Must Reads

Patient Safety Weekly Must Reads (February 25, 2017)

This week in #patientsafety, we issued a statement on our position about the need to treat patient ambulation as a key metric. From around the web, ISMP released an updated self assessment for community/ambulatory pharmacy medication safety. We also found figures on opioid-related inpatient stays and emergency department visits by state from 2009-2014, and a dentist’s statement that the industry prescribes opioids “way too quickly”.

From PPAHS:

Patient Ambulation a Key Metric to Improved Health. PPAHS calls for dialogue at the clinical and governmental levels to identify and codify best practices that will prioritize patient ambulation.

From Around the Web:

ISMP Releases Updated Community/Ambulatory Pharmacy Medication Safety Self Assessment. Community and ambulatory pharmacy settings can now access a newly revised tool that will help them review and improve their medication safety practices.

Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014. This HCUP Statistical Brief presents data from HCUP Fast Stats on the national rate of opioid-related hospital inpatient stays and emergency department (ED) visits from 2005 to 2014.

Opioids unnecessary for dental work, doc says. The American Dental Association recently reported dentistry is responsible for prescribing 12 percent of all instant-release opioids.

Patient Safety, Position Statement, Practices & Tips

Patient Ambulation a Key Metric to Improved Health

The following is a first in a series of position statements. If you would prefer to view our position on patient ambulation as a PDF, please click here.

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). Read More

Must Reads

Patient Safety Weekly Must Reads (February 18, 2017)

This week in #patientsafety, we highlight an article by the author of the RADEO Guide. From around the web, a daughter nearly died of sepsis and a mother died from blood clots after giving birth; plus, a JAMA study on whether financial penalties work to reduce hospital readmission rates.

From PPAHS:

Preventing Opioid-Induced Respiratory Distress In An Outpatient Setting. The author of the Reducing Adverse Drug Events related to Opioids (RADEO) Implementation Guide shared precautions to take during procedures in the outpatient setting, as well as upon patient discharge.

From Around the Web:

My Daughter Nearly Died of Sepsis. Here’s How You Can Stay Safe. A mother tells the story of her daughter’s near-miss after going into septic shock.

Husband wins seven year medical negligence fight after death of wife, 29. In the UK, the husband of a woman who died from a blood clot 16 days after the birth of her daughter has won a medical negligence claim.

Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions. The prospect of financial penalty appears to reduce hospital readmission rates, according to this JAMA study.

Opioid Safety

Preventing Opioid-Induced Respiratory Distress In An Outpatient Setting

by Thomas W. Frederickson, MD, MBA, FACP, SFHM, Medical Director, Hospital Medicine, CHI Health

Thomas W. Frederickson MD, FACP, SFHM, MBA discusses the deadly combination of opioids and benzodiazepines in hospitalized patients. Please click on the image to listen to an interview with Dr. Frederickson on YouTube.

With the increasing volume of procedures being moved to outpatient settings, procedures and processes need to be in place to make ensure patient safety.

The Society of Hospital Medicine has released a set of guidelines to reduce opioid-related adverse events in a clinical setting titled the Reducing Adverse Drug Events related to Opioids (RADEO) Implementation Guide. I had the pleasure of leading the expert panel tasked with developing the guide. The manual is designed as a resource to help clinicians successfully implement a quality improvement program.

In this article, I want to focus on some key precautions to take during procedures in the outpatient setting, as well as upon patient discharge.

Read the full article on Becker’s Hospital Review.

Must Reads

Patient Safety Weekly Must Reads (February 11, 2017)

This week in #patientsafety, we look at the CDC’s updated guidelines on opioids. From around the web, the CDC’s Opioid Guidelines are now available as a mobile app; a man experiences opioid-induced respiratory depression and dies after routine gallbladder surgery; and a study tries to test whether patient involvement actually improves patient safety.

From PPAHS:

Opioid Safety Starts with Informed, Mutual Decisions. Giving patients a decision-making role in their pain plan–and providing them with the information they need to arrive at informed mutual decisions–is a recurring theme in the CDC’s updated guidelines on opioids.

From Around the Web:

New CDC Opioid Guideline Mobile App Now Available. The CDC has released its free Opioid Guideline app, designed to help providers apply the recommendations of the CDC Guideline for Prescribing Opioids for Chronic Pain into clinical practice.

