Respiratory Compromise

Early Detection and Treatment of Sepsis Saves Lives!

On September 5th and 6th, the Global Sepsis Alliance, initiator of World Sepsis Day and World Sepsis Congress, will host the 2nd World Sepsis Congress. The 2nd WSC is a free online congress in which over 100 renowned experts from all around the world will give presentations on all aspects of sepsis. The congress will be held in English and is open to everyone with an internet connection.

For more information on program, speakers, time zones, and to register for free, please visit www.worldsepsiscongress.org

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Patient Safety

Why Healthcare Providers and PSOs Need to Work Together to Improve Patient Safety and Data Breaches

In this guest article, Meghann Chilcott discusses why healthcare providers need to work with PSOs in order to improve patient safety and reduce data breaches

By Meghann Chilcott (Information Technology and Services)

It’s only summer, and it’s already been an awful year for data security in the American healthcare sector. In April, a ransomware attack could have compromised the data of 85,000 patients at three orthopedic hospitals in California. Then, in June, a healthcare billing claims vendor experienced a cyber attack that may have breached the records of 270,000 patients. These incidents are just the tip of the iceberg. Between 2009 and 2017, 2,181 healthcare data breaches impacted more than 50 percent of the population of the United States.

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Patient Safety

How to Select the Best Patient Monitoring Systems

We are often asked how to select the best patient monitoring systems.

To help with the decision making process, we offer two resources:

  • In a clinical education podcast, “Selecting Patient Monitoring Systems,” Melissa Powell (Chief Operating Officer, The Allure Group); Priyanka Shah (Project Engineer, ECRI Institute); and Charlie Whelan (Director of Consulting, Transformational Health, Frost & Sullivan) provide their guidance on how to select the best patient monitoring systems to meet your clinical needs.
  • The Guide to Patient Monitoring features these manufacturers’ answers about their patient monitoring systems:
    • Becton Dickinson
    • EarlySense
    • GE Healthcare
    • Masimo
    • Medtronic – we recently added their answers, so please check it out and tell us what you think!
    • Philips
    • Respiratory Motion
    • Sotera Wireless

To view manufacturer answers, please click here.

If there is a question you’d like answered or a manufacturer that has not been included, please let us know!

 

Opioid Safety, Patient Safety

8 Signs You May Have an Opioid Addiction

Freelance writer and in recovery himself, Peter Lang discusses 8 signs that you may have an opioid addiction. To learn more and get help, please visit The Recovery Village.

Opiate addiction is a crisis in America. The proportion of the abusers of pain medication is not just alarming; it has reached critical levels. According to research, about one in every four opioid prescriptions ends up in the hands of abusers. About 35,000 people die every year from this menace. Further studies show that at least 12.5 million people abused opioids in 2015 alone. These pain-relieving medications include methadone, oxycodone, hydrocodone, codeine, fentanyl, and morphine. Some are legal, while others are not.

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Opioid Safety, Respiratory Compromise

Patient Monitoring Guide Features Manufacturers’ Answers on Their Monitoring Solutions Physician-Patient Alliance for Health & Safety Celebrates 7th Anniversary by Releasing Patient Monitoring Guide

On the 7th anniversary of the Physician-Patient Alliance for Health & Safety (PPAHS), PPAHS is pleased to release the Patient Monitoring Guide.

Since its first blog post 7 years ago, Michael Wong, JD (Founder and Executive Director, PPAHS) says PPAHS has advocated for continuous electronic monitoring of all patients receiving opioids. Mr. Wong explained that the primary motivation behind the Patient Monitoring Guide is to help answer questions posed by clinicians, hospital executives and risk managers about patient monitoring systems and to help them make decisions on which patient monitoring system best suits their clinical needs:

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Must Reads, Patient Safety

Ideas to Improve Patient Safety Articles PPAHS have been reading the week of July 9, 2018

Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of July 16, 2018 suggest ideas to improve patient safety.

Ideas to Improve Patient Safety – Requiring Patients to Comply to Conduct Rules to Fight the Opioid Epidemic

The University of Tennessee Medical Center (UTMC) is now requiring patients admitted for medical treatments of drug-use-related infections to comply with new conduct rules. Dr. Jerry Epps, UTMC’s senior vice president and chief medical officer, explains:

“This is done first and foremost for patient safety. When patients are bringing in needles and drugs, and their friends are coming in with drugs, and they can shoot up in the bathroom and maybe kill themselves, I argue we’re doing our best to protect patients and team members from this dreadful problem.”

