Like most of the country, Nebraska providers over-prescribe opioids. The CDC Prescription Drug Overdose Web site reports that Nebraska providers are writing 72-82.1 opioid prescriptions for every 100 persons in the state. In addition, an analysis of data gathered by three Nebraska skilled nursing facilities and three Nebraska long-term care community pharmacies found that more than 30 percent of all medication orders were incomplete or in error lacking dosage, strength, or indication and required a change. These errors can lead to Adverse Drug Events (ADEs), which are a patient safety concern.

Medication errors caused by lack of standard and effective internal communication contribute to patient harm and inefficient care, particularly among patients transferred from hospitals to skilled nursing facilities.

In 2009, after a Nebraska Senator’s daughter died of a prescription opioid overdose, stakeholder meetings began to discuss creation of a Prescription Drug Monitoring Program (PDMP) in Nebraska. A PDMP is a tool to help prevent overdose deaths due to prescription drugs, while preserving access for those in need of narcotic pain relievers.

Through collaborative efforts with the Nebraska Health Information Initiative (NeHII), the Department of Health and Human Services and the professional associations working with the pharmacies and their software vendors, Nebraska became the first state in the nation to collect all dispensed prescription drug data in the PDMP beginning January 1, 2018.

The Nebraska PDMP now works as a medication reconciliation tool to improve patient care by improving the accuracy of the prescribed medication list, reduce the risk of ADEs and prevent and detect the illicit use of prescribed controlled drugs. The state now utilizes the PDMP, not only for opioids, but for all prescribed medications to improve medication reconciliation. In some hospitals, Pharmacy Technicians are gathering medication histories from patients and families at hospital admission and in Emergency Departments to create a complete and accurate medication list. The PDMP is a valuable tool for medication reconciliation in all healthcare settings.

There is still much work to be done in promoting and enhancing the Nebraska PDMP. Great Plains Quality Innovation Network, Nebraska stakeholders and the provider community are committed to working across the state to share resources and tools related to prevention and reduction of opioid abuse and to promote the utilization of the PDMP in all healthcare settings. The overall goal is to improve medication safety by decreasing errors related to transitions in care as an individual transfers from one healthcare setting to another.

To learn more about the Nebraska Prescription Drug Monitoring Program, access the WebEx recordings and handouts from two WebEx events offered this year.

For more information or to connect with our team, visit the Great Plains QIN Medication Safety Page