April 7, 2022

Analgesic stewardship pilot program on the way

Northern Health is working with Safer Care Victoria, Acute Pain Service (APS) and surgical teams to create a pilot program focusing on analgesic stewardship across Northern Hospital, aiming to produce significant, positive changes for our patients.

Danni Miatke, Project Lead and Grade 3 Analgesic Stewardship Pharmacist, explained one of the priority actions for Australia, on the basis of World Health Organization recommendations and the global patient safety challenge, is to develop a national guideline for high-risk medicines, with analgesics and opioids a part of this.

“We are looking at safer ways to prescribe and administer opioids and other analgesics within the hospital, and, in particular, looking at peri-surgical patients, and how we prescribe strong analgesics before and after surgery. We are also looking at the quantities and strengths we send patients home with,” she explained.

This state-wide, multi-site project includes six selected health services across Victoria – Northern Health, Eastern Health, Albury-Wodonga Health, Barwon Health, Melbourne Health and Peninsula Health.

“It’s a very fast turnaround with this project, and we are hoping to prove change within 18 weeks,” Danni added.

Some of the tasks the team is facing now is setting up an analgesic stewardship committee, creating a new procedure to guide prescribing and providing education around this, as well as collecting data and proving the positive change.

“Probably the biggest challenge will be rolling out the education, and we will be targeting surgical units and patients,” she added.

Preliminary data the team has been working on has shown that surgical patients who have experienced an adverse event related to their analgesia had a four times longer stay in hospital compared to other patients that underwent similar surgery. This data highlights, not just the need for a program, but the need for change in analgesic prescribing and additional education around safety.

“We’d like to draw attention to the analgesic prescribing procedure that will soon be released and we’ll be rolling out education shortly as well. This is a great program for Northern Health, and we are lucky to be working with Safer Care Victoria on this, as not every health service that applied was selected to participate,” she added.

Anaesthetist and Pain Medicine Specialists, Dr Sarah Donovan and Dr Moira Rush, added their support to the program and highlighted the excellent opportunity for the service to promote safer and more effective analgesic use, as well as greater continuity of care through improvements in both patient education and information provided to primary health providers on discharge.

”While our patient population is complex and diverse, the stewardship program will assist with discharge prescription advice for all patients at Northern Health. We want to better engage with GPs to ensure that patient care is consistent across the acute and primary care settings,” Dr Rush added.

The Acute Pain Service (APS) and Pharmacy are confident that when the results of the pilot demonstrate the expected positive change, there will be support for an ongoing full-time Analgesic Stewardship Pharmacist, so the initiative can be expanded to cover the whole health service, regardless of the patient’s clinical team.