From: Jerry Robinson Pharm.D.
To: Pharmacists
Sent: Monday, September 17, 2018 5:30:59 PM
Subject: Multimodal pain management surgery wide is coming

Similar information was sent to nursing this afternoon. Please review the information and link below to make sure you can speak to multimodal pain management changes.

Multimodal pain management is moving to the standard of care for perioperative pain management in most surgery patients. This strategy incorporates scheduled medications with the use of PRN narcotics if required.

Order sets will be updated and IT will notify you when these change on September 18th. Please make sure that order sets received after the IT notification for surgery are the same as the order set listed on Pulse. I cannot provide the actual date that will show at the bottom of the new order sets at this time. Due to Cerner, this project to reduce IV narcotic use and to improve perioperative pain management has been in process for months and I am excited to finally announce this. Order sets already having multimodal incorporated were not affected with this update.

Over 20 surgical order sets will be updated in this implementation of multimodal analgesia.

A new ADULT General Multimodal Analgesia PreOP and PostOp order sets have been created. [Note: These are very similar to the order sets utilized in Joint Camp patients currently.]

Important: the Q position will only enter the Oxycodone or Ultram listed on the PreOp order set for ORTHOPEDIC Multimodal [Joint Camp patients] at this time. The new Adult General Multimodal Analgesia PreOp orders to enter Oxycodone or Ultram will not be entered at this time unless specifically requested for a patient due to workload issues. This addition to the order set was added to reduce the need for narcotic overrides and use of PCAs in Joint Camp patients where multiple patients arrive to the unit at the same time.

Please check out the flyer here for additional information.

Thanks.

Jerry Robinson, Pharm.D., BCPS

Clinical Specialist STICU/Co-Chairperson, Medication Safety Committee Department of Pharmacy Huntsville HospitalQ