Opioid Safety, Respiratory Compromise

8 Key Points to Improving Patient Safety: Physician-Patient Alliance for Health & Safety Presents at AORN Annual Conference 2014

At the annual conference of Association of periOperative Registered Nurses (AORN), which took place March 30 – April 2, 2014, the Physician-Patient Alliance for Health & Safety (PPAHS) presented eight key points to improve patient safety and health outcomes.

Three of the most commonly overlooked clinical points are:

  • Verify hand–off or transition of care from nurse-to–nurse that continuous electronic monitoring is in place, has been maintained and double-checked.
  • Double check PCA dosing, pump parameters, and continuous monitor settings.
  • Include in the post-operative orders daily lead changes and hands off communication on lead changes to decrease nuisance alarms.

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Opioid Safety, Respiratory Compromise

Monitoring the High-Acuity Patient: Does Risk Stratification Increase or Decrease Patient Safety?

by Dr. Frank Overdyk (Executive Director for Research, North American Partners in Anesthesiology, and Professor of Anesthesiology at Hofstra University School of Medicine)

Summary: The topic of who is a suitable candidate for outpatient surgery is front and center with productivity pressures being intense at ambulatory surgery centers. However, with surgery often comes the necessity of the use of opioids for pain control. Studies have shown that any patient receiving opioids may be at risk of postoperative respiratory depression and if undetected, respiratory arrest  (also known as “Code Blue”). The most common antecedents to cardiopulmonary arrest are of respiratory origin. Respiratory decompensation—as evidenced by tachypnea, bradypnea, hypoxia, hypercarbia or changes in mental status—are often the earliest warning signs of physiologic instability. Monitoring respiratory function and level of consciousness are especially important in detecting and preventing adverse events for patients receiving opioids and sedatives. Read More

Opioid Safety, Respiratory Compromise

Monitoring Technology for PCA Pumps Can Prevent Adverse Events with Patient-Controlled Analgesia (PCA): So Why Are Hospitals Not Using It?

By Michael Wong

(This article has also been published in SurgiStrategies, which can be read here.)

According to its newly-updated, “How-to Guide: Prevent Harm from High-Alert Medication”, the Institute for Healthcare Improvement (IHI) looked at high-alert medications, which are “more likely than other medications to be associated with harm”.

One of the areas that the IHI singles out is narcotics. Read More

Opioid Safety, Respiratory Compromise

How often do errors with patient-controlled analgesia (PCA) occur?

by Michael Wong

Many readers of this website have asked, how often do errors with patient-controlled analgesia (PCA) occur?

In a retrospective analysis lead by Rodney Hicks (who at the time of the study was Manager, Patient Safety Research and Practice, United States Pharmacopeia), the magnitude, frequency, and nature of non-harmful and harmful medication errors associated with PCA were studied. (Professor Hicks is now Professor, Western University College of Graduate Nursing, Pomona, California). Read More

Opioid Safety, Respiratory Compromise

Preventing “Dead In Bed Syndrome” with Patients After Surgery

Survey found that a patient safety checklist may help prevent “dead In bed” syndrome.

by Michael Wong

In our recently conducted survey among healthcare providers, almost all the respondents (85%) favor the development and use of safety checklists.

Because of this strong desire of healthcare professionals to have a checklist, PPAHS is putting together a working group to create a checklist targeted towards patient-controlled analgesia. This checklist would reinforce the need for continuous electronic monitoring for oxygenation and ventilation. Read More

Opioid Safety, Respiratory Compromise

Post-Surgical Patients Require Better Monitoring Anesthesia Patient Safety Foundation recommendations improve safety of post-surgical patients

by Michael Wong

PPAHS encourages the adoption of the Anesthesia Patient Safety Foundation (APSF) recently released recommendations to improve the safety of patients by continuously monitoring patients following surgery. Read More

Opioid Safety, Respiratory Compromise

What are the costs of implementing patient safety? How St. Joseph’s/Candler averted more than 471 adverse events and saved costs

St. Joseph’s/Candler Health System (SJCHS) found out that the “costs” over a 5-year period of implementing a patient safety initiative was the prevention of at least 471 adverse events, a return on investment of $1.87 million, an internal rate of return of 81%.

by Michael Wong

St. Joseph’s/Candler Health System (SJCHS) found out that the “costs” over a 5-year period of implementing a patient safety initiative was the prevention of at least 471 adverse events, a return on investment of $1.87 million, an internal rate of return of 81%. Read More