• Anoush Kalachian, Judith Barberio, and Jill Cox.
• Englewood Health, Englewood, New Jersey. Electronic address: Anoush.Costanian@EHMCHealth.org.
• Pain Manag Nurs. 2024 Jun 1; 25 (3): 211216211-216.

PurposeTo determine whether the elimination of extended release (ER) opioids in the multimodal medication regimen of total knee replacement (TKR) patients resulted in improved patient outcomes.DesignRetrospective cohort quality improvement.MethodsThis project utilizes a retrospective chart review to evaluate an institution's current postoperative pain protocol. The outcomes of interest include mean hospital length of stay, discharge disposition, mean pain score, antiemetic use, mean opioid dose used, and number of opioid discharge prescriptions.Results, Conclusions, And Clinical ImplicationsSixty patients were reviewed with a mean age at 70 years for both the pre-protocol (n = 36) and post-protocol groups (n = 34). There was a reduction in antiemetic use, t(59) = 2.2, p = .03 and length of stay, t(58) = 1.0, p = .33, and more discharges to home than rehab, x2 = 60, p < .001. All patients received 30 tablets of only one opioid prescription upon discharge with no refill, either oxycodone-IR (82%, n = 49), hydromorphone (5%, n = 3), or tramadol (12%, n = 7). The project, aimed to reduce opioid overprescription and overconsumption, has the potential to improve prescribing practices, promoting patient safety and healthcare quality by supporting the current guidelines that recommend against using ER opioids for the study population.Copyright © 2024 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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