Nurse Practitioner Opioid Prescribing and Safety Measure Utilization Patterns in Ontario

Standing

Undergraduate

Type of Proposal

Oral Research Presentation

Faculty

Faculty of Nursing

Faculty Sponsor

Gina Pittman

Proposal

Background: In 2012, the Canadian federal government amended the Controlled Drugs and Substances Act authorizing nurse practitioners (NPs) to prescribe controlled substances. Ontario was the last province to adopt this legislation in 2017. Despite this change, a significant gap exists in research seeing as there are currently no published studies regarding NP opioid prescribing patterns (Pittman et al., 2020). Purpose: The qualitative aspect of this mixed-methods study aims to further explain the quantitative findings. Qualitative interview data provided insight into the impact of NP practice setting and patient population on survey responses. Content analysis will illustrate the key factors influencing NP opioid prescribing and safety measure utilization patterns. Methods: 262 participants completed the survey and 153 agreed to qualitative follow-up. NPs across Ontario (n=14) selected from various geographical locations agreed to be interviewed for the qualitative component. Results: Areas explored included prescribing preference for specific opioids, the impact of practice setting on utilization of safety measures, and the perceived effectiveness of suggested safety measures. Three key findings emerged: (a) hydromorphone is the preferred opioid due to a better reported side effects profile when used in small dosages, especially in the elderly (b) NPs practicing in hospital settings use safety measures less often than community counterparts as a result of organizational structures (c) limiting supply is considered the most effective safety measure. Implications for Future Research: A follow-up study focusing on a cohort of NPs practicing in emergency departments could illustrate how this unique practice setting impacts NP opioid prescribing.

References

Pittman, G., Morrell, S., & Ralph, J. (2020). Opioid prescribing safety measures utilized by primary healthcare providers in Canada: A scoping review. Journal of Nursing Regulation, 10(4), 13-21. https://doi.org/10.1016/S2155-8256(20)30009-0

Availability

March 29 12-3pm, March 30 12-3pm, March 31 12:45-3pm

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Nurse Practitioner Opioid Prescribing and Safety Measure Utilization Patterns in Ontario

Background: In 2012, the Canadian federal government amended the Controlled Drugs and Substances Act authorizing nurse practitioners (NPs) to prescribe controlled substances. Ontario was the last province to adopt this legislation in 2017. Despite this change, a significant gap exists in research seeing as there are currently no published studies regarding NP opioid prescribing patterns (Pittman et al., 2020). Purpose: The qualitative aspect of this mixed-methods study aims to further explain the quantitative findings. Qualitative interview data provided insight into the impact of NP practice setting and patient population on survey responses. Content analysis will illustrate the key factors influencing NP opioid prescribing and safety measure utilization patterns. Methods: 262 participants completed the survey and 153 agreed to qualitative follow-up. NPs across Ontario (n=14) selected from various geographical locations agreed to be interviewed for the qualitative component. Results: Areas explored included prescribing preference for specific opioids, the impact of practice setting on utilization of safety measures, and the perceived effectiveness of suggested safety measures. Three key findings emerged: (a) hydromorphone is the preferred opioid due to a better reported side effects profile when used in small dosages, especially in the elderly (b) NPs practicing in hospital settings use safety measures less often than community counterparts as a result of organizational structures (c) limiting supply is considered the most effective safety measure. Implications for Future Research: A follow-up study focusing on a cohort of NPs practicing in emergency departments could illustrate how this unique practice setting impacts NP opioid prescribing.

References

Pittman, G., Morrell, S., & Ralph, J. (2020). Opioid prescribing safety measures utilized by primary healthcare providers in Canada: A scoping review. Journal of Nursing Regulation, 10(4), 13-21. https://doi.org/10.1016/S2155-8256(20)30009-0