NR565 Week 3 Collaboration Cafe Discussion
NR565 Week 3 Collaboration Cafe Discussion: Opioid CPG – Step-by-Step Guide
The first step before starting to write the NR565 Week 3 Collaboration Cafe Discussion, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment.
It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.
How to Research and Prepare for NR565 Week 3 Collaboration Cafe Discussion
The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list.
You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.
How to Write the Introduction for NR565 Week 3 Collaboration Cafe Discussion
The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.
How to Write the Body for NR565 Week 3 Collaboration Cafe Discussion
The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.
How to Write the In-text Citations for NR565 Week 3 Collaboration Cafe Discussion
In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:
The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.
How to Write the Conclusion for NR565 Week 3 Collaboration Cafe Discussion
When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.
How to Format the Reference List for NR565 Week 3 Collaboration Cafe Discussion
The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication.
Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:
References
Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456
Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.
NR565 Week 3 Collaboration Cafe Discussion Opioid CPG Instructions
Preparing the Collaboration Café
Follow these guidelines when completing each component of the Collaboration Café. Contact your course faculty if you have questions. Have a look at NR565 Week 3 Hypertension and Lipid Protocol.
General Instructions
Step 1: Review your assigned client scenario below. Your assigned client is based on the first letter of your last name in the chart below. The scenarios below depict inappropriate or excessive opioid use.
| Last Name | Client from Week 3 Lesson |
| A – E | David Ball, a 45-year-old male, is currently taking hydromorphone (Dilaudid) 4mg PO QID for chronic pain from fibromyalgia. |
| F – J | Terrence Brown, a 71-year-old male, is currently taking oxycodone 10mg/acetaminophen 325mg (Percocet) QID for neuropathic pain from diabetic peripheral neuropathy. |
| K – N | Geraldine Marzec, a 60-year-old female, is currently taking oxycodone ER (OxyContin) 20mg PO BID for chronic low back pain from an old injury. |
| O – R | Bola Ogunwande, a 31-year-old female, is currently taking oxymorphone ER (Opana) 5mg PO QID for migraines. |
| S – V | Le Chin, a 54-year-old male, is currently taking morphine sulfate (MS Contin) 30mg PO TID for dental pain. |
| W – Z | Marianne Rubenstein, an 80-year-old female, is currently taking hydrocodone 10mg/acetaminophen 325mg (Norco) PO QID for osteoarthritis. |
Step 2: Review the client’s case and CDC’s (2022) CPG related to opioid prescribing. You can use the Ctrl F function on your keyboard to assist in your review of the CPG to help find keywords.
Step 3: Analyze and critique your assigned case and answer the prompts below with explanation and detail, providing complete references for all citations.
Step 4: Reply to peers with different assigned clients.
Include the following sections:
- Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
- Introduce your client, their situation, and their medication regimen. Calculate and describe your client’s daily morphine milligram equivalents (MME). Provide your calculations and a rationale for your answer. Refer to this link.for reference.
- Discuss how your client’s daily MME falls above or below the threshold for additional consideration. How do you know?
- Consider the need for additional considerations given the total MME, the limited information available in the case, and the risks for overdose. What other consultations, prescriptions, and education may be required given their current individual circumstances and medications?
- Consider the appropriateness of your client’s medication regimen. According to the CPG, what other prescriptions may be more appropriate for their individual circumstances? If no change is needed or warranted according to the CPG, state that with support from the CPG.
NR565 Week 3 Collaboration Cafe Discussion Example
Opioid Medication Case Study
- Geraldine Marzec, a 60-year-old female, is currently taking oxycodone ER
(OxyContin) 20mg PO BID for chronic low back pain from an old injury. Based on her
dosing, the patient is at 60 MME/day. This is calculated based on the information
provided: 20mg PO BID = 40mg total per day; the conversion factor for oxycodone is
1.5 (Dowell et al., 2022). Therefore, 40mg/day x 1.5 = 60 MME/day. This patient’s
MME is considered high, with the threshold starting at 50 MME/day. According to the
CDC (2016), the risk of overdose doubles with dosages at or above 50 MME/day.
