Using implementation science to decrease variation and high opioid administration in a surgical ICU.

Kyle J Kalkwarf, Brett J Bailey, Allison Wells, Allison K Jenkins, Rebecca R Smith, Jordan W Greer, Richard Yeager, Nolan Bruce, Joseph Margolick, Melissa R Kost, Mary K Kimbrough, Matthew L Roberts, Benjamin L Davis, Anna Privratsky, Geoffrey M Curran
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Abstract

High doses and prolonged duration of opioids are associated with tolerance, dependence, and increased mortality. Unfortunately, despite recent efforts to curb outpatient opioid prescribing because of the ongoing epidemic, utilization remains high in the intensive care setting, with intubated patients commonly receiving infusions with a potency much higher than doses required to achieve pain control. We attempted to use implementation science techniques to monitor and reduce excessive opioid prescribing in ventilated patients in our Surgical ICU.
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利用实施科学来减少外科重症监护室中阿片类药物用量的变化和高用量。
高剂量和长时间使用阿片类药物与耐受性、依赖性和死亡率增加有关。不幸的是,尽管最近由于阿片类药物的流行而努力抑制门诊阿片类药物的处方,但在重症监护环境中的使用率仍然很高,插管患者通常接受的输液剂量远远高于实现疼痛控制所需的剂量。我们尝试使用实施科学技术来监控和减少外科重症监护病房通气患者过量使用阿片类药物的情况。
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