Good Idea for #Opioidepidemic? - Require Patients to Comply to Conduct Rules Click To Tweet

Ideas to Improve Patient Safety – Encourage COPD Patients to Regularly Exercise

Researchers at the University of Lincoln and the University of Oxford have found:

“Pulmonary rehabilitation — a patient-tailored approach combining exercise, education, and behavioral changes — can improve physical capacity, reduce shortness of breath, and enhance the quality of life of COPD patients.”

Arwel Jones, PhD, research fellow at the Lincoln Institute for Health in the U.K., who is the senior author of the study, discusses the difficulty that such a recommendation may be for COPD patients:

“Being physically active is extremely important for people with COPD, however, people with the disease find it difficult to remain physically active once they have finished pulmonary rehabilitation.”

Encourage #COPD Patients to Regularly Exercise Click To Tweet

Ideas to Improve Patient Safety – Utilize Capnography to Monitoring Patients Under Conscious Sedation

Referring to the clinical education podcast, “Capnography Monitoring During Conscious Sedation: A Must for Maintaining “Eyes and Ears,” Melicent Lavers-Sailly writes about the value of monitoring with capnography:

“Capnography, the measurement of carbon dioxide (CO2) in respiratory gases, has long been used to monitor the breathing of patients under anesthesia in the operating room. Now there is a growing recognition of its value as a reliable tool for monitoring patients under conscious sedation in ambulatory settings outside the OR.”

Utilize Capnography to Monitoring Patients Under Conscious Sedation Click To Tweet

Ideas to Improve Patient Safety – Use Data to Help Make Better Healthcare Decisions & Treatment Choices

In the article, “The benefits of leveraging data and analytics in EMS,” Dr. Brent Myers makes the case for using date to help make better healthcare decisions and treatment choices. Rather than make decisions “either guessing or using their gut,” Dr. Myers encourages “leveraging data to make smarter decisions.”

He provides two examples where data has helped make smarter decisions:

“For example, stroke assessment and care have changed since the beginning of 2018, dramatically. This can’t be emphasized enough as the entire industry is still processing this information. Two recent studies – the DAWN Trial and the DEFUSE-3 Study – highlight findings that provide new guidelines for stroke patient assessment and transport. Specifically, these studies indicate the benefit of extending the treatment window to 16 or even 24 hours after the onset of symptoms for a subset of patients with large vessel occlusion acute ischemic stroke (LVO-AIS).

“While the nearest hospital may have been an appropriate destination in the past, the new research indicates transport to the nearest thrombectomy-capable or comprehensive stroke center may be preferred for those with evidence of LVO-AIS, even when it is not the nearest facility.”

Use Data to Help Make Better Healthcare Decisions & Treatment Choices Click To Tweet

Ideas to Improve Patient Safety – Reducing Psychological Distress May Decrease the Risk of COPD and Other Diseases

A research team led by Catharine Gale, PhD, a professor at the University of Edinburgh and at MRC Lifecourse Epidemiology Unit, University of Southampton, reviewed the clinical records of 16,485 individuals over a three-year period and found that psychological distress may increase the risk of COPD and other diseases:

“The study showed that, compared with people who had no symptoms of psychological distress, those with low levels of distress had a 57% increased chance of having arthritis and those with moderate distress levels had a 72% increased chance. A similar pattern was reported regarding cardiovascular diseases, with low distress levels increasing the risk by 46% and moderate levels by 77%.”

Reducing Psychological Distress May Decrease the Risk of COPD and Other Diseases Click To Tweet
Opioid Safety, Respiratory Compromise

PPAHS Remembers Amanda Abbiehl on Her 8th Death Anniversary PPAHS Remembers Amanda Abbiehl on Her 8th Death Anniversary

The Physician-Patient Alliance for Health & Safety remembers Amanda Abbiehl on her 8th death anniversary.

As reported by ABC News, “When Amanda Abbiehl’s parents kissed her goodnight on July 16, 2010, they never imagined it would be for the last time.”

