Pain management of buprenorphine patients in the perioperative setting

Abstract

Background: Buprenorphine is an FDA-approved medication for the treatment of opioid use disorder and a useful tool in helping patients recover from opioid addiction. Due to the mechanism of action of buprenorphine on opioid receptors, treatment of acute pain in the perioperative setting can be challenging. Local problem: At the facility site, buprenorphine patients who present for surgery have a longer average length of stay in the post-anesthesia care unit (PACU). Nurses also expressed a need for further education and increased proficiency in caring for buprenorphine patients. Methods: The purpose of this project was to increase staff communication, provide specific education to staff about buprenorphine, and decrease the length of stay for buprenorphine patients in the PACU. Interventions: This project involved the implementation of three interventions. The first intervention involved adding chart documentation of buprenorphine status, allowing for notification to the operating room and PACU staff. The second intervention was the initiation of improved communication between the preoperative department and the PACU. The third intervention was an educational presentation and reference sheet that was provided to the PACU staff. Results: After implementation, 80% of buprenorphine patients had a note in their chart alerting the OR and PACU staff of their buprenorphine status, however direct communication between departments only occurred for 20% of patients. 100% of PACU staff nurses reported increased proficiency in caring for buprenorphine patients after education implementation. Conclusion: The QI project resulted in increased staff proficiency and interdepartmental communication, indicating improved care for buprenorphine patients in the perioperative setting.