Hospital Spotlight: Oaklawn Hospital Reduces Narcan Utilization
Posted on November 02, 2018
Michigan hospitals voluntarily and regularly submit data to the MHA Keystone Center to be analyzed and used to drive improvement and help healthcare providers avoid future harm.
The data is shared among Hospital Improvement Innovation Network (HIIN) member hospitals to help them find areas of opportunity and gauge where they land on the performance metric spectrum.
Marshall-based Oaklawn Hospital realized it was consistently above similarly sized organizations in Narcan utilization. Soon after, Oaklawn monitored its usage of Narcan after opioid administration hospitalwide and noted that Narcan was most often administered after receiving anesthesia.
Oaklawn’s anesthesia team, which is comprised of a team of certified registered nurse anesthetists, were immediately called to action. They set a goal to reduce adverse drug events that require the use of Narcan after opioid administration by 25 percent within one year.
To accomplish this, the anesthesia team first conducted full chart reviews to determine if the correct medication and dose was provided to the patient, if Narcan administration was warranted and if the correct dose of Narcan was administered.
In 2017, the anesthesia team implemented an Enhanced Recovery Program to focus on pain management during or after major colon surgeries, joint replacements and breast reductions. The program encourages the use of anesthetic blocks rather than narcotics.
Anesthetic blocks provide pain management for 18 to 24 hours post-surgery and do not pose the same risks of respiratory or neurological depression as some opioids.
In the past year, Oaklawn has increased anesthetic block utilization by 30 percent, decreased fentanyl use by 35 percent and dilaudid use by 20 percent. It also decreased Narcan administration by 42 percent.
The anesthesia team recently set a new goal to expand the Enhanced Recovery Program and further decrease Narcan usage post-anesthesia administration by an additional 10 percent over the next nine months.
Instructions regarding pain management are provided post-op to patients as well as a follow-up call three days and 21 days post-surgery to address concerns, discuss pain management and counsel patients about opioid use.
Oaklawn strives to keep expanding the program, work closely with surgical navigators who look at patients pre-and post-op and decrease Narcan utilization within its organization. This article was featured in the MHA Keystone Center Newsletter. To subscribe, please contact Ashley Sandborn, MHA Keystone Center communications specialist.
Posted in: Patient Safety & Quality