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We’re your partner in safety

We are committed to supporting opioid stewardship initiatives.

According to the Institute for Safe Medication Practices, opioid stewardship may be described as “coordinated interventions designed to improve, monitor, and evaluate the use of opioids in order to support and protect human health.” 1

Opioid stewardship is a concept that emerged only recently and is modeled after the antimicrobial stewardship programs that have been widely implemented and are now required for Joint Commission-accredited hospitals and nursing care centers.2

The Joint Commission revised their pain standards in 2018 to include leadership standard: “A hospital has a leader or leadership team that is responsible for pain management and safe opioid prescribing and develops and monitors performance improvement activities.”3

Fresenius Kabi supports leadership efforts for implementing hospital-wide opioid stewardship.

Opioid stewardship in a hospital has been focused on discharge orders and prescribing of limited opiates, education, and establishing treatment protocols for OUD (opioid use disorder). Below are additional initiatives for considerations to improve pain management before surgical procedures.

Are you following pain assessment and management standards?

On January 1, 2018, The Joint Commission released its updated pain assessment and management standards. The requirements outline a multi-level approach to pain management to help frontline staff and clinicians deliver safe, individualized pain care. This page is designed to assist users in standard interpretation and provide resources on the topic of pain assessment and management.

Are you carrying out ERAS protocols?

Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery.

Are you administering multi-modal strategies?

A multimodal approach may decrease the use of opioids and associated side effects (e.g., delirium, and respiratory depression), tolerance, and diversion.4,5,6 Second, a multimodal approach may be a more effective pain control strategy, potentially decreasing the complications associated with suboptimal pain control, such as pneumonia, deep venous thrombosis, and postoperative cognitive dysfunction.4,5,6

Are you employing Perioperative Surgical Home?

Perioperative Surgical Home is a patient-centric, team-based model of care created by leaders within the American Society of Anesthesiologists to help meet the demands of a rapidly approaching health care paradigm that will emphasize gratified providers, improved population health, reduced care costs, and satisfied patients.

How are you minimizing waste of controlled substances?

Waste may include products expiring, products prepared for administration but not administered to the patient (e.g., when a physician discontinues or a patient refuses administration), and drug product remaining after a partial dose is removed from its packaged unit.7 To minimize waste, controlled substances are stocked in as ready-to-use form as possible (e.g., avoiding the use of multidose vials) and in the lowest commercially available units for doses frequently prescribed for patients.7

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How are you addressing drug diversion in your institution?

Drug diversion can be defined as any criminal act or deviation that removes a prescription drug from its intended path from the manufacturer to the intended patient.7 Controlled substances diversion in health systems can lead to serious patient safety issues, harm to the diverter, and significant liability risk to the organization.7

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