Preferred Name

Kimberly Manning

Date of Graduation

12-16-2023

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

School of Nursing

Advisor(s)

Erica Lewis

Abstract

Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases that collect and monitor the prescriptions of controlled substances. PDMPs help the prescriber understand the patient’s medication history to reduce opioid abuse and misuse, overdose risk, and harmful medication interactions. Considering the national persistent opioid epidemic and its impact on patient safety, it is essential to assess how a large healthcare system encourages PDMP use. PDMP participation is a Virginia Commonwealth licensing requirement, a Center of Disease Control 2022 opioid prescribing guideline, and a healthcare system requirement. The healthcare systems Controlled Substance Policy for Adult Patients (Feghali, 2020) was evaluated using the Collins eight-step method to evaluate evidence-based solutions to recommend process improvements to improve adherence to policy. The eight steps include 1. Define the context, 2. State the problem, 3. Search for evidence, 4. Consider different policy options, 5. Project outcomes, 6. Apply evaluative criteria, 7. Weight the outcomes, and 8. Make the decision. This policy analysis included interviews with subject matter experts and a literature review. The following three process improvement options were analyzed: annual training on the PDMP, adding clinical decision support in the EHR software and maintaining the status quo. The analysis used a weighted matrix with evaluative criteria to assess and rank-order the process improvement options. The findings indicate that the process improvement option of the educational initiative has the highest probability of impacting the five domains of public health impact, economic and budgetary impact, feasibility, employee acceptance, and the training level of effort.

Available for download on Thursday, November 13, 2025

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