Opioid Safety, Patient Safety, Respiratory Compromise

Recommendations for Procedural Sedation Physician-Patient Alliance for Health & Safety Announces Intention to Develop Position Statement

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:

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Opioid Safety, Respiratory Compromise

Using Capnography and Recognizing Respiratory Compromise Could Save Patient Lives Physician-Patient Alliance for Health & Safety Releases Clinical Education Podcast with Dr. Jenifer Lightdale

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.

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Opioid Safety, Respiratory Compromise

3 Must View Podcasts on Reducing Opioid-Related Adverse Events An invitation to view PPAHS's latest podcasts

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:

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Patient Safety

Capnography use associated with reduction of adverse outcomes during procedural sedation Continuous Patient Monitoring Reduces Likelihood of Adverse Events and Patient Deaths

Millions of gastrointestinal endoscopy are performed each year in the US, with colonoscopies making up the majority of such procedures. Research conducted by Michael W. Jopling, MD and Qiu Jiejing published in BMC Anesthesiology concluded that capnography use associated with reduction of adverse outcomes during procedural sedation.

Their research sought to “estimate the incidence of pharmacological rescue events and death at discharge from an inpatient or outpatient hospitalization where [gastrointestinal endoscopic procedures] GEP was performed with sedation, and to determine if capnography monitoring was associated with reduced incidence of these adverse outcomes.”

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Opioid Safety, Respiratory Compromise

Nursing Recommendations on How Capnography Improves Patient Safety Sunnybrook Health Sciences Centre monitors patients with capnography during procedural sedation

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.

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Opioid Safety, Respiratory Compromise

Capnography Monitoring During Conscious Sedation: Essential for Maintaining "Eyes and Ears" on Patients

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.” 

 

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Opioid Safety, Respiratory Compromise

Today’s Must-Have: Capnography Monitoring During Conscious Sedation Clinical Education Podcast with Drs. Matt Kurrek and Richard Merchant

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.

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Opioid Safety, Respiratory Compromise

Capnography The Ventilation Vital Sign

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.

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Opioid Safety, Patient Stories, Respiratory Compromise

Capnography Monitoring of Five-Year Old Amber Athwal May Have Prevented Her Brain Damage

The recent case of five-year old Amber Athwal is a reminder yet again of the dangers of dental sedation without the availability of adequate personnel and patient monitoring. Unfortunately, what happened to Amber is not an isolated event, as other pediatric deaths have recently occurred, tragically with 6 year-old Caleb Sears, as well as 9-year old Solomon Womack, 17-Year Old Mariah Edwards, and 17-year-old girl, Sydney Gallegher. Read More

Alarm Fatigue, Hospital Acquired Conditions

Advances in Alarm Management and Surveillance Monitoring

Written by James Welch, CEO Arc Biomedical Consultants (jwelch@arcbiomed.com)

james-welch

Mr. Welch is a Clinical Engineer with 17 yrs experience in hospitals and over 24 yrs as an executive in the medical device industry. His focus has been on applying technologies to improve patient safety through continuous surveillance monitoring. Mr. Welch has ten patents and articles in the field of wireless physiologic monitoring, surveillance systems and alarm management. He regularly contributes to the AAMI Foundation on alarm safety and is a voting member on a number of International Standards committees.

Early detection of physiologic deterioration is essential in improving patient safety in acute care hospital settings.  Patients in non-ICU settings who are recovering from surgery or special procedures are especially vulnerable because of private or semi-private room settings prevents direct observation and nurse to patient ratios are often 1:6. Experts in Rapid Response Systems (RRS) have arrived at a consensus that strengthening early detection through continuous monitoring is essential in improving the effectiveness of RRS but only if such systems do not impose a burden on the clinical staff. The high incidence of nuisance alarms and cost are two of the major barriers preventing broader adoption of continuous monitoring on the general care floor. Read More