Date of Award

Spring 5-2015

Degree Type

Doctoral Nursing Capstone Project

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Dr. Anita Davis-Boykins

Committee Chair Department

Nursing

Committee Member 2

Dr. Janie Butts

Committee Member 2 Department

Nursing

Committee Member 3

Dr. Patsy Anderson

Committee Member 3 Department

Nursing

Committee Member 4

Dr. Lynn Langley

Committee Member 4 Department

Nursing

Abstract

Background: Prescription opioid pain medication misuse has become a nationwide epidemic. Many states have implemented prescription drug monitoring programs (PDMP) to assist in combating the problem of prescription opioid pain medication misuse. Evidence-based clinical practice guidelines as well as the PMDP should be utilized by healthcare providers to guide treatment of chronic pain with opioid pain medications. Purpose: The purpose of this doctoral capstone project was to determine if providers are accessing the Prescription Drug Monitoring Program (PDMP) and utilizing evidence-based guidelines to minimize opioid pain medications misuse among patients with chronic pain in a primary care setting. Method: This project consisted of a retrospective chart review of prescribers’ documentation in the medical record to determine if the PDMP was accessed and if evidence-based protocols were used when prescribing opioid pain medication to patients diagnosed with chronic pain seen in a primary care clinic. Results: Seven (N=7) records that met inclusion criteria for the project were identified for review over a three month time frame. The seven records were all identified to have been seen by a nurse practitioner. All (N=7; 100%) of the charts had a history and physical documented. The PDMP was documented to be accessed on 5 of the 7 records (n=5; 71.4%). Patients were prescribed an opioid pain medication by the provider less than half (n=3; 42.9%) of the time. Conclusion: This doctoral capstone project shows that the providers are documenting components of the history and physical when patients present to a primary care clinic with complaints of chronic pain. Past history of drug abuse and ordering urine drug screens are evidence-based practice recommendations where prescribers have not documented consistently. Accessing the PDMP is another area where it shows the prescribers are not consistently documenting. Implementation of evidence-based guideline will be imperative in the fight to minimize risk of misuse of opioid pain medications among patients with chronic pain in the primary care setting.

Key terms: Prescription Drug Monitoring Program, opioid pain medication, evidence-based guidelines, chronic pain, provider prescribing habits, mitigation strategies.

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