Nursing

Screen all patients and caregivers.

• Check a patient’s electronic health record (EHR) and ask the patient about previous naloxone use.
• Check Rhode Island’s Prescription Drug Monitoring Program (PDMP) for clinical alerts and evidence of high-dose opioids (i.e., more than 50 oral Morphine Milligram Equivalents (MMEs) per day), long-acting opioid use, or opioid use for longer than 90 days.
• Screen all patients for a history or diagnosis of Substance Use Disorder (SUD), Alcohol Use Disorder (AUD), mental health conditions, respiratory or neurologic conditions that affect breathing, harmful use or misuse of opioids, and/or opioid overdose.
• Screen patients for use of Medication Assisted Treatment (MAT) to treat OUD.
• Screen all patients to identify use of opioids in combination with benzodiazepines, alcohol, anti-depressants, and/or sedatives.

Educate yourself, patients, and staff.

• Ask caregivers if they feel comfortable administering naloxone during an overdose in case a friend or loved one is experiencing a bad reaction to an opioid.
• Tell patients who are taking opioids about the potential for bad reactions that make breathing slow down or stop, leading to an overdose.
• Emphasize to patients that naloxone is an antidote and can save a life, just like a seatbelt or fire extinguisher.
• Tell patients and caregivers about what to expect after giving someone naloxone.
• Include a conversation about the importance of having naloxone on-hand as a standard part of opioid safety messages.
• Ensure all office staff know where to locate and how to use naloxone in case of an overdose.
• Review the signs and symptoms of opioid overdose and the legal protections under Rhode Island’s Good Samaritan Law.
• Sign and display these pledges on opioid safety.
• Print, hang, and distribute educational materials about naloxone.

Promote increased access to naloxone.

• Join the US Surgeon General and be a role model. Purchase and carry naloxone. Incorporate naloxone co-prescribing in EHRs, office protocols, and electronic prescribing systems.
• Co-prescribe naloxone to patients who are currently being prescribed syringes and needles.
• Stock naloxone in the office for emergency use and for direct dispensing to patients.
• Remind patients and staff that pharmacists can dispense naloxone and bill insurance companies without a prescription from a healthcare provider.
• If cost is a barrier for patients, help them enroll in a health insurance plan.

Register with the Prescription Drug Monitoring Program (PDMP) . Check the PDMP each time you dispense/prescribe a controlled substance to help prevent fraudulent prescriptions from being filled. This will also help identify suspected pharmacy/doctor "shopping." More

Contact us for PDMP support.