Opioid Safety, Practices & Tips, Respiratory Compromise

Minnesota RTs Help Implement Continuous Capnography Program

peggy lange

Peggy Lange, BA, RRT (RT Department Director, St. Cloud Hospital in St. Cloud, MN)

A recent article published by the American Association for Respiratory Care (AARC) has highlighted how respiratory therapists (RT) can play an integral role in using capnography to detect the signs of respiratory depression.  The post focuses on the experiences of Peggy Lange, BA, RRT (RT Department Director, St. Cloud Hospital in St. Cloud, MN).

Over a three month period, St. Cloud Hospital ran a pilot program to test the effectiveness of continuous capnography monitoring Center for Surgical Care, PACU, surgical care units, interventional radiology, electrophysiology lab, and emergency trauma center.  The trial was successful, proving the monitors gave an early alert to the signs of respiratory distress, as well as resolving issues caused by nuisance alarms – particularly with patients experiencing sleep apnea or periods of hyperventilation.  As a result, continuous capnography monitoring was implemented hospital-wide. Read More

Opioid Safety, Patient Stories, Respiratory Compromise

Opioid Deaths Are (Still) Preventable: Remembering Leah

Leah

Leah walked into a Los Angeles hospital a healthy, 11-year old girl.  She needed an elective surgery to repair a condition called pectus carinatum.  Despite delays, the surgery went well, but Leah was in considerable pain; to manage it, she was given escalating doses of fentanyl, along with Ativan.  

Her mother, Lenore Alexander, was concerned by Leah’s increasing unresponsiveness – but was assured by staff that Leah would be ready to walk out of the hospital in the morning.  Exhausted, Lenore took a nap by her daughter’s bedside; it would be the last time Leah was seen alive.  Lenore woke to find Leah dead in bed.

In 2012, Lenore wrote an article for PPAHS asking if continuous monitoring would have saved her daughter, Leah.  The answer, then, was a resounding “yes”.  During her hospital stay, Leah received only infrequent spot checks from staff to confirm her condition despite the administration of powerful opioids.  If only she were monitored with capnography and pulse oximetry – we would not have another tragic story to tell.

Now, on the 14th anniversary of Leah’s death, we ask the same question: would continous monitoring have saved Leah’s life?   Read More

Must Reads, Patient Safety

Top 10 Patient Safety Must Reads – November 2016

We’re saying “hello” to December, and looking back at some of PPAHS’ top posts and tweets in November.

Top Posts

This month, as part of our new campaign targeting VTE in orthopedic patients, PPAHS was invited to become a partner of World Thrombosis Day!  We also provided bittersweet coverage regarding opioid safety, including celebrating St. Joseph’s/Candler Health System’s (SJ/C) 12-years event-free and opioid safety’s place – once again – on ECRI’s Top 10 Health Technology Hazards. Read More

Opioid Safety

The U.S. Opioid Epidemic In Numbers

opiod infographic thumbnailOpioid safety is one of the top patient safety concerns in the U.S.; with more than 2 million Americans dependent on opioids, opioid-related harm is an issue that has spans the continuum of clinical and public safety.

On August 25, 2016, the Surgeon General issued a letter to physicians urging them to take a part in combating the opioid epidemic. On the Surgeon General website, healthcare providers are encouraged to help solve the opioid epidemic.

The PPAHS conducted a survey to gauge how clinicians and the public felt about the Surgeon General’s recommendations to fight the opioid epidemic, with results released early November.  Key aspects of the survey were recently featured in an article published by Advance for Nurses.  The Advance Healthcare Network also distilled the survey’s top data points and recommendations. Read More

Opioid Safety, Respiratory Compromise

Preventing Opioid-Related Adverse Events with Capnography

Patient Monitoring

This year, St. Joseph’s/Candler Health System (SJ/C) celebrated 12 years free from opioid-related adverse events.  The PPAHS had the pleasure of interviewing Harold Oglesby, RRT, Manager to uncover the SJ/C team’s learnings in implementing the quality improvement project.

From the inception of the project, continuous electronic monitoring with capnography has been a cornerstone technology to keeping patients at SJ/C safe.  Mr. Oglesby and his team implemented a continuous monitoring program with capnography after identifying a need for reliable, early indication of patient decline in ventilation.  Since the initial pilot, the monitors have shown tangible results:

“There was a couple of ‘aha’ moments when we saw that capnography giving us, sometimes an hour earlier, [indication] of a patient that was getting into distress.”

Effective implementation is crucial whenever new technology is introduced in a clinical setting.  During our interview, Mr. Oglesby speaks to three key learnings to make continuous monitoring with capnography a success. Read More

Opioid Safety, Respiratory Compromise

Respiratory Therapists Are Integral to Reducing Opioid-Related Adverse Events

Harold Oglesby - Celebrating 10 Years's Event Free

In a recent interview with Harold Oglesby, RRT, Manager, The Center for Pulmonary Health, Candler Hospital, St. Joseph’s/Candler Health System (SJ/C), our discussion focused on the success factors that contributed to SJ/C’s 12 years free from opioid-related adverse events.

During the interview, Mr. Oglesby highlighted five key learnings from his experiences in implementing and continuously improving SJ/C’s QI initiative.  One of these learnings was the importance of involving Respiratory Therapists (RT) throughout the process. Read More

Must Reads

Patient Safety Weekly Must Reads (November 11, 2016)

This week in #patientsafety, the PPAHS interviewed Harold Oglesby, RRT, to uncover the strategies implemented to keep the Candler Hospital, St. Joseph’s/Candler Health System free from opioid-related adverse events for 12 years in a row.  From around the web, we’ve found 3 articles highlighting national efforts to raise the bar in patient safety education and one on “routine” medical procedures that go wrong. Read More

Opioid Safety

Physicians on Surgeon General’s Letter on Opioid Epidemic: Survey Results

surgeon-general-turn-the-tide

On August 25, 2016, the Surgeon General issued a letter to physicians urging them to take a part in combating the opioid epidemic. On the Surgeon General website, healthcare providers are encouraged to help solve the opioid epidemic:

“Our nation faces an opioid crisis. Health care providers are uniquely positioned to help communities and their patients #TurnTheTide on the opioid epidemic. Providers can be the solution. Join the movement. Sign the pledge.”

To gauge whether clinicians would answer this call and how clinicians and the public felt about the Surgeon General’s recommendations to fight the opioid epidemic, the Physician-Patient Alliance for Health & Safety (PPAHS) conducted a survey to examine perceptions about the Surgeon General’s appeal to physicians to play an active role in stemming the opioid epidemic. Read More

Must Reads

Top 10 Patient Safety Must Reads – October 2016

In October, the PPAHS celebrated it’s 5th anniversary.  In addition to building around the growing body of knowledge regarding accounting for OSA in patients receiving opioids, the PPAHS also announced a new campaign targeting VTE in orthopedic patients. Read More