Therefore, clinicians should evaluate individual benefits and risks when prescribing
opioid pain medications that result in a daily MME of 50 or higher (Rosenthal &
Burchum, 2021, p. 192). - The client’s daily MME falls above the threshold for additional consideration. It is
considered a medium opioid dosage falling within the 36 to 120 MME/day range,
according to the CDC (Dowell et al., 2022). The CDC reports that many patients do
not experience improved pain or function from higher opioid dosages to >=50
MME/day but are instead exposed to higher risks for complications and are more
likely to yield less benefits for pain and functions relative to these risks. In fact, the
CDC discusses clinical evidence reviews of several observational studies which
found that opioid dosages for chronic pain of 50 to <100 MME/day were associated
with increased risks for opioid overdose by factors of 1.9 to 4.6 compared with
lower dosages of 1 to < 20 MME/day. Therefore, prior to a clinician increasing the
total opioid dosage to 50 MME/day or above, they should carefully reevaluate
individual benefits and risks (Dowell et al., 2022). - According to the CDC (2016), the risk of overdose doubles with dosages at or above
50 MME/day. Additional considerations should include reviewing the patient’s
history of controlled substance prescriptions using the state prescription drug
monitoring program (PDMP) data to determine if the patient is receiving opioid
dosages or combinations that could be dangerous and place them at risk for
overdose. Reviewing the PDMP should also be done periodically while the patient is
on long-term opioid therapy for chronic pain, with every prescription to every 3
months (Rosenthal & Burchum, 2021, p. 192). In addition, clinicians should
consider urine drug testing before starting opioid therapy and at least annually to
assess for prescribed medications as well as other controlled prescription and illicit
drugs. Lastly, opioid pain medication and benzodiazepines should not be
prescribed concurrently, whenever possible (Rosenthal & Burchum, 2021, p. 192). It
is extremely important that the patient understands the risks versus benefits of
using opioids to treat chronic pain (noncancer-related). Setting pragmatic goals regarding pain and function should be done between the patient and provider prior to starting opioid pain medications, and the goals should be reevaluated at each follow-up appointment. If the benefits no longer outweigh the risks of opioid therapy, the patient and provider should develop a new plan of care (Rosenthal & Burchum, 2021, p. 192). Considering my patient’s higher dosage, it is also important to provide good, thorough patient education on risks and potential side effects. Addiction, abuse, and misuse are potential risks of prolonged use of OxyContin which can lead to overdose and death. The patient may also be susceptible to life-threatening respiratory depression and the risk for this increases at age 65 and older (Purdue Pharma, 2024). Other serious adverse reactions include apnea, respiratory arrest, circulatory depression, hypotension, or shock. The most common adverse reactions in adult patients are constipation, nausea, somnolence, dizziness, pruritus, vomiting, headache, dry mouth, asthenia, and sweating (Purdue Pharma, 2024). - According to CPG guidelines (Dowell et al, 2022), unless contraindicated, NSAIDs should be used for low back pain as is seen in this patient. NSAIDs should also be used in cases with painful musculoskeletal injuries, dental pain, postoperative pain, and kidney stone pain. However, due to my patient’s older age, NSAIDs should be used with consideration of use, dose, and duration. The CPG recommends using NSAIDs at the lowest effective dose and shortest duration, if possible. If there are no contraindications, clinicians can also prescribe duloxetine for chronic low back pain. There is the potential, however, that NSAIDs may be inappropriate for use in older adults with chronic pain due to the higher risk for adverse effects with longterm use (Dowell et al., 2022). Therefore, it is important to perform a thorough assessment regarding past medical history and medication (including supplements) regimen so that the clinician can make the safest clinical decision. The CPG also states that opioid pain medications should not be considered firstline or routine therapy for chronic pain and clinicians should weigh the benefits and risks of opioid medications if non-opioid approaches fail (Dowell et al., 2022). However, if there is a serious illness in a patient with poor prognosis for return to previous level of function, contraindications to other therapies, and clinician and patient agree that the overriding goal is comfort, then opioid medications may be appropriate regardless of previous therapies used (Dowell et al., 2022).
References
Centers for Disease Control and Prevention (CDC). (2016, March 14). Calculating total
daily dose of opioids for safe dosage. https://stacks.cdc.gov/view/cdc/38481
Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC clinical
practice guideline for prescribing opioids for pain – United States. Recommendations and
reports, 71(3), p. 1-95. http://dx.doi.org/10.15585/mmwr.rr7103a1
Purdue Pharma. (2024). Important safety information. Oxycontin.
https://www.oxycontin.com/
Rosenthal, L. & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice
nurses and physician assistants (2nd ed.). Elsevier. Chapter 24, p. 192.
