Researchers at the University of Colorado Hospital recently reported that their use of a PCA safety checklist was found to reduce pain from moderate-severe pain to no-mild pain in 42% of patients within 2 days. In “Let’s Be Smart About Improving Pain,” they reported:
Our PCA safety checklist smart phrases increased use of a safety checklist and documentation of daily PCA opioid trends, and correlated with more rapid improvement in moderate-severe pain levels.
They used smart phrases in these four areas covering a patient’s continuum of care – PCA initiation, PCA titration, PCA transition to oral opioids, and PCA discharge handoff – to facilitate standardized documentation of PCA management.
The Physician-Patient Alliance for Health & Safety released a PCA Safety Checklist developed in conjunction with renowned medical experts, including intensive care specialist and a leader in medical checklist development Peter J. Pronovost, MD, PhD, FCCM, Professor, Departments of Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University School of Medicine and Medical Director, Center for Innovation in Quality Patient; and Atul Gawande, MD, Professor in the Department of Health Policy and Management at the Harvard School of Public Health, who is a surgeon at Brigham and Women’s Hospital Professor of Surgery at Harvard Medical School and author of “The Checklist Manifesto.”
“We would recommend that all patients receiving opioids be continuously electronically monitored,” said Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety.
Please refer to the PPAHS position statement on continuous electronic monitoring for more information.
Using benzodiazepines and opioids may be a deadly combination. According to the National Institute on Drug Abuse, more than 30% of opioid overdoses involve the use of benzodiazepines.
One of the commonly overlooked complications to safe opioid administration is failing to account for the additive sedation effects of non-opioid medication. In recognition of these dangers, in August 2016, the FDA issued its strongest warning about combined use of opioids and benzodiazepines and issued another caution more recently on September 20, 2017.
Recent survey points to the need for better education for COPD patients on how to use inhalers.
Chronic obstructive pulmonary disease (COPD) is a respiratory disorder that affects millions of patients and leads to substantial morbidity, mortality, disability, impaired quality of life, and increased health care costs. As the COPD Outcomes-based Network for Clinical Effectiveness & Research Translation (CONCERT) explains:
“Chronic Obstructive Pulmonary Disease (COPD) is a respiratory disorder that affects about 300 million patients worldwide and 30 million patients in the US alone. COPD carries a substantial burden in human suffering. Dyspnea and other respiratory symptoms are common and can be disabling. Respiratory infections and exposure to environmental triggers lead to episodic deteriorations (acute exacerbations of COPD; AE-COPD) and result in over 700,000 hospitalizations and 100,000 deaths each year in the U.S. alone.
Articles we have been reading this past week of May 7, 2018 focus on opioids and preventing “dead-in-bed.”
How Often Does “Dead-In-Bed” Happen in Hospitals?
The Physician-Patient Alliance for Health & Safety (PPAHS) announced its intention to develop a position statement on recommendations for procedural sedation.
Michael Wong, JD (Founder and Executive Director, PPAHS) explained that such a position statement on recommendations for procedural sedation would encapsulate guidelines and recommendations from leading medical organizations in Canada and the United States:
The number of patients – and, particularly, children – dying from dental sedation is indicative that there are gaps in the standard of medical care being used during dental sedation.
In this article by Bradley T. Truax, MD (The Truax Group) and Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety), the authors discuss why dental sedation needs better standards to prevent further patient deaths and provide seven keys.
To read the article in Dentistry Today, please click here.
The Physician-Patient Alliance for Health & Safety (PPAHS) released a clinical education podcast, “Using Capnography and Recognizing Respiratory Compromise Could Save Patient Lives.”
The podcast features an interview with Jenifer Lightdale, MPH, MD who is division chief, pediatric gastroenterology and chief quality officer at the Children’s Medical Center at the University of Massachusetts Medical School.
To help identify and monitor for respiratory compromise, Canadian Society of Respiratory Therapists has launched a Respiratory Compromise Toolkit.
By Adam Buettner, RRT, FCSRT (President-Elect, Canadian Society of Respiratory Therapists) and Carolyn McCoy, BHS, RRT, FCSRT (Director of Professional Practice, Canadian Society of Respiratory Therapists)
The Canadian Society of Respiratory Therapists (CSRT) recently released a Respiratory Compromise Toolkit to help detect and prevent respiratory compromise.
With the permission of the Association for the Advancement of Medical Instrumentation (AAMI), the Physician-Patient Alliance for Health & Safety (PPAHS) is pleased to release the AAMI video on how to keep patients and their families safe, “Only Continuous Electronic Monitoring Can Ensure Patients Receiving Opioids Are Safe.”
In a clinical education podcast, Frank Overdyk, MD, who is an anesthesiologist practicing in Charleston, SC, discusses preventing avoidable deaths and the costs of monitoring patients receiving opioids and the costs of not being monitored. It is impossible to predict with 100% accuracy how a particular patient will react when administered an opioid. Continuous patient monitoring, which costs just $20-$30 per day in the case of monitoring with pulse oximetry, is a small price to pay to help prevent avoidable patient deaths.
By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)
I recently interviewed Frank Overdyk, MD, who is an anesthesiologist practicing in Charleston, SC, about the costs of monitoring patients receiving opioids and the costs of not being monitored. Dr. Overdyk is a member of board of advisors of the Physician-Patient Alliance for Health & Safety and organized the two conferences on opioid-induced respiratory depression (“OIRD”) for the Anesthesia Patient Safety Foundation.