1. Kamendat, Josephine DNP, RN
  2. Dabney, Beverly W. PhD, RN
  3. McFarland, Marilyn PhD, RN, FNP-BC, CTN-A
  4. Gilbert, Gregory E. EdD, MSPH, PStat(R)
  5. Richards-Weatherby, Kathleen MSA, RN, BSN


Background: Opioid-induced respiratory depression (OIRD) is a serious adverse reaction associated with opioid administration.


Local Problem: The purpose of this quality improvement study was to evaluate the impact of implementing a clinical practice guideline for OIRD in a medical-surgical setting lacking standardized monitoring techniques and reporting criteria for patients receiving opioid analgesia.


Methods: An American Society for Pain Management Nursing protocol was implemented in 4 medical/surgical units. The impact on OIRD-related nurse knowledge, documentation, and opioid-related rapid response calls was measured pre- and postimplementation.


Results: Nurse OIRD-related knowledge significantly increased. The number of naloxone administrations associated with prior intravenous opioid analgesic administration did not significantly change. However, there was a significant decrease in the postimplementation number of respiratory distress-related rapid response calls.


Conclusions: Implementation of the American Society for Pain Management Nursing guidelines had a positive impact on knowledge, documentation, early intervention of OIRD, and the number of opioid-related rapid response calls.