Franciscan Health in Indianapolis adopted a new protocol for scheduled cesarean sections to help fight the opioid epidemic while improving the state's maternal mortality rate, WRTV reported.
Enhanced Recovery Care After Cesarean covers a combination of protocols and applications for patient care from before surgery to postpartum, cutting down on the use of opioids for patients.
Patients in the new protocol are encouraged to talk with their nurses about any pain or discomfort, and the nurses take note of that and try to find ways to ease the discomfort. Though narcotics are available for breakthrough pain, a majority of moms in the program don't want them.
The program also looks at different things that contribute to pain and different methods hospitals can use to help the pain.
Some of the alternative ways to manage pain in the program include using medications like Tylenol and Motrin around the clock and not waiting until patients feel pain to take those medications. In addition, the anesthesiologist performs tap blocks around the incision site to reduce pain from the incision. Other methods include providing ice packs and heat packs and providing abdominal binders for moms to support them for a few weeks after surgery.
"It not only helps a mother use less narcotics but it also helps with the baby's feeding," Scott Bowers, MD, a practicing OB-GYN and director of quality for the Franciscan Women and Children's service line, told WRTV. "Opioids are very addictive, which has been part of the problem. It has not just been the access to the narcotics, but the addictive nature of the narcotics. So many people get addicted to the narcotics not trying to be addicted, but it started out with some type of surgery."
Christine Hunkele, MSN, RN, a clinical nurse specialist for Franciscan Health, looks at similar successful programs with colorectal surgeries and finds ways to utilize the best parts of that protocol for C-section surgeries.
"It's going wonderfully. We are seeing a lot less usage of narcotics. We have our moms getting up and moving around more. Their pain scores are a lot less," Ms. Hunkele told WRTV. "We are starting to recognize that there's a lot more to pain than just, ouch it hurts."