Utilizing a Multidisciplinary Team Approach to Opioid Stewardship in a Long-Term Acute Care Hospital
Date of Completion
Summer 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Dr. Corrine Cochran
Second Advisor
Dr. Melanie Brewer
Third Advisor
Dr. Adriane Stausurak
Abstract
Problem:
The opioid crisis continues to negatively affect patient safety and healthcare outcomes across the United States. Long-term acute care hospitals (LTACHs) care for medically complex patients who often require prolonged pain management and are at increased risk for opioid-related adverse events. At the project site, a 32-bed LTACH, 72% of reviewed patient charts included an opioid prescription upon admission, exceeding recommended prescribing benchmarks and identifying a gap in opioid stewardship practices. The absence of a standardized opioid stewardship program (OSP) and opioid risk screening process increased the risk of opioid misuse, dependency, and adverse patient outcomes.
Aim of the Project:
The aim of this quality improvement project was to improve opioid prescribing practices and patient safety by implementing a multidisciplinary OSP within a 12-week period in an LTACH setting.
Review of the Evidence:
Current evidence supports multidisciplinary OSPs as effective strategies for reducing inappropriate opioid prescribing, improving adherence to prescribing guidelines, and decreasing opioid-related adverse events. Literature also supports the use of opioid risk assessment tools, multimodal pain management strategies, and Plan-Do-Study-Act (PDSA) cycles to promote safe opioid prescribing and sustainable quality improvement outcomes.
Project Design:
This quality improvement project utilized the PDSA framework and the OhioHealth Change Management Model to guide implementation. A multidisciplinary team consisting of physicians, nurses, pharmacists, case managers, and therapists integrated the Opioid Risk Assessment Tool (ORAT) into admission workflows and opioid prescribing practices.
Intervention:
The intervention included staff education, ORAT implementation during admission assessments, multidisciplinary opioid prescription review, opioid tapering protocols for high-risk patients, and ongoing prescribing audits with performance feedback.
Significant Findings/Outcomes:
Average daily morphine milligram equivalents per patient decreased by 28%, and high-dose opioid prescriptions decreased by 35%. Opioid-related adverse drug events declined from 6.2% to 3.8%, while ORAT screening compliance increased from 42% to 94%. Patient pain scores and satisfaction remained stable throughout implementation.
Implications for Nursing:
Implementation of a multidisciplinary OSP improved opioid prescribing safety, reduced opioid-related harm, and supported evidence-based pain management. Nurses played a critical role through patient assessment, opioid risk screening, education, and monitoring. Findings support the integration of standardized opioid stewardship practices within LTACH settings to improve patient safety and healthcare outcomes.
Recommended Citation
Moore, Lesley, "Utilizing a Multidisciplinary Team Approach to Opioid Stewardship in a Long-Term Acute Care Hospital" (2026). Doctor of Nursing Practice (DNP) Scholarly Project. 65.
https://fuse.franklin.edu/dnp-project/65
Rights
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