Postpartum Overdose Prevention Bundle

AIM Patient Safety Bundle Adaptation

⏱️ Duration: 50 minutes | Audience: L&D, Postpartum, ED, Social Work, Peer Specialists

Learning Objectives

  1. Describe the six points of preventable postpartum overdose death
  2. Apply the 5-domain AIM bundle to institutional workflows
  3. Implement universal naloxone distribution protocols
  4. Navigate policy considerations for harm reduction in perinatal care

Slide-by-Slide Notes

Slide 1: Title 2 min
Key Points: Emphasize that this bundle is specifically designed for the postpartum period—the highest-risk window.
Slide 2: The Crisis 5 min
Key Points: The 60-73% statistic is key—deaths occur OUTSIDE healthcare. This justifies universal naloxone distribution regardless of documented SUD.
Anticipated Q: "Why universal naloxone? Why not just for high-risk patients?"

A: Many overdose victims had no documented SUD. Universal distribution increases community saturation and reduces stigma.

Slide 5: Domain 1 - Readiness 4 min
Key Points: Peer specialists with lived experience are essential. Staff must complete implicit bias training BEFORE implementing universal naloxone.
Slide 7: Domain 3 - Response 8 min
Key Points: Never-use-alone counseling is critical. Many overdoses occur when someone uses alone. Fentanyl test strips (where legal) allow people to make informed decisions.
Slide 10: Implementation Strategy 5 min
Key Points: Start with a single L&D unit. Weekly huddles are critical for troubleshooting. Don't expand until metrics stabilize.

Anticipated Q&A

Q: What if someone refuses naloxone?

A: Respect refusal but document education provided. Refusal rates are low (11% in Maine pilot). Reframing as "first aid kit" rather than "overdose medication" increases acceptance.

Q: How do we stock naloxone on the unit?

A: Work with pharmacy to add to formulary. Standing orders allow nursing to dispense without individual prescriptions. Consider partnerships with harm reduction organizations for free naloxone.

Q: What about legal liability?

A: Good Samaritan laws protect naloxone administrators. Standing orders and nursing protocols provide institutional coverage. Document education provided.

Q: How do we handle fentanyl test strips in prohibited states?

A: Focus on never-use-alone counseling and naloxone distribution. Consider policy advocacy. Some states have decriminalized test strips through harm reduction programs.

Key Messages

  1. 84-91% of pregnancy-associated overdose deaths are preventable.
  2. The 5-domain AIM bundle provides a structured, implementable framework.
  3. Universal naloxone distribution is feasible and effective (89% acceptance).
  4. Every postpartum person with known or suspected SUD/OUD needs the full bundle.