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Reducing Opioid-Induced Constipation Post-Cardiac Surgery: An Improvement Project in a Pediatric Cardiac Intensive

Miranda A Rodrigues1, Tochie Lofton, Sebastian C Tume

  • 1Heart Center (Dr Rodrigues) and Cardiac Intensive Care Unit (Drs Tume and Lemming), Texas Children's Hospital, Houston; and Talent Management, Mobile Infirmary Medical Center, Mobile, Alabama (Dr Lofton).

Journal of Nursing Care Quality
|January 20, 2022
PubMed

Insights

Implementing electronic order sets and assessment tools reduced constipation in pediatric cardiac patients. Increased use of bowel regimens shows promise for improving pain management and hospital stays.

Area of Science:

  • Pediatric Cardiac Surgery
  • Pain Management
  • Gastrointestinal Complications

Background:

  • Opioid therapy for pain management in pediatric postoperative cardiac patients can lead to constipation.
  • Underutilization of constipation prophylaxis prolongs hospital stays and hinders effective pain management.

Purpose of the Study:

  • To evaluate the impact of an electronic order set and validated assessment tool on constipation incidence in pediatric postoperative cardiac patients.
  • To improve the use of prophylactic bowel regimens in this high-risk population.

Main Methods:

  • Retrospective review of 50 patients' medical records for baseline data.
  • Provider knowledge and practice survey.
  • Implementation of an electronic order set with decision support and a validated assessment tool for constipation risk.

Main Results:

  • A 21.5% decrease in postoperative constipation incidence was observed postintervention.
  • A 57% increase in ordered bowel regimens was noted.
  • Changes were not statistically significant but indicated a positive trend.

Conclusions:

  • Enhanced focus on prophylactic bowel regimens is crucial for reducing constipation risk in pediatric cardiac surgery patients.
  • Interventions like electronic order sets can support improved management of opioid-induced constipation.
Abstract

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