4CPS-172 Improving post-operative analgesia and associated prescribing in the orthopaedic setting

Background and Importance In January 2022 the HSE issued 'Guidance for opioid prescribing for acute noncancer pain, postoperative pain and post-procedure pain'. Three Guidance documents were developed by a multidisciplinary team comprising of: senior pharmacist, pain management CNS, consultant ortho-geriatrician and consultant anaesthetist. Three key documents were developed Post-Operative Opioid Conversion Chart Analgesia Prescribing Guideline Opioid Patient Information Leaflet Aim and Objectives The aim of the project was to implement the recommendations of the HSE Guidelines to 'improve quality and safety of opioid prescribing in the acute hospital setting and reduce harm from their use'. The objectives were Avoid use of long-acting opioids in the port-operative setting Appropriate prescribing of post-operative medicines. Material and methods A point prevalence baseline audit of post-operative prescribing was undertaken in July 2022 before the introduction of the guidelines. A2 posters of the guidance documents were printed and displayed on the orthopaedic ward accompanied by intensive education. Prescribing was reaudited using the same parameters in November 2022. Results The demographics of the patients for the audit (n=29) and re-audit (n=28) were comparable. Hip related injuries was the most prevalent type of injury for patients in both audits. The baseline audit found the highest incidence of inappropriate prescribing in the areas of: Opioids, Laxatives and NSAIDs. These three areas were targeted for improvement. A summary of the key results is depicted in table 1 below: Conclusion and Relevance Post-operative analgesia and associated prescribing can be improved with provision of clear, accessible, evidence based guidelines and information to prescribers and ward staff. A key learning point was that education provision must be continuous with intensification at the time of team rotations. Since completion of this initial project, a separate general surgery post-operative prescribing guideline has been developed. References and/or Acknowledgements 1. Guidance for opioid prescribing for acute noncancer pain, postoperative pain & postprocedure pain, HSE, Jan 2022, https://msurgery.ie/wp-content/uploads/2022/02/Opioid-guidance-HSE-1.3-CDI-Final.pdf Conflict of Interest No conflict of interest.