Advocate Trinity Hospital

Presentation Notes

Quality Improvement poster presented at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.


Background: The opioid crisis in the United States, related to the misuse and addiction to prescribed opioid medications, continues to reach epidemic proportions. Millions of Americans who undergo surgical procedures routinely receive opioid prescriptions at discharge. Alternative pathways to post-operative pain management need to be explored and utilized. For many surgical patients, nerve blocks can reduce opioid use and expedite mobility.

Local problem: In a 2020 Chicago Department of Public Health study, a 52% increase in opioid related deaths were identified between 2019 and 2020. In our community, the majority of pre-operative joint replacement patients report taking opioid medications regularly due to severe arthritis pain. They are dependent on their medications to perform their activities of daily living.

Method: Various nerve blocks given were primarily for orthopedic procedures. Data was collected over a two- year period to determine the efficacy of the nerve blocks and patient’s need for opioid medications post-operatively. The data collection was obtained through direct patient interviews conducted over the first two days post-operatively.

Results/Conclusions: The average time span of analgesia from the nerve blocks was an average of 20.5 hours. Many patients reported that after the block wore off, their pain was managed with over the counter, non-opioid medication. If opioid medications were needed for pain, their use was reported to be short term per the patient’s responses. Immediate long term opioid medication use was eliminated.

Implications for practice: With the use of nerve blocks, there is a reduced need for opioid prescriptions post-operatively. Several different nerve block modalities have been recently explored to include pain control for abdominal surgical procedures. Data collection will be continued to evaluate the efficacy of nerve blocks and the decreased use of opioids.

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