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Full-Text Articles in Medicine and Health Sciences

Opioid-Prescribing Practices For Post-Operative Patients In Otolaryngology: A Multiphasic Quality Improvement Project In A Single Large Institution, Zachary Gandee, Sophia Dang, Alexander N. Duffy, Jonathan C. Li, Tanvi Rana, Brittany Gunville, Tingting Zhan, Elizabeth Cottrill, Md, David Cognetti, Md Dec 2018

Opioid-Prescribing Practices For Post-Operative Patients In Otolaryngology: A Multiphasic Quality Improvement Project In A Single Large Institution, Zachary Gandee, Sophia Dang, Alexander N. Duffy, Jonathan C. Li, Tanvi Rana, Brittany Gunville, Tingting Zhan, Elizabeth Cottrill, Md, David Cognetti, Md

Phase 1

Objectives:

In otolaryngology, postoperative pain management lacks evidence-based guidelines. We investigated opioid prescription and consumption for common procedures to develop prescribing guidelines at our institution.

Study Design:

Prospective, survey study.

Methods:

Patients who underwent surgery between July and September were given surveys upon discharge and at first follow-up visit. We assessed opioid usage and pain using the visual analog scale and opioid consumption throughout the postoperative period. Opioid prescriptions were converted to a standardized unit of 5 mg Oxycodone pills for reporting. Four procedures (transoral robotic surgery resection [TORS], sialendoscopy, parathyroidectomy/thyroidectomy, and parotidectomy) were selected for isolated analysis.

Results: …


Standardized Discharge Instructions And Their Impact On Post Operative Patient Knowledge, Nikolaus Hjelm, Md, Gregory Epps, Md, Ryan Rimmer, Md, Lauren Bogdan, Md, Erin Reilly, Md Jun 2018

Standardized Discharge Instructions And Their Impact On Post Operative Patient Knowledge, Nikolaus Hjelm, Md, Gregory Epps, Md, Ryan Rimmer, Md, Lauren Bogdan, Md, Erin Reilly, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

After every surgery, surgeons send their patients home with discharge instructions. The information is intended to educate the patients about their postoperative care and how to safely care for themselves upon returning home. Each surgeon reviews and approves the discharge instructions before they are given to their patients. This information is once again reviewed by the patient’s nurse before the patient leaves the hospital.

Within a large hospital, there are often several surgeons within each specialty that perform the same surgeries. The department of Otolaryngology at Thomas Jefferson University Hospital is no exception. Within otolaryngology there are several subspecialties. At …


Clinical Handover Of Immediate Post-Operative Patients: A Literature Review, Samantha Clarke, Karen G. Clark-Burg, Elaine Pavlos Jun 2018

Clinical Handover Of Immediate Post-Operative Patients: A Literature Review, Samantha Clarke, Karen G. Clark-Burg, Elaine Pavlos

Journal of Perioperative Nursing

The transfer of professional responsibility for some or all aspects of patient care, within and between professional groups on a temporary or permanent basis, is termed clinical handover. Communication during clinical handover is considered a challenging patient safety problem. A key principle of transfer of professional responsibility for patient care is the minimum amount of information or content that must be contained and transferred in any particular type of clinical handover.

Aim: The purpose of this literature review was to establish the scope of the literature about clinical handover from the operating room to Post Anaesthesia Care Unit (PACU) published …


Acute Post-Operative Pain Management: Preventing Overuse Of Opioids, Alison Hirsch Jan 2018

Acute Post-Operative Pain Management: Preventing Overuse Of Opioids, Alison Hirsch

Theses and Graduate Projects

Background: Surgical pain management with opioids is common. The use of multimodal analgesia has been proposed in order to provide opioid-sparing regimens and improve pain control post-operatively. Inadequate control of surgical pain can lead to development of chronic pain. Furthermore, studies have linked acute surgical opioid use to increased risk of long-term use. Long-term opioid use has undesirable, life-altering consequences, including physical dependence and addiction which may lead to overdose or death. Use of a variety of medications in the operative setting can lead to synergistic or additive effects on pain control, thus decreasing post-operative opioid consumption.

Methods: A literature …