DES PLAINES, Ill., (August 19,
2014) – Emergency
nurses report a surprising lack of consistency in criteria for discharge after
emergency department patients receive Schedule II or III narcotic medications. These
findings appear in a new
study published online today in the Journal
of Emergency Nursing, the peer-reviewed
journal of the Emergency Nurses Association
conducted a qualitative study of 19 emergency nurses from around the U.S., who practice in a variety of emergency
settings,to understand their perceptions about common practices related to discharge after administering Schedule II or III narcotics. They examined dosage, time,availability of care resources, and other criteria. Schedule II and III narcotics are often prescribed to treat acute pain and include opioids such as
codeine, morphine, and Vicodin®.
According to the research by Lisa
Wolf, PhD, MS, RN, CEN, FAEN, Altair M. Delao, MPH, and Cydne Perhats, MPH, of the Institute for Emergency
Nursing Research at the Emergency Nurses Association in Des Plaines, Ill., all study participants reported their emergency department had no evidence-based discharge policy for patients receiving strong narcotic medications. Few reported having any policy related to discharging these patients.
Drug-to-discharge timeframes ranged from zero to 240 minutes after administration
of Schedule II and III narcotics, and the most common reason for a wait was
attributed to assessing a patient for a reaction. Criteria used for discharge
readiness included assessing physiologic, cognitive, and social conditions. Yet
no objective measures for readiness were noted.
Respondents say the decision about patient readiness for discharge is left largely to the
primary nurse. Discharge practices vary, and are often administrative personnel-dependent as opposed to administrative systems-dependent.
The study reveals these healthcare
practices are largely based on tradition rather than evidence. Researchers note that further studies are needed for developing, implementing, and
evaluating a discharge tool based on evaluation of patient outcomes, along with nurse satisfaction and confidence.
About the Emergency Nurses
Emergency Nurses Association (ENA) is the premier professional nursing
association dedicated to defining the future of emergency nursing through
advocacy, education, research, innovation, and leadership. Founded
in 1970, ENA has proven to be an indispensable resource to the global emergency
nursing community. With more than 40,000 members
worldwide, ENA advocates for patient safety, develops industry-leading practice
standards and guidelines, and guides emergency healthcare public policy. ENA
members have expertise in triage, patient care, disaster preparedness, and
nearly all aspects of emergency care. Additional information is available at www.ena.org.