What question did this study set out to answer?

To standardize postoperative pain management guidelines and decrease discharge opioid prescribing in pediatric cardiac surgery patients.

June 1, 2025Cardiology in the Young

Standardising discharge post-surgical pain control: a quality improvement project

View Full Paper

Ask AI

Bookmark

Why the study?

Healthcare-prescribed opioids contribute to the opioid epidemic, presenting an opportunity to standardise post-surgical pain management and reduce discharge opioid prescriptions in cardiac surgical patients.

Do standardised prescribing guidelines reduce opioid prescriptions at discharge in pediatric cardiac surgical patients?

Population

289 postoperative cardiac surgical patients at a freestanding children's hospital

Comparison

Standardised evidence-based prescribing guidelines and enhanced non-opioid management vs baseline practices

Design

Quality improvement project

Authors

KWKathyrn M. WhellerAkron Children's Hospital RSRobert D. StewartUniversity of Washington KBKristen Breedlove

Discussion

Member takes

Implication

Supports local opioid-sparing discharge after pediatric cardiac surgery; single-center QI leaves open generalizability.

Key Points

To standardize postoperative pain management guidelines and decrease discharge opioid prescribing in pediatric cardiac surgery patients.
Conducted a quality improvement initiative using the Model for Improvement at a freestanding children's hospital across 289 cardiac surgery patients from January 2019 to December 2021, with sustainability monitored through December 2022.
Implemented age- and surgical approach-based prescribing guidelines, prioritized non-opioid analgesics, and embedded protocol rules directly into the electronic health record.
Assessed guideline compliance, discharge morphine equivalent dosing, opioid-free discharge rates, hospital length of stay, and post-discharge opioid re-prescriptions.
Guideline compliance increased from 24% at baseline to 100%.
Discharge morphine equivalent dosing fell from a baseline of 36.25 in 2019 to 22.5 in 2021, reaching 0 in 2022.
Protocol implementation produced reductions in discharge morphine equivalents without increasing patient length of stay or triggering additional opioid re-prescriptions.

Structured PICO

Do standardised prescribing guidelines reduce opioid prescriptions at discharge in pediatric cardiac surgical patients?

Population

289 postoperative cardiac surgical patients at a large midwestern freestanding children's hospital

Intervention

Standardised evidence-based prescribing guidelines based on patient age and surgical approach, enhanced pain management with non-opioid medications, and integration of prescribing guidelines into the electronic health record

Comparator

Baseline prescribing practices (2019)

Outcome

Rate of compliance with the prescribing guidelines

Implementing standardized pain management guidelines in pediatric cardiac surgery significantly improved compliance and reduced opioid prescribing at discharge without increasing length of stay or re-prescriptions.

Cite This Study

Wheller et al. (2025) studied this question.

synapsesocial.com/papers/6a7f76b2fd903b7756ca7831 https://doi.org/10.1017/s1047951125100474

View Full Paper

Ask AI

Bookmark