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

J Nurs Care Qual. 2022 Jul-Sep;37(3):213-217. doi: 10.1097/NCQ.0000000000000616. Epub 2022 Jan 19.

Abstract

Background: Pain management with opioids and underutilization of prophylaxis for constipation can prolong a patient's hospital length of stay and impede pain management efforts.

Problem: In pediatric postoperative cardiac patients, opioid therapy is a common approach to pain management but often places them at greater risk for constipation due to anatomy and age.

Methods: A retrospective review of 50 patients' medical records for baseline data was conducted, and a survey evaluated providers' current knowledge and practice.

Interventions: The intervention was an electronic order set that provided decision support. Additionally, prophylactic measures were supported by a validated assessment tool that created a common language to report constipation risk.

Results: Although not statistically significant, postintervention data demonstrated a 21.5% decrease in postoperative constipation and a 57% increase in ordered bowel regimens.

Conclusion: More focus is needed toward prophylactic bowel regimens to reduce the risk in this already high-risk population.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Cardiac Surgical Procedures* / adverse effects
  • Child
  • Constipation / chemically induced
  • Constipation / drug therapy
  • Constipation / prevention & control
  • Humans
  • Intensive Care Units
  • Opioid-Induced Constipation*

Substances

  • Analgesics, Opioid