Must Reads, Patient Safety

Ideas to Improve Patient Safety Articles PPAHS have been reading the week of July 9, 2018

Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of July 16, 2018 suggest ideas to improve patient safety.

Ideas to Improve Patient Safety – Requiring Patients to Comply to Conduct Rules to Fight the Opioid Epidemic

The University of Tennessee Medical Center (UTMC) is now requiring patients admitted for medical treatments of drug-use-related infections to comply with new conduct rules. Dr. Jerry Epps, UTMC’s senior vice president and chief medical officer, explains:

“This is done first and foremost for patient safety. When patients are bringing in needles and drugs, and their friends are coming in with drugs, and they can shoot up in the bathroom and maybe kill themselves, I argue we’re doing our best to protect patients and team members from this dreadful problem.”

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Ideas to Improve Patient Safety – Encourage COPD Patients to Regularly Exercise

Researchers at the University of Lincoln and the University of Oxford have found:

“Pulmonary rehabilitation — a patient-tailored approach combining exercise, education, and behavioral changes — can improve physical capacity, reduce shortness of breath, and enhance the quality of life of COPD patients.”

Arwel Jones, PhD, research fellow at the Lincoln Institute for Health in the U.K., who is the senior author of the study, discusses the difficulty that such a recommendation may be for COPD patients:

“Being physically active is extremely important for people with COPD, however, people with the disease find it difficult to remain physically active once they have finished pulmonary rehabilitation.”

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Ideas to Improve Patient Safety – Utilize Capnography to Monitoring Patients Under Conscious Sedation

Referring to the clinical education podcast, “Capnography Monitoring During Conscious Sedation: A Must for Maintaining “Eyes and Ears,” Melicent Lavers-Sailly writes about the value of monitoring with capnography:

“Capnography, the measurement of carbon dioxide (CO2) in respiratory gases, has long been used to monitor the breathing of patients under anesthesia in the operating room. Now there is a growing recognition of its value as a reliable tool for monitoring patients under conscious sedation in ambulatory settings outside the OR.”

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Ideas to Improve Patient Safety – Use Data to Help Make Better Healthcare Decisions & Treatment Choices

In the article, “The benefits of leveraging data and analytics in EMS,” Dr. Brent Myers makes the case for using date to help make better healthcare decisions and treatment choices. Rather than make decisions “either guessing or using their gut,” Dr. Myers encourages “leveraging data to make smarter decisions.”

He provides two examples where data has helped make smarter decisions:

“For example, stroke assessment and care have changed since the beginning of 2018, dramatically. This can’t be emphasized enough as the entire industry is still processing this information. Two recent studies – the DAWN Trial and the DEFUSE-3 Study – highlight findings that provide new guidelines for stroke patient assessment and transport. Specifically, these studies indicate the benefit of extending the treatment window to 16 or even 24 hours after the onset of symptoms for a subset of patients with large vessel occlusion acute ischemic stroke (LVO-AIS).

“While the nearest hospital may have been an appropriate destination in the past, the new research indicates transport to the nearest thrombectomy-capable or comprehensive stroke center may be preferred for those with evidence of LVO-AIS, even when it is not the nearest facility.”

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Ideas to Improve Patient Safety – Reducing Psychological Distress May Decrease the Risk of COPD and Other Diseases

A research team led by Catharine Gale, PhD, a professor at the University of Edinburgh and at MRC Lifecourse Epidemiology Unit, University of Southampton, reviewed the clinical records of 16,485 individuals over a three-year period and found that psychological distress may increase the risk of COPD and other diseases:

“The study showed that, compared with people who had no symptoms of psychological distress, those with low levels of distress had a 57% increased chance of having arthritis and those with moderate distress levels had a 72% increased chance. A similar pattern was reported regarding cardiovascular diseases, with low distress levels increasing the risk by 46% and moderate levels by 77%.”

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Respiratory Compromise

Proper Inhaler Use Can Prevent Many Instances of Respiratory Compromise Doctors Should Ensure that Patients are Using Their COPD Inhalers Properly

Proper inhaler use can prevent many instances of respiratory compromise.  In a recent survey, “The Role of Inhalation Delivery Devices in COPD: Perspectives of Patients and Health Care Providers,” researchers from the American College of Chest Physicians surveyed 513 healthcare providers managing COPD and 499 patients with COPD across the United States and found that both patients and healthcare providers place less importance on inhaler devices than medication in the treatment of chronic obstructive pulmonary disease (COPD) and concluded:

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Respiratory Compromise

COPD’s Role in Respiratory Compromise A Clinical Education Podcast with the Society of Hospital Medicine’s COPD Team

COPD is a tremendous healthcare burden in the U.S. and worldwide, and it is important for patients and their clinicians to understand COPD’s role in respiratory compromise.

To better understand some of the key issues every patient and clinician should know about COPD’s role in respiratory compromise, the Physician-Patient Alliance for Health & Safety is pleased to release a clinical education podcast with the Society of Hospital Medicine’s COPD Team.

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Respiratory Compromise

Are You Using Your COPD Inhaler Properly? COPD Patients Need Better Education on Using Inhalers

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. 

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Patient Safety

COPD’s Role in Respiratory Compromise PPAHS Clinical Education Podcast to Focus on COPD’s Role in Respiratory Compromise

The Physician-Patient Alliance for Health & Safety (PPAHS) announced its intention to broaden its discussion of respiratory compromise to include non-opioid-related issues and COPD’s role in respiratory compromise.

Michael Wong, JD (Founder and Executive Director, PPAHS) explained that a discussion of COPD’s role in respiratory compromise is a natural progression of PPAHS initiative in growing awareness of this critical patient safety issue:

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