Vaso-occlusive crisis (VOC) is the leading cause of hospital admissions in pediatric patients with sickle cell disease (SCD). Achieving the maximum opioid dose earlier in the admission is associated with shorter lengths of stays, allowing children suffering from SCD to spend less time in the hospital and decreasing their risk for depression and other long-term hospital-associated complications.
The purpose of the project was to investigate whether individualized pain plans (IPPs) for patients with SCD admitted for VOC could decrease the time to administration of the first dose of opioids in inpatient pediatric hematology hospitalizations. The goal was to increase the total number of IPPs for patients with SCD and decrease the time to administration of the first opioid. This retrospective cohort project was performed at Riley Hospital for Children’s inpatient hematology-oncology floor. The population included all patients with SCD admitted for VOC. IPPs were created for patients who were admitted two or more times in the past 3 months. IPPs include a regimen of analgesics and opioids, with recommendations for exact dosages specific to the patient to be initiated immediately upon patient arrival to the floor. Retrospective data was collected to investigate whether the implementation of IPPs significantly decreased the time to administration of the patient’s first opioid dose. Data suggests that IPPs can reduce the time to administration of the first opioid to patients with SCD in the inpatient setting. Pain plans will continue to be used on this unit and physicians and nurses will continue to be educated on how and when to implement pain plans for patients with SCD.
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