Editor’s note: In this week’s must reads, we look at articles that discuss the role of clinicians in the opioid epidemic.
Last week, we posted the article, “Is this the Right Question to Ask – Who’s to Blame for the Opioid Epidemic?” In that editorial, we applauded the efforts of the Massachusetts Attorney General in seeking to fine culpability and responsibility for the opioid epidemic. A lawsuit filed by the state of Massachusetts against Purdue Pharma alleges that the company, the Sackler family (which controls Purdue), and Purdue executives misled doctors and patients about the potential addictive qualities of opioids and, in particular, OxyContin, which Purdue manufactures.
The Physician-Patient Alliance for Health & Safety wishes you a safe and Happy New Year!
To help make 2019 patient safe, please implement the following 3 recommendations to keep your patients safe:
Patients Receiving Opioids Must Be Monitored With Continuous Electronic Monitoring
Much of the public attention has been focused on the harm caused by prescription use and abuse of opioids. However, there is another facet that must be focused on: opioid-induced respiratory depression in clinical settings. This includes patients undergoing moderate and conscious sedation, or recovering from procedures and managing pain using a patient-controlled analgesia (PCA) pump, particularly those during the postoperative period.
In this article published in the December 2018 issue of the British Columbia Medical Journal, Drs Richard Merchant and Matt Kurrek encourage the use of capnographic monitoring to improve the safety of patients undergoing procedural sedation.
By Richard Merchant, MD, FRCPC (Clinical Professor, University of British Columbia, Department of Anesthesia, Pharmacology, & Therapeutics) explained in a clinical education podcast with Matt Kurrek, MD, FRCPC (Professor, Department of Anesthesia, University of Toronto)
At the recent 4th Annual AARC Respiratory Patient Advocacy Summit, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) discussed 3 key patient safety initiatives for PPAHS for 2019.
Also speaking with Mr. Wong on the panel discussion were:
Tim Myers (Chief Business Officer, AARC) moderated the session.
The 3 key patient safety initiatives for 2019 emphasized by Mr. Wong are:
The recent jury finding that a Holy Family Hospital nurse was negligent in the care of Helen Marie Bousquet raises the question whether negligence can result in safer patient care.
By Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)
According to recently released press release by the Estate of Helen Marie Bousquet:
“A jury in the Essex County Superior Court in Lawrence, Massachusetts found that a Steward Health Care owned Holy Family Hospital nurse was negligent in her care of Helen Marie Bousquet on Monday, Sept. 17.”
Helen Marie Bousquet tragically passed away after what has been described by her son, Brian Evans, singer and nominee for Hawaii’s 2nd congressional district, as “a basic routine procedure” for knee surgery. Mr. Evans said that her tragic and avoidable death highlights the need for better assessment of patients for sleep apnea and for better treatment and monitoring of such patients before, during and after surgery.
Brian Evans, singer and nominee for Hawaii’s 2nd congressional district, and the Physician-Patient Alliance for Health & Safety (PPAHS) announce plans to evaluate hospitals on their sleep apnea preparedness.
Helen Marie Bousquet tragically passed away after what is being described by her son, Mr. Evans, as “a basic routine procedure” for knee surgery. Mr. Evans said that her tragic and avoidable death highlights the need for better assessment of patients for sleep apnea and for better treatment and monitoring of such patients before, during and after surgery.
In an article for DoctorWeighsIn, Michael Wong, JD, discusses why opioids don’t just cause harm on the “street”. Opioids can kill people in hospital too!
Much of the public attention on the opioid-epidemic has been focused on the harm caused by prescription use and abuse of opioids. However, there is another facet that must be focused on: opioid-induced respiratory depression in clinical settings.
The theme of this year’s American Thoracic Society annual conference was “where today’s science meets tomorrow’s care.” In keeping with that theme, we would like to highlight one poster on detection of opioid-induced respiratory depression through continuous electronic monitoring. To view a copy of the poster, please go to the ATS website or see an image of the poster below.
“Measuring vital signs every four hours is an outdated and dangerous practice. Patients on our hospital wards deserve continuous vital sign monitoring so they are not found ‘dead in bed,’” said Dr. Frank Overdyk, a Charleston-based anesthesiologist and expert on respiratory compromise. Dr. Overdyk is also a member of our board of advisors.
The study analyzed 6,590 hospitalization days and detected 91 events of respiratory depression. The positive predictive value of 70% of events were classified as respiratory depression or sleep apnea related. Additionally, the study indicated a very low false alarm rate – less than one in 5,000 hours of monitoring, translating to just one false alarm every seven months The study also covered a range of care units and highlighted the variance in incidence rate. Long term care units had the lowest incidence rate of respiratory depression, while post-op units had the highest. Please see an image of the poster presented at the ATS conference:
Detection of Opioid-Induced Respiratory Depression Through Continuous Electronic Monitoring
“One of the key complications resulting from opioid use in hospitalized patients is respiratory distress that can lead to ICU transfers and sadly, even death. Moreover, respiratory depression is a key risk factor across the healthcare continuum, from hospitals to skilled nursing facilities,” explained Michael Wong, JD, Executive Director of The Physician-Patient Alliance for Health & Safety (PPAHS). “For this reason, all patients receiving opioids should be continuously electronically monitored, to help provide early detection of the risk of respiratory depression and enable timely intervention.”
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.
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: