Safe Opioid Prescribing for Nurse Practitioners

by D'Arcy, Yvonne; Bruckenthal, Patricia

• ISBN13: 9780199737703
• ISBN10: 0199737703
• Edition: 1st
• Format: Paperback
• Copyright: 2011-08-17
• Publisher: Oxford University Press

Summary

Opioid prescribing presents many challenges to all clinicians, including nurse practitioners, who often feel ill-equipped to deal with the myriad of complex issues involved. Fear of regulatory oversight and fear of potential addiction in patients often prevents nurse practitioners from prescribing opioids to those patients who could benefit from them. Although addiction is a legitimate concern for practitioners prescribing opioids, practitioner fear can disproportionally influence patient care in the pain management setting. When faced with treating a patient suffering from a chronic condition, understanding safe prescribing guidelines can provide the practitioner with the accurate information--and confidence--necessary to treat pain patients safely and effectively. Part of the Oxford American Pocket Notes series, this ultra concise pocket guide provides helpful information for prescribers in an easy-to-tab format. The introduction addresses practitioners' specific considerations while subsequent sections provide information on selecting and screening patients for opioid therapy. Moreover, the volume includes a special section on opioid prescription for patients who have a history of substance abuse. The author provides examples of patient opioid agreements, an algorithm for treating chronic pain with long-term opioids and information on interpretation of urine screening results. Authored by two highly experienced nurse practitioners on the frontlines of patient care, this volume uses the most up-to-date information available in order to function as a clinically focused tool for safe opioid prescribing.

Table of Contents

Issues surrounding safe prescribing (Introduction)

Treating chronic pain with opioids

Legal considerations

The need for an adequate knowledge base

Assessment: How to determine if the pain complaint needs opioid therapy

Using the brief Pain Impact Questionnaire (BPIQ)

Criteria for implementing opioid therapy

Screening for opioid risk

CAGE

Opioid Risk Tool (ORT)

COMM

SOAPP-R

Prescribing opioids for chronic pain

Using universal precautions

Addiction, dependency, tolerance

Commonly prescribed opioids and equivalent doses

How to rotate opioids

Prescribing opioids for patients with a history of addiction or substance abuse

Developing a comprehensive treatment plan

Using an opioid treatment agreement

Elements of the treatment agreement

Algorithm for treating chronic pain with opioids

Interpreting results of a urine screen

Enforcing the opioid treatment agreement and developing an exit strategy

Adding complementary methods to a treatment plan

Documentation

Using the PADT

Using the four A"s for reassessment

Recommended readings and websites

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