Week 8; Peer response Rajpati

PICOT

              The basis for the proposed DNP project is the following question: For patients, 18 years and older, in a primary care clinic, does the use of the Opioid Risk Screening Tool improve the identification and referral rates of chronic pain patients to a pain clinic or pain specialist in 8-10 weeks?

             The proposed project implements the opioid risk tool (ORT) in the primary care setting. The ORT tool has been vetted for reliability, validity, ease of use, and previous service in similar clinical settings (Weber 2005). The implementation process guiding me is the Knowledge to Action theory (Petzold et al., 2010). Leadership qualities of communication, knowledge of the topic, and experience in the clinical setting are leadership qualities that will lead to a higher likelihood of successful project implementation (Porter-O'Grady, 2018). Nurses are historically leaders and advocates for people in our communities (Porter-O'Grady, 2018). Using the leadership skills, I have learned and developed throughout this program, I will meet with stakeholders to discuss the implementation plan.

             The implementation process is to educate the staff members by giving them access to the tool and time for questions. Following education, the adult client of the clinic receives the test. Once the patient completes the ORT test, the nurse will score the test and hand it to the medical provider. The medical provider will then discuss the results with the patient. Milestones for this project are the receptionist handing out the tool, the nurse scoring it, and the medical provider reviewing the patient's results. Achieving this milestone will be performed by being on-site throughout the implementation process.

            I have started implementing the ORT test. So far, I have had occasions when the receptionist forgets to give the test on the initial visit of the patient with CNCP. In these cases, the staff gave the test to the patients once admitted to being seen by a provider. So far, everything seems to be progressing slowly as the team becomes accustomed to instituting this change in practice.

References

Petzold, A., Korner-Bitensky, N., & Menon, A. (2010). Using the knowledge to action process

             model to incite clinical change *. Journal of Continuing Education in the Health Professions, 30(3), 167–171.                                                              https://doi.org/10.1002/chp.20077

Porter-O'Grady, T. (2018). Leadership advocacy. Nursing Administration Quarterly, 42(2), 115–122.                                                                                          https://doi.org/10.1097/naq.0000000000000278

Webster, L.R., & Webster, R. M. (2005). Predicting aberrant behaviors in opioid-treated patients:

              Preliminary validation of the Opioid Risk Tool. Pain Medicine (Malden, Mass.). 6(6), 432-442.                                                                                        https://pubmed.ncbi.nlm.nih.gov/31585357/