Response to peer
Two paragraphs and two references no more than 5 yearsOpioid and alcohol addiction impacts the nursing profession, quality of nursing care, and healthcare organizations. Nursing care is compromised as the complexity of a patient’s health increases with the use of alcohol and opioids. Addiction also commonly causes withdrawal symptoms, making it difficult to focus on non-pharmacological treatment options (Hagemeir, 2018). First responders become overwhelmed with opioid overdose related calls and it is common for cardiac or injury patient calls to be delayed.The American Association of Colleges of Nursing has taken the initiative to reach local levels through academics. Schools are being provided with webinars that discuss the CDC’s recommendations on opioid prescribing for chronic pain management, early interventions, treatments, and appropriate discontinuation of these medications (AACN, 2021).As mentioned by CCN (2021), relevant stakeholders related to opioid and alcohol addiction at a local level includes the patient, families, pharmacies, and health care professionals. Due to the increased need for healthcare resources through outpatient or ER visits and inpatient hospital admissions, less available appointments and longer ER wait times are the result (Hagemeier, 2018).The Florida Department of Health (2021), identifies an intervention that the pain management facility that I am currently employed at has adopted to address addiction concerns. In 2009, Legislation in Florida released the E-FORCSE initiative (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program), to promote safer prescribing and to reduce addiction/abuse of prescribed opioid medications within the state. This prescription reporting platform has made a huge difference in patient outcomes and helps identify patients that attempt to “doctor shop” or receive multiple narcotic prescriptions in between monthly follow up visits and refills. The medication, amount, dosage, prescribing physician, pharmacy, and date of all opioid medications is recorded on a patient’s E-FORCSE and is updated the day of their monthly follow up to ensure accuracy. The E-FORCSE reporting system is used within all our clinics scattered throughout Florida and three Alabama locations.  The MME’s or Morphine Milligram Equivalent score related to a patients daily dose of opioid medication is also provided to ensure that the optimal range of 30 or less is maintained.  The MME per day metric is a tool used to identify those with higher risks of overdosing and to ensure that closer monitoring is implemented (Dowell, Haegerich, & Chou, 2016). From my personal perspective I feel that this intervention is effective in addressing the addiction practice problem; however, there are still some improvements that need to be made with E-FORCSE reporting. All prescribing pharmacies do not use the E-FORCSE reporting platform to record all filled medications, which could lead to overprescribing and ultimately death.References:American Association of Colleges of Nursing (AACN) (2021). Opioid Epidemic Resources for Nurse Educators.https://www.aacnnursing.org/Policy-Advocacy/Opioids (Links to an external site.)Centers for Disease Control and Prevention (2016). CDC Guideline for Prescribing Opioids for Chronic Pain” United States, 2016. Morbidity and Mortality Weekly Report (MMWR).https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm (Links to an external site.)Chamberlain College of Nursing (2021). Week 2: The Practice Problem: Stakeholder Roles. The Role of the Stakeholder in Addressing Local Practice Problems.https://chamberlain.instructure.com/courses/81888/pages/week-2-the-practice-problem-stakeholder-roles?module_item_id=11581120Dowell, D., Haegerich, T., & Chou R. (2016). CDC Guideline for Prescribing Opioids for Chronic Pain — United States-2016. Recommendations and  Reports;65 (1) :1–49. DOI:http://dx.doi.org/10.15585/mmwr.rr6501e1Florida Department of Health (2021). E-FORCSE Home Page.http://www.floridahealth.gov/statistics-and-data/e-forcse/#:~:text=The%20Florida%20Prescription%20Drug%20Monitoring%20Program%2C%20known%20as,abuse%20and%20diversion%20within%20the%20state%20of%20Florida (Links to an external site.)Hagemeier, N. (2018). Introduction to the Opioid Epidemic: The Economic Burden on the Healthcare System and Impact on Quality of Life. The American Journal of Managed Care.https://www.ajmc.com/view/intro-opioid-epidemic-economic-burden-on-healthcare-system-impact-quality-of-life (Links to an external site.)
