The Physician-Patient Alliance for Health & Safety (PPAHS) is pleased to announce that the Columbia University Medical Center (CUMC) webinar on respiratory compromise prevention, recognition and intervention is now available on the PPAHS YouTube Channel.
Columbia University Medical Center Webinar on Respiratory Compromise Prevention, Recognition and Intervention
The webinar features the following clinicians from CUMC:
- Paul Boerem, ACNP, RT, Critical Care Nurse Practitioner and Certified Respiratory Therapist, Department of Medicine, Pulmonary, Allergy and Critical Care;
- Monica P. Goldklang, MD, Assistant Professor of Medicine (in Anesthesiology)
Department of Anesthesiology, Critical Care Medicine;
- Steven E. Miller, MD, Assistant Professor of Anesthesiology (Moderator)
Department of Anesthesiology, Critical Care Medicine; and
- Amanda J. Powers, MD, Assistant Professor of Surgery (in Anesthesiology)
Department of Surgery, Acute Care
The Respiratory Compromise Institute (RCI) — a diverse coalition of 13 medical and safety organizations devoted to raising awareness about the condition — defines respiratory compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death, but in which specific interventions (enhanced monitoring and/or therapies) might prevent or mitigate decompensation.
“This webinar highlights how respiratory compromise is a serious, potentially deadly patient safety issue that may be avoidable when proper prevention and identification strategies are used, and when healthcare providers are equipped with comprehensive patient monitoring technology,” explains Michael Wong, JD, Executive Director, PPAHS. “Education about the condition and how it can be prevented is vital to reducing its incidence. We encourage all clinicians to view the webinar to learn how they can provide the safest possible care for their patients, particularly those with risk factors that may increase their chances of developing respiratory compromise.”
Risk factors for respiratory compromise include obstructive sleep apnea, older age, obesity and chronic obstructive pulmonary disease1-2, in addition to receiving opioid administration.3
The webinar was made possible through an educational grant from Medtronic plc, one of the world’s largest medical technology, services and solutions companies.
- Frederickson TW, Gordon DB, De Pinto M, et al. Reducing Adverse Drug Events Related to Opioids Implementation Guide. Philadelphia: Society of Hospital Medicine, 2015.
- Karcz M, Papadakos PJ. Respiratory complications in the postanesthesia care unit: A review of pathophysiological mechanisms. Can J Respir Ther. 2013;49(4):21-29.
- Jarzyna D, Jungquist CR, Pasero C, et al. American society for pain management nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain Manag Nurs. 2011;12(3):118-145. doi: 10.1016/j.pmn.2011.06.008.
From the articles we have been reading this week, here are 3 tips for managing pain and using opioids safely.
#1 Tip for Managing Pain and Using Opioids Safely – Premier Safety Institute new toolkit helps providers manage pain, curb opioid use
Editor’s note: In this personal message from the Founder and Executive Director, Physician-Patient Alliance for Health & Safety, Michael Wong invites you to listen to 3 must view podcasts on reducing opioid-related adverse events.
By Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety)
Watch and share these 3 Clinical Education Podcasts on how to reduce opioid-related adverse events.
Our podcasts feature health and safety experts on the latest recommendations and best practices:
Reading about the ongoing coverage of the opioid epidemic this past week has prompted the following questions – do you agree or disagree?
Should newborns with opioid withdrawal be kept together with their mothers?
Newborns suffering from opioid withdrawal have traditionally been separated from their mothers.
The PPAHS team has been reading many must read articles for battling the opioid epidemic this week.
Must Read Articles for Clinicians and Hospital Executives for Battling the Opioid Epidemic
Nursing recommendations from ARIN and AORN encouraged Sunnybrook Health Sciences Centre to monitor with capnography patients undergoing procedural sedation.
In a podcast with the Physician-Physician Alliance for Health Safety, Barbara McArthur, RN, BScN, CPN(C), an advanced practice nurse at Sunnybrook Health Sciences Centre in Toronto, Canada, discussed why Sunnybrook Health Sciences Centre decided to monitor with capnography.
The Physician-Physician Alliance for Health Safety has released a clinical education podcast on capnography monitoring during conscious sedation with Barbara McArthur, RN, BScN, CPN(C). Ms. McArthur is an advanced practice nurse at Sunnybrook Health Sciences Centre in Toronto, Canada.
Capnography Monitoring: An Early Indicator of Patient Deterioration
After reviewing the current literature, Sunnybrook decided that monitoring with capnography resulted in safer patient care. Capnography monitoring provides an early indicator of patient deterioration, which can be crucial in averting adverse events and patient deaths. Capnography monitoring, says Ms. McArthur, is monitoring in “real time. With pulse oximetry, there is a delay, which could be up to a minute in healthy patients. So, that’s a significant sort of time that is delayed that reaction could happen.”
Today, the Physician-Patient Alliance for Health Safety released a clinical education podcast with Matt Kurrek, MD, FRCPC (Professor, Department of Anesthesia, University of Toronto) and Richard Merchant, MD, FRCPC (Clinical Professor, University of British Columbia, Department of Anesthesia, Pharmacology & Therapeutics).
Drs. Kurrek and Merchant coauthored an editorial, “Yesterday’s Luxury, Today’s Necessity” after the Canadian Anesthesiologists’ Society [CSA] published its revised 2012 guidelines to the practice of anesthesia. The CSA guidelines recommend capnography monitoring during conscious sedation. In the podcast, Drs. Kurrek and Merchant discuss why capnography monitoring may have been considered yesterday’s luxury, but is now a necessity during conscious sedation.
Editor’s Note: This research was presented as a poster at the 2017 ANCC National Magnet Conference.
By Eric Griffin MSN, RN, CEN (Magnet Program Director, Baystate Medical Center) and Laura Bolella MSN, RN (Assistant Nurse Manager, Baystate Medical Center)
For over a hundred years nurses have monitored the same vital signs. Unfortunately these vital signs can be slow to change, inaccurate, and misleading. Although there have been modern advances in physiological monitoring devices, their acceptance has been limited. Pulse oximetry developed in the early 1970’s is extremely useful in measuring oxygenation, although it has limitations related to the following factors: poor signal strength, fingernail polish, anemia, patient motion, calloused skin, hypoperfusion, time lag, and vasoconstriction.
Despite the focus on appropriate use of opioids for pain management, ECRI Institute Patient Safety Organization (PSO) found that there are many hospitals that continue to experience opioid-related adverse events and deaths. To help prevent further patient harms and deaths, PSO conducted a deep dive analysis of adverse events related to opioids in the acute care setting.