Nurse Practitioners: A Case Study

Decent Essays
Shepperd, J. R., & Hale, S. E. (2016). Nurse Practitioners in the World of Pain Management: A Cautionary Tale. The Journal for Nurse Practitioners, 12(2), 102-108. doi:10.1016/j.nurpra.2015.10.006

This work has the purpose of informing Nurse Practitioners of the potential dangers and pitfalls within prescribing pain medication to patients. It uses a methodology of first giving an example of a case where a nurse practitioner was charged with running a pill mill due to her numerous prescriptions for opioid pain medication. This study went on to list multiple ways that nurse practitioners and other providers can prescribe these medications safely base off of recommendations from the Model Policy on the Use of Opioid Analgesics in the Treatment
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Research was done to identify clinical guidelines, clinical pathways, and systematic reviews. Further research was then conducted on recently published trials to provide the numerical data. Systematic reviews where assessed using AMSTAR and evidence quality was assessed using a modified GOAL scale. The evidence found by this showed that self-management and education had a small effect on pain and only in the short term. Psychosocial therapy had a medium to large effect on pain in both the short and long term. Exercise also had a medium to large effect in both the short and long term. Manual therapy had a small effect in the short term. Pharmacological (analgesics) had a medium effect on pain in the short term. Corticosteroids had a medium to large effect on pain in the short term for shoulder and knee pain. Surgery had inconsistent results with research only being conducted for short term relief of pain. This report allows me to compare and contrast the different measures besides pharmacological interventions for efficacy. By including this research into my article I can provide increase validity in providing recommendations for the treatment of pain by providers. There is potential for bias in the selection process of research to include, while the author did provide inclusion and exclusion criteria, some research was not included simply because it was …show more content…
This rate of opioid prescriptions led the health department to begin research on ways to decrease the number of prescriptions. In this study they provided pre and post surveys to 1182 prescribers in the area, after the pre-survey was taken they then provided education to all providers and the risk and benefits of opioid pain medication. The survey consisted of three questions which were taken from recommendations by the states board of health. These recommendations are: 3 day supply of opioids is enough for acute pain, Avoid opioids in non-cancer chronic pain, and avoid high dose prescriptions. The study looked for improved knowledge and improved prescribing practices through the provider’s response to these three questions. Overall there was a 26% increase in the number of providers who correctly answered the first question, 9% for the second, and 36% for the third. The study also examined the number of prescriptions written for opioids pre and post education. There was a decreased from 889 per 10000 residents to 785 per 10000 residents. This study highlights potential ways to reduce morbidity and mortality in prescribing opiates while still allow for the writing of the prescriptions for acute pain. Limitations for this study is the small sample size and the area in question; with this burrow having more opioid prescriptions than any other burrow in New York, would others have

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