poppy plant, otherwise known as opium, was used for medicinal and recreational purposes. As society evolved so did the abuse of opioids, including prescription opioids. This evolution brings us to today's national opioid epidemic and global health crisis with opioids. Opioid abuse affects lives across all populations, without regard to age, race, economic standing, or any of society's boundary lines. Prescription opioid addiction problems affected more than 2 million people in the U.S. in 2014. Educating communities, providers and patients on the opioid epidemic is crucial in decreasing knowledge gaps surrounding prescription opioid abuse. Unsafe opioid use can lead to misuse, addiction and abuse. When this project started, no guideline existed for opioid discharge teaching in the emergency department (ED). The purpose of this project was to increase ED nurses' knowledge on the prescription opioid epidemic, and develop guidelines for ED nurses to provide opioid discharge teaching. The four objectives for this project included: 1) Assessing ED nurses' knowledge and practice regarding opioids and discharge teaching; 2) Developing a guideline for ED nurses to use while discharging patients with an opioid prescription; 3) Presenting a guideline to ED nurses to evaluate feedback regarding usability, feasibility and satisfaction; and 4) Disseminated findings to ED nurses and provider group and submit to a larger audience. A thorough literature review revealed a deficit in nursing knowledge related to adjunct therapies and medications, risk of addiction, risk of respiratory depression, and lack of awareness on disposal and storage. Research also found a lack of evidence-based protocols on discharge standards involving prescription opioids. This project started with Institutional Review Board submission and approval. Implementation of the project objectives included developing a knowledge assessment tool and presenting it to ED nurses to assess their knowledge about opioids. During the process of this project the Utah Department of Health, Violence and Injury Prevention Program presented their public campaign called STOP THE OPIDEMIC. The STOP THE OPIDEMIC pamphlet was reviewed by the project chair and content experts and was determined that it could be used as the guideline for this project. An Assessment of the ED nurses' knowledge related to opioid prescribing was analyzed and the results were presented to ED nurses and providers along with the STOP THE OPIDEMIC guideline. Usability, feasibility and satisfaction of the guideline was not measured due to the delay in IRB approval process. However, feedback from the staff after the presentation was documented and given to ED management for future reference. The overall goal of this project was the incorporation of this guideline into the discharge teaching for patients receiving an opioid prescription. A future study is recommended to measure the usability, feasibility and satisfaction of this guideline and reevaluation of the ED nurses. The information gained from this project will be presented to the Utah Department of Health, Violence and Injury Prevention Program. Emergency department nurses can make a difference in the war on opioid prescription abuse. It is important for all ED providers and staff to understand the opioid epidemic.