• G Randy Smith, Sridevi Ramalingam, Shuhan Zhou, Chen Yeh, Jungwha Lee, and Kevin J O'Leary.
• Division of Hospital Medicine, Department of Medicine.
• Pain Med. 2022 Apr 8; 23 (4): 669-675.

ObjectiveTo determine the efficacy of a program to limit the use of the intravenous (IV) push route for opioids on the experience of pain by inpatients and on associated safety events.DesignRetrospective cohort study.SettingTwo inpatient general medicine floor units at an urban tertiary care academic medical center.Subjects4,752 inpatient opioid recipients.MethodsPatients in one unit were exposed to a multidisciplinary intervention to limit the prescription of opioids via the IV push route, with the other unit used as a control unit. The primary study outcome was the mean numeric pain score per patient during the hospital stay. Secondary measures included the hospital length of stay and postdischarge patient satisfaction. Fidelity measures included the percentage of the patient population exposed to each opioid administration route and the amount of opioid administered per route. Safety measures included patient disposition, transfer to intensive care, and incidence of naloxone administration.ResultsThe intervention was successful in decreasing both the percentage of patients exposed to IV push opioids and the amount of opioid administered via the IV push route, but no associated changes in other study outcomes were identified.ConclusionsFor the treatment of acute pain in medical inpatients, no evidence of benefit or harm was identified in relation to an increase or decrease in the use of the IV push opioid route.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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