The basis for the proposed DNP project is the following question: For patients, 18 years and older, in a primary care clinic, does the use of the Opioid Risk Screening Tool improve the identification and referral rates of chronic pain patients to a pain clinic or pain specialist in 8-10 weeks? The proposed project implements the opioid risk tool (ORT) in the primary care setting. The ORT tool has been vetted for reliability, validity, ease of use, and previous service in similar clinical settings (Weber 2005). The implementation process guiding me is the Knowledge to Action theory (Petzold et al., 2010). Leadership qualities of communication, knowledge of the topic, and experience in the clinical setting are leadership qualities that will lead to a higher likelihood of successful project implementation (Porter-O’Grady, 2018). Nurses are historically leaders and advocates for people in our communities (Porter-O’Grady, 2018). Using the leadership skills, I have learned and developed throughout this program, I will meet with stakeholders to discuss the implementation plan. The implementation process is to educate the staff members by giving them access to the tool and time for questions. Following education, the adult client of the clinic receives the test. Once the patient completes the ORT test, the nurse will score the test and hand it to the medical provider. The medical provider will then discuss the results with the patient. Milestones for this project are the receptionist handing out the tool, the nurse scoring it, and the medical provider reviewing the patient’s results. Achieving this milestone will be performed by being on-site throughout the implementation process. I have started implementing the ORT test. So far, I have had occasions when the receptionist forgets to give the test on the initial visit of the patient with CNCP. In these cases, the staff gave the test to the patients once admitted to being seen by a provider. So far, everything seems to be progressing slowly as the team becomes accustomed to instituting this change in practice. Petzold, A., Korner-Bitensky, N., & Menon, A. (2010). Using the knowledge to action process model to incite clinical change *. Journal of Continuing Education in the Health Professions, 30(3), 167–171.                                                              https://doi.org/10.1002/chp.20077 Porter-O’Grady, T. (2018). Leadership advocacy. Nursing Administration Quarterly, 42(2), 115–122.                                                                                          https://doi.org/10.1097/naq.0000000000000278 Webster, L.R., & Webster, R. M. (2005). Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the Opioid Risk Tool. Pain Medicine (Malden, Mass.). 6(6), 432-442.                                                                                        https://pubmed.ncbi.nlm.nih.gov/31585357/

The proposed Doctor of Nursing Practice (DNP) project aims to investigate whether the use of the Opioid Risk Screening Tool (ORT) improves the identification and referral rates of chronic pain patients to a pain clinic or pain specialist within 8-10 weeks in a primary care clinic. The ORT tool has previously been validated for its reliability, validity, and ease of use in similar clinical settings (Webster & Webster, 2005).

To guide the implementation process, the Knowledge to Action theory will be employed (Petzold, Korner-Bitensky, & Menon, 2010). This theory emphasizes the importance of effectively translating knowledge into practice by integrating knowledge, facilitating action, and evaluating outcomes. The project will require strong leadership qualities such as effective communication, in-depth knowledge of the topic, and experience in the clinical setting (Porter-O’Grady, 2018).

As nurses have a historical role as leaders and advocates for their communities, leveraging these leadership skills will contribute to the successful implementation of the project (Porter-O’Grady, 2018). In order to effectively implement the ORT tool, stakeholders, including staff members, will be engaged in discussions regarding the implementation plan. Staff members will be educated on the use of the tool and provided with opportunities to ask questions and seek clarification. Following education, adult patients visiting the clinic will be administered the ORT.

Once the patient completes the ORT test, the nurse will score the test and hand it to the medical provider. The medical provider will then discuss the results with the patient, enabling appropriate referral to a pain clinic or pain specialist if necessary. Milestones for this project include the receptionist handing out the ORT tool, the nurse scoring the test, and the medical provider reviewing the patient’s results. To ensure the timely achievement of these milestones, the project leader will be onsite throughout the implementation process, providing support and guidance as needed.

While the project is underway, there have been a few initial challenges. For instance, there have been instances where the receptionist has forgotten to give the ORT test to patients during their initial visit for chronic non-cancer pain (CNCP). In such cases, the staff has promptly provided the test to the patients once they are admitted to be seen by a provider. These challenges highlight the need for ongoing monitoring and quality improvement to ensure smooth implementation and adherence to the new practice.

In conclusion, the proposed DNP project aims to investigate the effectiveness of the ORT tool in improving the identification and referral rates of chronic pain patients in a primary care setting. By implementing the Knowledge to Action theory and leveraging leadership qualities, such as effective communication and knowledge of the topic, successful project implementation can be achieved. Ongoing monitoring and quality improvement processes will contribute to the overall success of the project.

References:
Petzold, A., Korner-Bitensky, N., & Menon, A. (2010). Using the knowledge to action process model to incite clinical change. Journal of Continuing Education in the Health Professions, 30(3), 167–171. doi:10.1002/chp.20077
Porter-O’Grady, T. (2018). Leadership advocacy. Nursing Administration Quarterly, 42(2), 115–122. doi:10.1097/naq.0000000000000278
Webster, L.R., & Webster, R.M. (2005). Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the Opioid Risk Tool. Pain Medicine (Malden, Mass.), 6(6), 432-442. doi:10.1111/j.1526-4637.2005.00072.x.