Date of Conferral
Doctor of Nursing Practice (DNP)
The purpose of this scholarly project was to evaluate an evidence-based quality improvement program implemented in 2016 in a clinical practice setting to curtail overprescribing of opioids for noncancer pain management. In 2001, the National Pharmaceutical Council and The Joint Commission on Accreditation and Hospital Accreditation initiated a standard of practice for opioid use in noncancer pain management that resulted in opioid overprescribing and a 200% increase in opioid-related deaths and incalculable societal costs. Primary care providers including nurse practitioners issue the greatest number of opioid prescriptions; therefore, to address the problem of opioid overprescribing, the 2016 Centers for Disease Control and Prevention guidelines for opioid administration were implemented as a quality improvement program in a primary care setting with 10 providers. Lewin's change model was the vehicle for change and included an ongoing audit developed for tracking provider prescribing rates. The project sought to determine if adoption of the opioid administration guidelines reduced the prescribing rates in a clinical practice setting and thereby justify expanding the program to other primary clinic sites. A pre- post-single group comparison was conducted of prescribing rates from May 15, 2015 prior to implementing the guidelines and December 19, 2016 after the guidelines were in place. Analysis from t tests indicated a 41% (p < .01) reduction in prescribing rates. The project promotes positive social change through the decreased individual and societal cost of opioid- related deaths.