Integrating Virtual Reality Headsets Within the Patient-Driven Opioid-Free Surgical Pathway at UPMC Shadyside

Grant Application

Heather Margonari, DNP, CRNP, UPMC Shadyside

Proposed Innovation

Opioid use disorder is a significant risk associated with the overprescription of opioids in surgical patients. Due to the opioid crisis and growing concerns about addiction and side effects, more surgical patients are asking to avoid opioids during their hospital stay.

The Patient-Driven Opioid-Free Surgical Pathway — launched at UPMC Shadyside in May 2024 — gives surgical patients the choice of opioid-free or opioid-sparing postoperative pathways. It uses a team-based, holistic approach designed to manage perioperative pain through a combination of therapies, including nonopioid analgesics, regional anesthesia, and complementary techniques such as acupuncture, hypnosis, aromatherapy, nanotechnology, and mindfulness. Currently, the pathway is successful for 70% of patients. To improve these results, this project will expand on this innovative approach by integrating virtual reality (VR) to further enhance pain management and help more patients achieve opioid-free surgery.

Improvements in Action

Through this project, VR headsets are being introduced as a novel, nonopioid tool patients can use to manage both pain and anxiety. This VR technology creates immersive environments that can distract and relax patients prior to surgery by engaging them in calming experiences like virtual nature walks or guided relaxation sessions. After surgery, the VR headsets continue to engage patients in immersive experiences that distract from pain sensations.

One of the challenges identified in the initial phase of the Patient-Driven Opioid-Free Surgical Pathway was patient withdrawal from the program due to inadequate pain management. By providing effective relief from pain and anxiety through VR, this project also aims to improve patient adherence and encourage more patients to choose this pathway.

Intended Outcomes

Use of VR headsets within the Patient-Free Opioid-Free Surgical Pathway at UPMC Shadyside is expected to make the surgical experience more comfortable and less stressful for patients, resulting in a smoother recovery process with fewer complications related to opioid use. Reducing preoperative anxiety and pain perception before and after surgery also is expected to result in decreased pathway dropout rates among patients and a boost in overall patient satisfaction.