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Patient Safety

How to Reduce Medication Errors by 82% 5 Recommendations from a Hospital Pharmacist in Preventing Medication Errors

In this article, “How to Reduce Medication Errors by 82%,” Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) discusses his interview with Steven Meisel, PharmD, who discusses how to reduce medication errors by 82%.

Mr. Meisel is a patient safety expert at the Institute for Health Care Improvement (IHI) and the Director of Medication Safety at Fairview Health Services in Minneapolis

According to the US Department of Health and Human Services, adverse drug events account for nearly 700,000 emergency department visits and 100,000 hospitalizations each year.

Source: https://en.wikipedia.org/wiki/Health_literacy

Hospital pharmacists are uniquely positioned to prevent medication errors in the hospital because of their centralizing function for medications prescribed and dispensed within the hospital setting. Read More

Patient Safety

Is a Patient’s Life Worth $30 per Day? The Costs of Monitoring and Not Monitoring Patients

When I interviewed Dr. Frank Overdyk for a clinical education podcast, “Preventing Avoidable Deaths” I asked myself this question, “Is a Patient’s Life Worth $30 per Day?”

Frank Overdyk, MD is an anesthesiologist practicing in Charleston, SC.  He organized two conferences on opioid-induced respiratory depression for the Anesthesia Patient Safety Foundation. Dr. Overdyk also is a member of the advisory board for the Physician-Patient Alliance for Health & Safety.

During the podcast, Dr. Overdyk said that the costs of monitoring patients was between $20 to #30 dollars per day:

“there are estimates that the daily cost of continuous monitoring of a patient for example with a pulse oximetry is on the order of 20 or 30 dollars a day. This does not include the cost implications of staff workflow and some of these other softer costs – indirect costs.”

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Must Reads

3 Ways We May Need to Change Our Perception of Opioids and Other Sedatives Articles PPAHS have been reading the week of July 9, 2018

Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of July 9, 2018 ask us to consider 3 ways we need to change our perception of opioids, pain medications, and other sedatives

There is No Absolute Safety When Using an Opioid

In an interview with Christopher G. Gharibo, MD, a pain specialist and the director of pain medicine at NYU Langone Health, Dr. Gharibo discusses the use of opioids and pain medications. He cautions, “what we need to keep in mind is that there is no absolute safety in many of the medicines that we prescribe, whether it is an opioid or a nonopioid.”

To improve the safety when using opioids, he suggests a number of measures, including these two:

  • Individualize Treatment – “This is a category—that is clearly effective—that needs to be individualized to the patient, and that needs to be kept in check in terms of the dosing that’s provided to the patient, the pill counts, and the combination therapy that’s provided.”
  • Be Prepared for An Adverse Event – “What can also be available when opioids are prescribed—especially in the chronic setting—is a take-home naloxone. Now this comes in a variety of different forms. Whatever the form is, it needs to be easy to administer, and it needs to be reliably administered to reverse the effects of the opioid. Now that’s not so simple. I think it also concomitantly requires education of the patient as well as the caretaker for the patient. … This is something that is relatively low-cost and can make a huge difference in the ultimate outcome.”

To read the complete interview with  Dr. Gharibo, please go to Pain Medicine News.

There is No Absolute Safety When Using an #Opioid Click To Tweet

Opioids Aren’t necessarily the Culprit

Much has been discussed about the role of opioids in deaths. However, a recent study found that 82.5% of opioid-related overdose deaths in 2016 involved either fentanyl or heroin.

This is not to suggest that caution should not be used when prescribing or using opioids, but merely to point out that it is often opioid use in combination with other substances that is deadly.

#Opioids Aren’t necessarily the Culprit Click To Tweet

Under General Anesthesia May Not Mean “Out Cold”

Being under general anesthesia is often thought to be when the patient is “out cold.” However, recent research suggests that brain activity and responses to stimuli may persist. Harry Scheinin, MD, PhD, one of the project leaders, commented on the results:

“I don’t think it’s bad that brains are working more than we had previously thought and that anesthesia would resemble sleep more than we had previously thought. But there still is this problem of unintended awareness, so we need better ways to measure really objectively the level of sleep, especially when we are using these muscle relaxants because we are then putting the patients into a situation where they can’t show ‘hey, I’m awake.’”

Under General Anesthesia May Not Mean “Out Cold” Click To Tweet