Nurse Practitioner Opioid Prescribing and Safety Measure Utilization Patterns in Ontario: An Explanatory Sequential Mixed Methods Study

Background: Across Canada, opioid-related hospitalizations, emergency department visits, and mortality have increased. A literature gap exists related to opioid prescribing safety measure utilization patterns among nurse practitioners (NPs). Purpose: The objectives of this study were (a) identify opioids prescribed by NPs in Ontario for pain, (b) examine when opioids, (c) explore factors associated with utilization, (d) survey NPs’ confidence. Methods: An explanatory sequential mixed method approach was used quantitative qualitative results a that achieves methodological triangulation. distributed 2,094 practicing between May August 2020. After analysis 158 completed surveys, phase conducted involved one-on-one semi-structured interviews 14 who the agreed follow up. Results: top three acute chronic pain reported hydromorphone followed acetaminophen codeine oxycocet. opioid-treated conditions (1) fracture, (2) postoperative (3) joint or muscle strain/sprain. cancer/palliative care, low back osteoarthritis. Results from demonstrated inpatient measures less often than community because institutional policies aid safe prescribing. NP preference rooted its appealing side effect profile ability prescribe smaller doses. Limiting medication supply considered most effective measure. more confident established diagnoses unclear diagnoses, history addiction, patients taking high dosages opioids. Conclusion: Findings research can inform curricula changes incorporate education populations which expressed confidence tapering on doses Gina Pittman, MN, NP, PhD, is an Assistant Professor, Faculty Nursing, University Windsor, Ontario, Canada. Jody Ralph, RN, BSc, BScN, MSc, Associate Windsor. Michelle Freeman, BA, MScN, CPPS, Professor Emeritus, Laurie MSN, Sylwia Borawski, third-year undergraduate nursing student,