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Decreasing Opioid Use in Pediatric Lower Extremity Trauma: A Quality Improvement Project

Jennifer Weiner, Rosie Zeno, Susan E Thrane

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |July 12, 2020
    PubMed

    Insights

    Routine consultations with Certified Child Life Specialists (CCLS) significantly reduced pain scores and opioid use in hospitalized children with traumatic injuries. This nonpharmacologic approach enhances pain management and coping skills.

    Area of Science:

    • Pediatric Surgery
    • Pain Management
    • Child Psychology

    Background:

    • Perioperative anxiety in children elevates postoperative pain and complication risks.
    • Nonpharmacologic pain management strategies, such as those provided by Certified Child Life Specialists (CCLS), are crucial adjuncts.

    Purpose of the Study:

    • To evaluate the impact of routine CCLS consultations on pain management outcomes in pediatric orthopedic trauma patients.
    • To compare pain scores, medication use, and other clinical outcomes between patients who received CCLS consults and those who did not.

    Main Methods:

    • Retrospective chart review of pediatric patients with traumatic lower extremity injuries requiring surgery.
    • Comparison of daily pain scores, opioid and nonopioid medication doses, physical therapy attempts, and length of stay between groups.

    Main Results:

    • A clinically significant reduction in pain rating scores was observed following routine CCLS consults.
    • Opioid utilization decreased significantly in patients who received CCLS support.

    Conclusions:

    • Implementing routine CCLS consultations for pediatric trauma admissions effectively reduces opioid consumption.
    • CCLS interventions provide valuable pain management resources and promote adaptive coping skills in children, potentially leading to long-term benefits.
    Abstract

    Keywords:
    Nonpharmacologic pain managementchild life specialistlower extremity traumaopioid crisispediatric orthopedics

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