Hospital Acquired Conditions, Opioid Safety, Respiratory Compromise

New Report on Preventing Respiratory Compromise in Vulnerable Patients

The Respiratory Compromise Institute (RCI) has recently published a new report titled “Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients”. PPAHS is a member of RCI, along with other health organizations such as the Society of Hospital Medicine, American Association for Respiratory Care, and CHEST/American College of Chest Physicians. Read More

Must Reads

Patient Safety Weekly Must Reads (April 22, 2017)

This week in #patientsafety, PPAHS offered a response to a question about whether a patient is right to be worried about receiving opioids after surgery. From around the web, a study in JAMA Surgery on when long-term opioid use starts, a doctor offers advice on how to have difficult conversations about opioids, and a look at the leading role played by nurses in patient safety.

From PPAHS:

Opioid Safety After Surgery. “I’m going to have surgery soon and I have been told I will be given an opioid medication to control the pain after the operation. But I see stories of people getting hooked on opioids all over the news, and I’m scared to take them. Am I right to be worried?” Read our response.

From Around the Web:

Long-Term Opioid Use Can Start After Surgery, New Study Shows. A study in JAMA Surgery suggests that many people start long-term opioid use after doctors prescribe them the drugs to relieve post-surgical pain.

Prescribing opioids safely: How to have difficult patient conversations. Building a strong doctor-patient rapport can help facilitate conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits, says the author.

Nurses Drive Change in Patient Safety Improvements. A look at nurses as changemakers for patient safety at hospitals.

Opioid Safety

Opioid Safety After Surgery

“I’m going to have surgery soon and I have been told I will be given an opioid medication to control the pain after the operation. But I see stories of people getting hooked on opioids all over the news, and I’m scared to take them. Am I right to be worried?”

Paul Taylor, patient navigation advisor at Sunnybrook Health Sciences Centre in Toronto, recently fielded this question in a special to the Globe and Mail. The answer recommended that concerns about opioids be “kept in perspective” and that they can be extremely useful in managing short-term pain, noting that “problems can arise when patients end up on the drugs for longer than is necessary.” The addictive properties of opioids are indeed reason for concern.

We wanted to add an additional perspective, particularly on safe use of opioids for acute pain after surgery, especially while patients are still in the hospital receiving care. Read More

Must Reads

Patient Safety Weekly Must Reads (April 15, 2017)

Great news–our video last week was watched over 25,000 times! Let’s keep working to transform that awareness into progress for patient safety.

This week in #patientsafety, PPAHS Founder and Executive Director Michael Wong, JD, penned an article for Healthcare Business Today on what makes “good” hospital leadership. From around the web, a study looks at the relationship between readmission rates and caregiver involvement in discharge discussions. Another study looks at factors associated with alarm response time. And a doctor asks if her peers have noticed an increase in inquiries about NSAIDs with growing awareness of the opioid epidemic.

From PPAHS:

“Good” Hospitals Require Real Leaders. How can you tell the difference between a “good” hospital and a “bad” one?

From Around the Web:

Study: To reduce readmissions, involve caregivers in discharge planning. A study finds that involving caregivers in discharge discussions was associated with a 25% reduction in the likelihood of an elderly patient being readmitted to the hospital within 90 days of discharge.

Video Analysis of Factors Associated With Response Time to Physiologic Monitor Alarms in a Children’s Hospital. Nurses who responded faster included those who were earlier in their shifts, had less than 1 year of experience, previously responded to an alarm requiring intervention, were caring for only 1 patient, and were responding to an alarm for lethal arrhythmia.

More information on NSAIDs & CV risk. A doctor looks at research on the cardiovascular risks of NSAIDs as patients appear to ask about them more frequently.

Patient Safety, Respiratory Compromise

“Good” Hospitals Require Real Leaders

The following is an excerpt of an article written by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety). It first appeared on Healthcare Business Today on April 9, 2017. To read the full article, please click here.

As the Executive Director of the Physician-Patient Alliance for Health & Safety, a non-profit whose mission is the improvement of patient safety, I am often asked how to tell a “good” hospital (i.e. patient safe) from a “bad” hospital (i.e. unsafe).

In thinking about “good” and “bad” hospital leadership, I am reminded of two discussions I had with hospital leaders – which leaders’ hospital would you rather be a patient at or, if you are a clinician, work at?

I spoke with the CEO of a hospital, who was dealing with the family of a child that had died within the hospital from opioid-induced respiratory depression. His clinicians had not employed continuous electronic monitoring with pulse oximetry for oxygenation or with capnography for adequacy of ventilation. Read More

Must Reads

Patient Safety Weekly Must Reads (April 8, 2017)

This week in #patientsafety, we released a video that summarizes experiences of clinicians in improving opioid safety in their hospital or healthcare facility, and reminds us of the tragic consequences of adverse events and deaths that may ensue if clinicians and healthcare executives are not proactive in promoting safety. From around the web, a look at alarm fatigue, pre-surgical counselling on opioid use, and reactions to a sepsis awareness campaign.

