Must Reads

Three Must Do’s for Patient Safety Must Reads for Week of December 18, 2017

This week’s must reads contain three must do’s for patient safety.

#1 Must Do for Patient Safety – Prescribe opioids in a reasonable manner

Although opioid abuse, misuse and diversion are clearly valid safety concerns, the current environment has resulted in a backlash against the use of opioids, which has led to reluctance on the part of some physicians to prescribe and to difficulty for some patient to filling their opioid prescriptions.

In their article, “Management of Chronic Pain in the Aftermath of the Opioid Backlash,” Kurt Kroenke, MD (Professor of Medicine, Indiana University School of Medicine) and Andrea Cheville, MD (Professor of Physical Medicine and Rehabilitation, Mayo Clinic) caution against an “opioids are bad” approach:

“There is an emerging reluctance to prescribe opioids, even for acutely painful conditions such as after surgery and dental procedures, or following discharge from the emergency room after traumatic injuries. Moreover, as overdose deaths due to prescription opioids decline, overdose deaths due to heroin and other illicit opioids are rapidly increasing. Thus, chronic pain and addiction are distinct challenges, but we must not assume that one invariably leads to the other.”

A balanced approach to opioid prescribing is what’s needed. If opioids are going to prescribed, make sure that a planned reduction is scheduled and discussed. The Orlando Medical News in a its recent article asks a very good question in telling the story of Katie Herzog who received opioids without also receiving a plan for tapering her use of opioids – “Opioids After Surgery Left Her Addicted. Is That A Medical Error?

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#2 Must Do for Patient Safety – Make hospitals stays less noisy

According to a Hospital Consumer Assessment of Healthcare Providers and Systems survey, hospital noise is the “top complaint” of patients, hospital staff and visitors.

Make hospitals stays less noisy

Make hospitals stays less noisy

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#3 Must Do for Patient Safety – Ensure patients are ambulated

According to the study by Carissa Low, PhD (Assistant Professor of Medicine and Psychology, Biobehavioral Oncology Program, University of Pittsburgh Hillman Cancer Center), there is a correlation between the number of inpatient steps and the likelihood of readmission.

Dr. Low encourages patients to move, “Patients are encouraged to get up and walk as soon as possible after surgery.”

Patient ambulation should be a key metric to improved health. According to the Physician-Patient Alliance for Health & Safety position statement:

“Movement is a critical factor to improving patient health. Patient ambulation, the ability to walk from place to place independently with or without an assistive device, is necessary to improve joint and muscle strength, as well as prevent pressure ulcers during extended bed rest. It is a critical factor in improving patient well-being while in hospital, as well as reducing total length of stay (LOS).”

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