Optimizing Opioid Prescribing at Discharge in Paediatric Supracondylar Humerus Fractures

Description

In this presentation, Lawrence Wengle, an orthopedic surgery resident at the University of Toronto, discusses an initiative aimed at optimizing opioid prescribing for pediatric patients discharged after surgery for supracondylar humerus fractures. Wengle outlines the background behind their research, noting that many opioids prescribed post-operatively often go unused, citing a study showing that 67% of prescribed morphine for pediatric patients was not utilized at home. The initiative was a collaborative effort between the anesthesia and orthopedic departments at the Hospital for Sick Children and aimed to reduce the amount of opioids dispensed at discharge by at least 50%.



The project involved a systematic approach, including an analysis of opioid use patterns post-surgery and the establishment of a streamlined prescription process using the hospital's new electronic medical record system. They introduced a focused prescription protocol that prioritized the use of non-opioid medications, establishing guidelines that were included in the training for residents. Results showed a 59% reduction in the amount of morphine dispensed with a notable increase in the adoption of alternative pain management strategies among families. Additionally, they encouraged proper disposal of unused opioids, with a significant percentage of families returning leftover medication to the clinic.



Wengle concludes by emphasizing the ongoing trends in opioid prescribing practices and outlines future steps, including further education for residents regarding opioid prescribing, enhancing family education on pain management, and expanding their opioid stewardship program to all surgical specialties.

Specialties