• Deborah Tedesco and James L Mayo.
• Orlando Health Aesthetic and Reconstructive Surgery Institute, Orlando, Florida. Electronic address: Deborah.Tedesco@orlandohealth.com.
• Pain Manag Nurs. 2020 Aug 1; 21 (4): 339-344.

BackgroundFlorida enacted legislation limiting opioid prescriptions and affecting the management of acute pain in the postoperative patient. Patients in a reconstructive surgery practice were receiving prescriptions for opioids as their primary method of pain management. Clinic providers identified a need to limit opioid prescriptions.AimThe aim of this quality improvement initiative was to decrease the number of opioids prescribed while effectively managing pain in women undergoing mastectomy and breast tissue expander placement.DesignThis is a quality improvement project.MethodsThe Model for Improvement was used as a framework for this project. An evidence-based pain management plan was developed after a review of the breast reconstruction surgery literature. The plan incorporated preoperative patient and family education and the standard use of preemptive analgesia, intraoperative nerve blocks, and postoperative multimodal analgesia in all patients undergoing mastectomy with breast tissue expander placement. Patient and family education and perioperative pain management were provided to patients, and the number of opioid tablets prescribed was tracked.ResultsBetween January 2018 and August 2019, the average number of opioid tablets prescribed per patient decreased from 84.7 to 8.4.ConclusionsOpioid prescriptions can be decreased in women undergoing breast reconstruction with the use of patient education and multimodal analgesia.Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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