Man dies after routine gallbladder surgery. Gary Bougie was two months shy of his 36th birthday when he died. His family suspects he died from opioid-induced respiratory depression after going to the hospital for gallbladder surgery.

Achieving Real-Time Respiratory Depression Surveillance of Post-Surgical Patients. A focus on challenges of alarm management in caring for patients at risk for respiratory depression–includes strategies for better monitoring, referencing PPAHS’ national survey on PCA.

Opioid Safety

Opioid Safety Starts with Informed, Mutual Decisions

In March 2016, the Centers for Disease Control and Prevention (CDC) released updated guidelines for prescribing opioids for chronic pain. Giving patients a decision-making role in their pain plan–and providing them with the information they need to arrive at informed mutual decisions–is front and centre in the document. Read More

Must Reads

Patient Safety Weekly Must Reads (February 4, 2017)

This week in #patientsafety, all quiet on the PPAHS front. We’re working on a few longer-form pieces and podcasts, so stay tuned! From around the web, our top news picks for the week focus on ambulatory care, sepsis, and painkiller prescriptions in Canada.

From PPAHS:

Nothing this week.

From Around the Web:

The Joint Commission publishes ambulatory care, office-based surgery chapters. The chapters describe how ambulatory care organizations and office-based surgery practices apply The Joint Commission’s requirements for patient safety.

Sepsis drives more readmissions than medical conditions tracked by CMS. Sepsis accounts for more 30-day readmissions and is more costly than heart attacks, heart failure, chronic obstructive pulmonary disease and pneumonia, according to new research in JAMA.

Guidelines for prescribing painkillers are silent on acute-pain treatment. In Canada, new national standards for prescribing painkillers do not address treating patients with acute pain–and some are questioning whether Health Canada’s rejection of a request to expand the scope of the standards was the right decision.

Must Reads

Patient Safety Weekly Must Reads (January 28, 2017)

This week in #patientsafety, we announced a partnership with SONORIA to improve patient safety outside the operating room. From around the web, a couple of first-hand accounts from patients who use opioids to manage their chronic pain, plus a discussion on what nurses can do to prevent opioid-induced respiratory depression.

From PPAHS:

SONORIA and PPAHS Announce Alliance to Improve Clinical Collaboration. The new alliance will focus on promoting safety and optimize outcomes for patients undergoing procedures outside of the Operating Room.

From Around the Web:

I’m dependent on narcotics; that doesn’t mean I’m an addict. A first-hand account of somebody managing their chronic pain with opioids.

Doctors prescribed me pain meds but couldn’t help me get off them. What used to be an opioid-naive patient describes his experience with being prescribed opioids after a collision.

What Can Nurses do to Prevent Opioid-Induced Respiratory Depression? We spoke with Carla Jungquist, PhD, ANP-BC, of the University of Buffalo School of Nursing on how post-operative patients are assessed by nurses.

Opioid Safety

What Can Nurses do to Prevent Opioid-Induced Respiratory Depression?

In an article recently published in The Journal of Nursing Administration, Carla Jungquist, PhD, ANP-BC, of the University of Buffalo School of Nursing and her colleagues, looked at data from eight US hospitals that volunteered to share information on how post-operative patients are assessed by their nurses.

The data came from nurse-abstracted electronic healthcare records (EHRs) and focused on nursing assessments conducted every 2 and 4 hours (in practice, assessments were conducted at the 2.5 and 4.5 hour periods because 30 additional minutes were needed for entry into EHRs). The assessments examined three key indicators:

  • oxygen saturation via pulse oximetry
  • respiratory rate
  • sedation score

Michael Wong, JD, founder and executive director, Physician-Patient Alliance for Health & Safety spoke with Jungquist about her research.

Read the interview on ADVANCE for Nurses.

Patient Safety

SONORIA and PPAHS Announce Alliance to Improve Clinical Collaboration

The Society for Non OR Intervention and Anesthesia (SONORIA) and the Physician-Patient Alliance for Health & Safety (PPAHS) are pleased to announce their new alliance focused on promoting safety and optimized outcomes for patients undergoing procedures outside of the Operating Room. Wendy Gross MD, President of SONORIA and Michael Wong JD, CEO and Executive Director of PPAHS have each agreed to serve as advisors to their respective organization’s Boards. Read More