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Reducing Opioid-Induced Constipation Post-Cardiac Surgery: An Improvement Project in a Pediatric Cardiac Intensive Care Unit

J Nurs Care Qual. 2022 Jan 19. doi: 10.1097/NCQ.0000000000000616. Online ahead of print.

ABSTRACT

BACKGROUND: Pain management with opioids and underutilization of prophylaxis for constipation can prolong a patient’s hospital length of stay and impede pain management efforts.

PROBLEM: In pediatric postoperative cardiac patients, opioid therapy is a common approach to pain management but often places them at greater risk for constipation due to anatomy and age.

METHODS: A retrospective review of 50 patients’ medical records for baseline data was conducted, and a survey evaluated providers’ current knowledge and practice.

INTERVENTIONS: The intervention was an electronic order set that provided decision support. Additionally, prophylactic measures were supported by a validated assessment tool that created a common language to report constipation risk.

RESULTS: Although not statistically significant, postintervention data demonstrated a 21.5% decrease in postoperative constipation and a 57% increase in ordered bowel regimens.

CONCLUSION: More focus is needed toward prophylactic bowel regimens to reduce the risk in this already high-risk population.

PMID:35051979 | DOI:10.1097/NCQ.0000000000000616

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