Professional affiliations

2018- pres  Academy of Integrative Pain management (AIPM)

2001- pres  American Academy of Pain Medicine (AAPM)

2018-pres   Practical Pain Management (PPM)

2001-pres   American Society of Health-Systems Pharmacists (ASHP)

1984             Phi Beta Kappa

1980-1984     Dean’s list – GPA > 3.5

Projects

2018-pres        Capnopraphy Performance Improvement Project

2017–pres       Opioid Stewardship Program

2016-pres        Multimodal order set revision for all surgeries to reduce opioid usage and reduce length of stay (ERAS – enhanced recovery after surgery)

2001-pres        Pain Management Inpatient administrative Policy – creation and revision

2016-pres        Chronic Opioid Policy for Providers – creation and revision

2015-pres        Pasero Opioid-Induced Sedation Scale (POSS) policy and education

2007-pres        Multiple proposals (seven) for a Multidisciplinary Pain Program

2014-pres        Naloxone Guideline

2012-pres        Methadone Guidelines and restrictions – revision 2017

2004-pres        Pain Reference Card with revisions

2008-2017       Informed Consent/Controlled Substance Agreement - creation and revision

2001-2017       Pain P & T Monographs – Monovisc, Synvisc -1, Euflexxa, Exparel, IV APAP, Duloxetine, Lidocaine 5% patch, Diclofenac gel, Meloxicam, Intranasal Narcan for ambulatory use, Intranasal Narcan, fentanyl, midazolam with MAD device in the ED, Ketamine PO, Ketamine IV PCA, Fentanyl IV PCA, ON-Q pump (bupivacaine, ropivacaine), Epidural (all formulations – fent/bup, hydro/bup)

2017                Vizient Opioid ADE Collaborative (9 month) - House-wide project on all chronic pain patients taking opioids for at least 3 months. Ensure compliance with CDC and Texas Medical Board guidelines.

2017-pres       Chronic Pain/Opioid registry in EPIC: collaborative effort with opioid stewardship team

2005-pres       MUE’s – IV APAP, Hyaluronate products, liposomal bupivacaine, meperidine IV PCA, Ketamine PO for wound care (current), Naloxone/flumazenil ongoing since 2011

2011 to pres   EPIC changes to ensure safe and effective pain management:

• Implemented administration instruction warnings to consider giving 1 hour apart on ALL CNS depressant PRN’s – 2011
• Changes to individual ERX’s to add lower dose buttons – opioids (e.g. morphine, benzodiazepines,  haloperidol)
• Preprogrammed opioid naïve settings in all IV PCA orders – 6/2011
• Implemented BPA alert on pediatric dosing - 2011

• Opioid/disease warnings on all morphine products – 2011    
• Revise order sets with pain medications - December 2011 to present
• Revise BPA on high risk patients receiving opioids - 2012
• POSS sedation scale built in EPIC for nursing documentation- April 23, 2012- “go live”
• Methadone restriction to specific consult services - Approved P & T  April 5, 2012
• Establish criteria for IV PCA’s  -  June 7, 2012- P & T Review
• Lorazepam dosing recommendations for benzodiazepine naïve and older patients – May, 2013
• Procedural order set revisions for moderate sedation. June, 2013
• Revision to fentanyl patch panels
• Codeine restriction to patients greater than or equal to 13 years of age

2011 to pres     PYXIS changes to ensure safe and effective pain management:

• Remove high concentration opioids from select pyxis machines (e.g. switch out hydromorphone 2mg/ml and replace with 1mg/ml, change morphine 10mg/ml, 5mg/ml to 4mg/ml, 2mg/ml, remove fentanyl 50mcg/ml 20ml  and leave 2ml and 5ml)
• Add pyxis alert with onset, peak and duration for IV sedation medications (e.g. opioids, benzodiazepines etc)
• Pediatric alert for hydrocodone solution, making only one hydrocodone concentration available on EPIC preference list and in pyxis. 

Presentations

2001 to pres    Safe and Effective pain management every 3 months for med-surg nurses

2017                Vizient Adverse Drug Event Improvement Collaborative:  Prescribing Opioids for Chronic Pain Knowledge Transfer Webinar

2017                TCPI Clinician Event, Specialty Care – Opioid Stewardship

2017-pres        Opioid Stewardship – phase I : opioid epidemic, CDC, TMB guidelines and Parkland Policy

2017-pres        Opioid stewardship – phase II : Baseline data from the chronic pain registry, urine tox screens, pain medication management

2017                The Role of Sub-dissociative Ketamine in Pain Management 

2014-2017       Patient Controlled Analgesia (PCA) and Conversion to PO/TDF: Clinical Pearls

                        Internal Medicine and Palliative care residents and faculty

2008- pres       Safe and Effective pain management for Surgery Interns

2008-pres        Safe and Effective pain management for Internal Medicine interns/residents

2012-pres        Developed Pain CIA training through Parkland Pathways – for providers and other clinical staff

2008-pres        Pain Self-Management for Patients

2008-pres        Non-opioids and Co-analgesics

1997-2004       It still Hurts

1997-2004       Pain Management Review

1997-2004       Adjuvant Pain Medications

1997-2004       Antidepressants in the management of Chronic Pain