Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Sandra Spoelstra, PhD, RN

Second Advisor

Sylvia Simons, DNP, RN;

Third Advisor

Nicole Wills MSN, RN;

Fourth Advisor

Lisa McCann-Spry MSN, RN


Opioids are among the most common pharmacological class of therapeutic medications prescribed to alleviate pain across all healthcare settings. However, opioid-related adverse events are a growing problem contributing to an increase in morbidity and mortality. Current hospital practice does not utilize a pre-opioid administration screening tool to assess patient risk of adverse events related to opioid administration. The implementation of the Michigan Opioid Safety Score (MOSS), an evidence-based risk assessment tool which utilizes patient characteristics as well as respiratory assessment for the prediction and early detection of opioid-induced adverse events. This quality improvement project evaluated the effectiveness of the MOSS in detecting opioid-induced adverse events prior to the need for naloxone. The MOSS was applied to hospitalized patients that experienced an opioid-induced adverse event which required the use of naloxone to determine if the safety score would have detected an adverse event prior to current practices. The main finding from the retrospective chart audit identified that POSS in conjunction with MOSS identifies more patients as at risk for an opioid-related adverse event than POSS alone, suggesting it would be beneficial to incorporate the MOSS into its screening process in order to reduce opioid-related adverse events. A secondary finding identified that scoring unsafe on the risk factors of snoring and abdominal and/or thoracic surgery on the MOSS were most commonly associated with an opioid-induced adverse event, suggesting that patients with these risk factors may need increased monitoring practices and equipment support, such as capnography and the use of BiPAP or CPAP.

Available for download on Sunday, May 01, 2022