From PPAHS:

Nine Minutes to Improving Opioid Safety: PPAHS Releases Patient Safety Video. Over 10 hours of in-depth interviews released by PPAHS in 2016 distilled into 9 minutes.

From Around the Web:

How Redesigning The Abrasive Alarms Of Hospital Soundscapes Can Save Lives. Alarm fatigue continues to be a problem at hospitals.

Here’s something that curbs opioid use: Pre-surgical counseling. This surgeon shows a video on opioid safety to patients before undergoing surgery, and says it works at reducing opioid use.

Sepsis awareness campaigner reacts to health board responses. Health boards in the UK are working on reducing sepsis, but some are wary of a widower’s awareness campaign.

Hospital Acquired Conditions, Opioid Safety, Patient Safety, Respiratory Compromise

Nine Minutes to Improving Opioid Safety: PPAHS Releases Patient Safety Video

The Physician-Patient Alliance for Health & Safety (PPAHS) has released a YouTube video which discusses in nine minutes how to improve opioid safety. The video features highlights from over 10 hours of in-depth interviews released by PPAHS in 2016; altogether, the podcast series has generated over 130,000 cumulative views on YouTube. The podcast series brings together physicians, nurses, and respiratory therapists discussing how they have improved opioid safety in their hospitals.

According to Michael Wong, JD, Founder and Executive Director of PPAHS:

“In just nine minutes, the video summarizes experiences of clinicians in improving opioid safety in their hospital or healthcare facility, and reminds us of the tragic consequences of adverse events and deaths that may ensue if clinicians and healthcare executives are not proactive in promoting safety. We hope that the video will energize quality improvement and patient safety teams to strive to reduce adverse events and deaths related to opioid use.”

The opioid epidemic was one of the most heavily-covered, and hotly-debated, topic in patient safety covered in 2016. This dialogue has been mostly centered around the effects of ‘street’ use and abuse of prescription painkillers. In contrast, the PPAHS podcast series aims to highlight the preventable harm of opioid-induced respiratory depression during hospital procedures. Read More

Must Reads

Patient Safety Weekly Must Reads (April 1, 2017)

This week in #patientsafety, we took a step back to develop more substantial pieces that will be published in the near future. From around the web, Dr. Pronovost describes the results of a peer-to-peer hospital review program; Healthy Canadians, a collaborative initiative by a number of agencies within the Government of Canada, is re-promoting a 2015 video about prescription drug abuse; and, an article on how to use pain medication more safely.

From PPAHS:

Nothing this week.

From Around the Web:

How peer-to-peer review helps hospitals. In light of last week’s article on the impact of inspections on patient safety, this article by Peter Pronovost, MD, who served on the PPAHS PCA Safety Panel, is particularly timely.

Jordan’s Story. In this YouTube video, listen to Jordan’s story and how his dependence on pain medication led to tragedy.

How to Avoid Opioid Addiction When You’re Prescribed Pain Medication. This article provides suggestions to make opioid use safer, such as knowing your risk factors, taking meds only as prescribed, and seeking non-opioid pain management treatments.

Must Reads

Patient Safety Weekly Must Reads (March 25, 2017)

This week in #patientsafety, we highlight again that it is Blood Clot Awareness Month. From around the web, three studies: one on the effect of hospital inspectors on patient safety; one on sepsis; and, one on the relationship between opioid supply levels and long-term use.

From PPAHS:

March is Blood Clot Awareness Month. Blood Clot Awareness Month is a time for us to highlight stories and resources that you can share with colleagues, patients, and loved ones to bring attention to blood clots.

From Around the Web:

When Hospital Inspectors Are Watching, Fewer Patients Die. A study published in JAMA Internal Medicine studied records of Medicare admissions from 2008 to 2012 at 1,984 hospitals and found that in the non-inspection weeks, the average 30-day death rate was 7.21 percent. But during inspections, the rate fell to 7.03 percent.

UAB study highlights risks of sepsis. A new study from researchers at the University of Alabama at Birmingham analyzing three different methods for characterizing sepsis has helped to illustrate the risk of death or severe illness attributable to the condition.

With a 10-day supply of opioids, 1 in 5 become long-term users. With an initial 10-day opioid prescription, about one-in-five patients become long-term users, according to data published Friday in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Blood Clots

March is Blood Clot Awareness Month

Blood Clot Awareness Month logo

March is Blood Clot Awareness Month.

Spearheaded by the National Blood Clot Alliance, #BCAM is a time for patients, caregivers, healthcare professionals, and advocates to draw attention to deep vein thrombosis and venous thromboembolism.

According to the National Blood Clot Alliance:

“Blood clots do not discriminate. They can and do affect anyone from children to senior citizens, from professional athletes to mothers, women and men – no one is immune. Tragically, roughly 274 lives are lost each day in the U.S. simply because public awareness about life-threatening blood clots is so low.”

Blood Clot Awareness Month is a time for us to highlight stories and resources that you can share with colleagues, patients, and loved ones to bring attention to blood clots. Read More