• Marilyn Bazinski, Catherine Lau, Brooke Clemons, Lisa Purser, Amy Kangwankij, Lena Ngo, Michael Lang, Brianna Besen, Kendall Gross, Amber Borucki, Matthias Behrends, Christine Miaskowski, and Hildy Schell-Chaple.
• Department of Nursing, UCSF Health, San Francisco, California. Electronic address: marilyn.bazinski@ucsf.edu.
• Pain Manag Nurs. 2024 Jun 1; 25 (3): 231240231-240.

BackgroundWithin the context of the opioid epidemic, changes needed to be made in the prescription and administration of analgesics. The purpose of this paper is to describe the development and implementation of a project that utilized a holistic pain assessment framework and introduced new order sets to guide the integration of nonopioid, opioid, and co-analgesics in a quaternary care medical center.MethodsAn interdisciplinary team updated policies and procedures for pain assessment and opioid administration and created new analgesic order sets for both adult and pediatric patients. Following requisite approvals, these order sets were integrated into the electronic health record. Education of clinicians, patients, and caregivers was provided to facilitate implementation of these new clinical practices.ResultsPrescribers' levels of adherence with the use of the pain order sets ranged from 80% to 90% and no adverse effects were reported. Education of nursing staff was incorporated into hospital orientation. Ongoing evaluations are providing insights into how the new policies and procedures can be optimized to ensure reliable, safe, and effective pain management.ConclusionsSince the implementation of the opioid optimization project, adherence with the tiered, multimodal approach to analgesic prescribing is high. Next steps include both qualitative and quantitative evaluations of the benefits and challenges associated with this practice change. For example, systems will be developed to monitor nurses' adherence with the implementation of the pain order sets and the use of both pharmacologic and nonpharmacologic pain management interventions.Copyright © 2024 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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