PP312 – The Transitional Pain Service Nurse Care Manager: A Novel Approach to Perioperative Surgical Pain Management
Many surgical interventions introduce or increase opioids as routine pain management post-surgery. Opioid naïve patients have up to a 14% risk continued opioid use, with rural patients taking longer time to decrease dosage with fewer resources to address long-term pain and opioid use. Post-operative pain is typically managed by the surgical team for 2-6 weeks after surgery with the primary care provider (PCP) assuming responsibility once the surgeon declares surgical follow-up complete. This practice pattern often leads to poor pain control with unnecessary and preventable ER visits for pain, uncertainty by the PCP regarding the expected course of recovery from surgery, and inappropriate and prolonged opioid therapy. Salt Lake City VA has developed a successful Transitional Pain Service (TPS), that incorporates patient-centered perioperative pain management and care coordination. This innovative pilot has incorporated recommendations VA/DOD Clinical Practice Guidelines for Chronic Opioid Use, American Pain Society, Patient-centered Outcomes, and integrates the concepts of a peri-operative surgical home with personalized nursing care coordination. This multidisciplinary program relies upon a clinical decision support tool that: 1. Provides patient tracking, 2. Allows communication between providers in the program, 3. Summarizes key clinical parameter’s, allowing for better clinical decision making.
1. Decrease new incidence of opioid misuse disorder in post- surgical patients
2. 100% follow-up with post-surgical patients prescribed opioids
3. Create a patient-tracking and summary system that is incorporated routine nursing charting.