P221 Variable dose analgesia administration and pain score documentation following the introduction of an electronic medical record

Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims In late 2023, a metropolitan hospital transitioned from paper prescribing to an Electronic Medical Record (EMR). Since the introduction of EMR, if variable dose analgesia is to be prescribed, a singular, higher strength dose is to be charted, with the dose range specified in the comments However, as the comments are not readily visible (See figures 1 and 2), we suspect that the higher dose is being administered on a more frequent basis. Aim: To evaluate the impact of EMR implementation on the administration of variable dose analgesia and the corresponding documentation of pain scores.Methods A retrospective data collection of patients who had been prescribed Oxycodone 5–10 mg during day one to three postoperatively. The data collection included 51 patients from a pre-EMR cohort, and 50 patients from a post-EMR cohort. The data was then reviewed in respect as to whether the lower (5 mg) or higher (10 mg) dose was administered on each individual occasion, as well as the total oral morphine equivalent dosage (OMED) administered during the 3 day window. The data was also reviewed to determine if the patients pain score was documented within a one hour window of analgesia administration.Results Our data showed that after EMR implementation, higher opioid doses were given more often (54% vs 41%, p=0.01475), although the resulting increase in OMED (15.45 mg vs 12.75 mg) was not significant (p=0.7818). Further, the absence of pain score documentation within 1 hour of administration significantly increased (88% vs 55%)Abstract P221 Figure 1Medication viewAbstract P221 Figure 2Medication view with commentsConclusions The findings were presented to the Analgesic Stewardship Committee and key stakeholders, highlighting that EMR based variable dose charting led to increased opioid use, raising concerns about potential overmedication. As a result, EMR workflow processes are being reviewed and educational material has been widely distributed. These initiatives aim to enhance patient safety, with a reaudit planned to assess effectiveness and compliance following implementation