Samantha Berliss CNP Leslie Cartagena CNP and Alex

Samantha Berliss, CNP, Leslie Cartagena, CNP, and Alex Nguyen, MD Palliative Care Fellows - Harvard Interprofessional Palliative Care Fellowship Massachusetts General Hospital Improving nursing documentation of post-opioid PRN effectiveness on Lunder 9 AIM: Increase the frequency of nursing documentation of PRN effectiveness after administration of short acting opioids (within 30 minutes of IV opioid or 60 minutes of enteral opioid) from 40. 59% to 75% between TEAM: December 2018 and January 2019. • MGH Lunder 9 Nurses Katie Kirkland, Lunder 9 CNS INTERVENTION: Survey of Lunder 9 RN’s on barriers to documenting PRN opioid effectiveness -> reasons for lack of PROJECT SPONSOR: documentation included too many obligations on time, unenforced MGH policy, and counterintuitive Kathleen Doyle, MD - Fellowship Epic documentation process -> educational poster addressing MGH policy, importance of Program Director, MGH Division documentation, and JCAHO expectations placed on bulletin boards on unit, in bathrooms, and weekly of Palliative Care newsletter -> Collect change data one week after posters were posted. • • • RESULTS: CONCLUSIONS: The AIM statement was not met with our intervention. After poster was implemented, we unfortunately saw a decrease in documentation of PRN effectiveness (from 40. 59% to 39. 67%), a deficit of more than 35% from our goal of 75%. • NEXT STEPS: -Obtain larger sample over longer period of time to better understand baseline data -Engage IT/Epic Support to focus efforts on making documentation more intuitive -Consider investment in technology that would allow patients to directly report pain assessment and reassessment, allowing nurses to focus on clinic duties