Opioid Safety, Respiratory Compromise

Nursing Recommendations on How Capnography Improves Patient Safety Sunnybrook Health Sciences Centre monitors patients with capnography during procedural sedation

Nursing recommendations from ARIN and AORN encouraged Sunnybrook Health Sciences Centre to monitor with capnography patients undergoing procedural sedation.

In a podcast with the Physician-Physician Alliance for Health Safety, Barbara McArthur, RN, BScN, CPN(C), an advanced practice nurse at Sunnybrook Health Sciences Centre in Toronto, Canada, discussed why Sunnybrook Health Sciences Centre decided to monitor with capnography.

Nursing Recommendations: Capnography monitoring provides an early indicator of patient deterioration

Capnography monitoring provides an early indicator of patient deterioration, which can be crucial in averting adverse events and patient deaths. Nursing recommendations played a key role in convincing Sunnybrook to monitor patients with capnography during procedural sedation. As Ms. McArthur explained:

“when we reviewed the literature, we came across a few position statements. The Association of Radiologic and Imaging Nurses (ARIN) published a position statement based on the evidence that has shown that capnography has a clear superiority in evaluating the patient’s ventilatory status when it’s compared to just the current routine monitoring practices. This is shown to result in safer patient care. 



“… Also, the AORN (Association of periOperative Registered Nurses) put out a guideline for the care of the patients receiving moderate sedation and analgesia that provide guidance based on the quality evidence. And, they also recommend that end tidal CO2 be used to monitor patients when ventilation cannot be directly observed during procedures.”                    

Nursing Recommendations - Association for Radiologic & Imaging Nursing (ARIN) Position Statement on Capnography

Nursing Recommendations – Association for Radiologic & Imaging Nursing (ARIN) Position Statement on Capnography

Nursing Recommendations and Interventions Save Lives, Reduce Adverse Events

Capnography monitoring, says Ms. McArthur, is monitoring in “real time. With pulse oximetry, there is a delay, which could be up to a minute in healthy patients. So, that’s a significant sort of time that is delayed that reaction could happen.” 

   

“Having the monitor can let you know the patient’s status sooner,” says Ms. McArthur, “for example, if they’re getting into respiratory problems, the nurses can intervene much quicker.” As a result, since implementing capnography monitoring, Ms. McArthur says that she is “not aware of any patients receiving reversal or any escalation of care with a rapid response team.”

To read a transcript of the interview with Ms. McArthur, please click here.

The podcast may be viewed on the PPAHS YouTube channel by clicking here.

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