Implementing an overdose education and naloxone distribution program in a health system
Implementing an overdose education and naloxone distribution program in a health system
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DOI：
10.1016/j.japh.2017.01.002
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Polston, Gregory
中科院分区：
文献类型：
--
作者：
Devries, Jennifer;Rafie, Sally;Polston, Gregory
目的：设计和实施一项卫生系统范围内的计划，增加阿片类药物过量风险患者的纳洛酮带回家，下游目的是减少死亡。该计划包括医疗保健专业教育和指导方针，开发和传播患者教育材料，电子健康记录的变化，以促进纳洛酮处方，以及纳洛酮在药店的可用性。设置：学术卫生系统，圣地亚哥，加州。实践描述：加州大学圣地亚哥分校提供住院和门诊初级保健和专科服务，拥有563张病床，分布在2家医院和6家药房。UCSDH是加州大学卫生系统的一部分，也是该县的安全网医院。实践创新：2016年1月，多地点学术卫生系统启动了全系统的过量教育和纳洛酮分发计划，以预防阿片类药物过量和阿片类药物过量相关死亡。一个跨学科，跨部门的团队走到一起，制定和实施该计划。为了加强机构支持，制定了纳洛酮处方指南，并批准用于卫生系统。通过部门培训、公告和电子邮件通知为医生、药剂师和护士提供纳洛酮教育。电子健康记录中的警报和预设纳洛酮订单促进了纳洛酮与阿片类药物处方的共同处方。评价：电子健康记录报告捕获了纳洛酮处方。总结报告的电子健康记录测量纳洛酮提醒警报和response rates.Results：自该计划开始以来，卫生系统已经培训了252名医生，药剂师和护士过量教育和带回家纳洛酮。纳洛酮处方的数量从基线的4.5每月增加到平均每月46在3个月后，全面实施该计划，包括实施电子健康记录alerts.Conclusion：启动和实施过量教育和纳洛酮分配计划是可行的学术卫生系统。(C)2017年美国药学协会（R）。爱思唯尔公司出版All rights reserved.
Objective: To design and implement a health systemewide program increasing provision of take-home naloxone in patients at risk for opioid overdose, with the downstream aim of reducing fatalities. The program includes health care professional education and guidelines, development, and dissemination of patient education materials, electronic health record changes to promote naloxone prescriptions, and availability of naloxone in pharmacies.Setting: Academic health system, San Diego, California.Practice description: University of California, San Diego Health (UCSDH), offers both inpatient and outpatient primary care and specialty services with 563 beds spanning 2 hospitals and 6 pharmacies. UCSDH is part of the University of California health system, and it serves as the county's safety net hospital.Practice innovation: In January 2016, a multisite academic health system initiated a system-wide overdose education and naloxone distribution program to prevent opioid overdose and opioid overdoseerelated deaths. An interdisciplinary, interdepartmental team came together to develop and implement the program. To strengthen institutional support, naloxone prescribing guidelines were developed and approved for the health system. Education on naloxone for physicians, pharmacists, and nurses was provided through departmental trainings, bulletins, and e-mail notifications. Alerts in the electronic health record and preset naloxone orders facilitated co-prescribing of naloxone with opioid prescriptions.Evaluation: Electronic health record reports captured naloxone prescriptions ordered. Summary reports on the electronic health record measured naloxone reminder alerts and response rates.Results: Since the start of the program, the health system has trained 252 physicians, pharmacists, and nurses in overdose education and take-home naloxone. There has been an increase in the number of prescriptions for naloxone from a baseline of 4.5 per month to an average of 46 per month during the 3 months following full implementation of the program including implementation of electronic health record alerts.Conclusion: Initiating and implementing an overdose education and naloxone distribution program is feasible in an academic health system. (C) 2017 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.