Patient Safety

How to Avoid Opioids and Surgery for Back Pain

Editor’s note: In this guest article, RJ Burr discusses how to avoid opioids and surgery for back pain.

By RJ Burr, DC, Cert. MDT, CSCS

The Opioid Epidemic. I’m sure you’ve heard of it and it’s very likely you have a personal experience whether it’s you or someone you know who has been affected by the opioid crisis.

Per the National Institute of Drug Abuse (NIDA), Every day, more than 130 people in the United States die after overdosing on opioids.

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Opioid Safety

Clinicians’ Roles in the Opioid Epidemic Articles PPAHS have been reading the week January 21, 2019

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.

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Patient Safety

Is this the Right Question to Ask – Who’s to Blame for the Opioid Epidemic? From the Desk of PPAHS’s Executive Director

Editor’s note: In this editorial from the desk of the Executive Director of the Physician-Patient Alliance for Health & Safety, Michael Wong, JD discusses the the recent documents disclosed in the State of Massachusetts against Purdue Pharma and asks whether this is right question to ask – “Who’s to Blame for the Opioid Epidemic?”

By Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety

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.

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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.”

Good Idea for #Opioidepidemic? - Require Patients to Comply to Conduct Rules Click To Tweet

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.”

Encourage #COPD Patients to Regularly Exercise Click To Tweet

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.”

Utilize Capnography to Monitoring Patients Under Conscious Sedation Click To Tweet

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.”

Use Data to Help Make Better Healthcare Decisions & Treatment Choices Click To Tweet

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%.”

Reducing Psychological Distress May Decrease the Risk of COPD and Other Diseases Click To Tweet
Must Reads

3 Patient Safety Ideas to Implement Articles PPAHS have been reading the week of July 2, 2018

Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of July 2, 2018 ask us to consider 3 patient safety ideas to implement.

#1 Patient Safety to Implement – Remember that Some Patients Need Opioids

In the nation’s battle to curtail the use of opioids, there are patients who need them.

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Opioid Safety

Do These 3 Efforts Help Stop the Opioid Epidemic? Articles PPAHS have been reading the week of June 25, 2018

Articles the Physician-Patient Alliance for Health & Safety (PPAHS) have been reading the week of June 25, 2018 focus on 3 efforts to help stop the opioid epidemic.

Effort #1 – Does Government Legislation Address the Opioid Epidemic?

The House of Representatives recently passed what has been called the “most expansive legislation” to address the opioid epidemic. According to CNN, the key provision would allow Medicaid to pay for certain treatments for mental illness.

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Opioid Safety

How Nurses Can Fight The Opioid Epidemic

In this article published in the February 2018 issue of Hospital News, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) discusses how nurses can fight the opioid epidemic. Mr. Wong cites resources, such as the PCA Safety Checklist, and harm reduction principles set forth in the Canadian Nurses Association paper, “Harm Reduction & Illicit Substance Use: Implications for Nursing.”

The US and Canada are both battling the opioid epidemic. As Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety) writes in the article, “How Nurses Can Fight The Opioid Epidemic”:

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Patient Safety, Patient Stories

Taking Fentanyl Can Kill You Michelle McNamara's Death Caused by a Toxic Mixture of Fentanyl and Other Drugs

Abstract: The lesson learned from the death of Michelle McNamara – taking opioids can kill you. The opioid fentanyl can cause delayed respiratory depression and tragically death, particularly when used in combination with other sedating drugs.

Michelle McNamara, the writer and wife of comedian Patton Oswalt, died unexpectedly in her sleep in April 2016. Mr. Oswalt says that her death was caused by a toxic mixture of fentanyl and other drugs. As reported by People:

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