Dispensing a Naloxone Kit at Hospital Discharge: A Retrospective QI Project.

Area of Science:

• Public Health
• Pharmacology
• Healthcare Quality Improvement

Background:

• The opioid epidemic necessitates harm reduction strategies to prevent overdose deaths.
• Hospitalized patients at risk for opioid-related adverse events may not receive necessary take-home naloxone.
• Improving naloxone coprescription at discharge is a key quality improvement goal.

Purpose of the Study:

• To implement and evaluate a quality improvement project to increase naloxone kit coprescription at patient discharge.
• To establish a harm reduction strategy for hospitalized patients at high risk of opioid overdose.

Main Methods:

• An interdisciplinary team developed and implemented a naloxone distribution program on a medical unit.
• Criteria for identifying high-risk patients, screening workflows, and patient/staff education were established.
• Naloxone kit distribution data were collected and analyzed for seven months pre- and post-implementation.

Main Results:

• Naloxone kit distribution increased significantly from 2 patients preimplementation to 64 patients postimplementation.
• High-risk criteria included high-dose opioid prescriptions, concurrent opioid and benzodiazepine use, substance use disorder history, and medication-assisted treatment.
• The majority of patients (86%) received naloxone kits at minimal personal cost (<$1).

Conclusions:

• The unit-based pilot project successfully identified high-risk patients for opioid overdose.
• The project effectively provided naloxone kits and education at hospital discharge.
• This initiative demonstrates a feasible harm reduction strategy within a hospital setting.