Implementation Of a Standardized Pain Assessment Tool to Drive Opioid Management in End-of-Life Patients in A Medical Intensive Care Unit

Purpose This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool. Background The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care. Methodology A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then implemented for staff to complete every four hours on each EOL patient. Education was provided before and during the implementation. Changes to the project course of action were made according to the Plan-Do-Study-Act quality improvement method. Data before and post-implementation are the results of opioid audits on seventeen patients. Results Twenty nurses completed the pre-survey, and sixteen nurses completed the post-implementation survey. The survey results, which included word-of-mouth results, showed a 3.11% increase in confidence levels. Audits of opioid administration showed over a 200% increase in opioid administration to EOL patients (N=17) after implementing the MOPAT. Education played a large role in why staff felt more confident in administrating opioids. Implications The MOPAT provided direction for nurses administering opioids to EOL patients. This project showed that increased education and guidance when caring for EOL patients is imperative. Ultimately, the utilization of a standardized tool improved opioid administration in EOL patients.