Key result
Removing gabapentin from APRN preoperative order sets reduces preoperative administration by ~24%.
Why the study?
Gabapentin is routinely used preoperatively in TJA surgery but evolving evidence shows it is ineffective for postoperative pain and has adverse effects.
Does removing gabapentin from preoperative order sets reduce its administration in patients undergoing total joint arthroplasty?
Does removing gabapentin from preoperative order sets reduce its administration in patients undergoing total joint arthroplasty?
An evidence-based practice change led by APRNs successfully reduced preoperative gabapentin administration by 23.8% in patients undergoing total joint arthroplasty.
Answers are grounded in this paper and cite their sources.
Order-set changes can reduce preoperative gabapentin use; leaves open effects on perioperative outcomes in total joint arthroplasty.
Gabapentin is routinely used in preoperative multimodal anesthesia to reduce pain following total joint arthroplasty (TJA) surgery. Evolving evidence has shown it is ineffective in reducing postoperative pain and should be used cautiously in this patient population due to its adverse effects. The purpose of this work was to implement an evidence-based practice (EBP) change in a small preadmission testing center. Utilizing the Melnyk EBP model, implementation occurred over 30 days. Pharmacy reports were used to determine the number of doses of gabapentin 300 mg dispensed from the ASU Phase II Omnicell 30 days before implementation and 30 days following implementation. During implementation, there was 23.8% reduction in gabapentin administration preoperatively. Advanced practice registered nurses (APRNs) removed gabapentin from the preoperative order set, resulting in a decrease in gabapentin use. This work demonstrates the role APRNs have in driving EBP changes.
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Jeanette R. Schultz (2022) studied Total joint arthroplasty. Removal of gabapentin from preoperative order set vs. Pre-implementation period (30 days before) was evaluated on Number of doses of gabapentin 300 mg dispensed (23.8% reduction). Removing gabapentin from the preoperative order set by advanced practice registered nurses resulted in a 23.8% reduction in its preoperative administration.
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