Safe Prescribing

The opioid epidemic began with the over-prescribing of opioids promised to alleviate pain. When patients come to the ED for pain, it is an opportunity to change the trajectory of a patient’s pain management plan and ensure the least harmful and most clinically appropriate therapy is provided by the care team. If an opioid is the most appropriate therapy for the patient’s condition, it is imperative to provide patient education about safe use of opioids not only to the patient, but to family accompanying the patient.     

Key Takeaways for the ED

  1. Develop a framework for safe prescribing practices using the NC Guidelines for Opioid Management in Emergency Departments , developed by the North Carolina Healthcare Association (NCHA) and the North Carolina Chapter of the American College of Emergency Physicians (NCCEP). 
  2. Convene a multidisciplinary team from the hospital (including risk management) to ensure a comprehensive strategy.
  3. Use existing, standing meetings to highlight safe prescribing practices. Be sure to plan how this information will be communicated to any locum tenens within the ED. 
  4. Institutionalize safe prescribing practices through formal policies and procedures within your ED in order to sustain true lasting culture change. Examples include updating EMR defaults and order sets.
  5. Hospital-specific opioid safety committees are integral to monitoring and improving workflows, policies, and communication about opioid-related activities in your hospital. A member from the ED should be part of the committee, as they are a vital part of the safe prescribing strategy.  

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