by Sean Power
Volume 8 Number 1 February-March 2013 of Respiratory Therapy Magazine features an article by the Physician-Patient Alliance for Health & Safety that summarizes the points of view of four experts.
The magazine calls attention to four flawed monitoring practices discussed at a webinar involving Dr. Frank Overdyk, Professor of Anesthesiology at Hofstra North Shore-LIJ School of Medicine; Ray Maddox, Director of Clinical Pharmacy, Research and Pulmonary Medicine at St. Joseph Candler; Tammy Haslar, Oncology Clinical Nurse Specialist at the Franciscan Alliance at St. Francis Health, and Debbie Fox, Director of Respiratory Care at Wesley Medical Center.
Let’s recap those flawed practices:
- Trusting that intermittent spot checks of vital signs are sufficient for assessing respiratory rate and CO2 levels.
- Continuously monitoring only “high risk” patients.
- Relying on pulse oximetry alone to detect respiratory depression.
- Implementing a monitoring program without creating an education plan.
The article present solutions for each problem highlighting that safer patient care is within reach of hospitals. The Respiratory Therapy Magazine feature comes on the heels of Patient Safety Awareness Week during which the PPAHS re-announced our PCA Safety checklist.
To hear a replay of the webinar, please click here.
What other flawed monitoring practices have you encountered? What solutions work?
Another excellent resource on PCA safety is the San Diego Patient Safety Council and the San Diego Patient Safety Taskforce, which put together a tool kit for PCA safety . It is a comprehensive document that discusses assessment for PCA appropriateness, distinction between opioid naïve and opioid tolerant patients, PCA patient education, pain assessment, sedation assessment, respiratory assessment, monitoring, adjuvant therapies (eg. for treating side effects of opioid therapy such as constipation, nausea and vomiting, pruritis), multimodal pain management strategies, standardized order sets, and specific issues related to equipment and products.
Thanks for sharing your thoughts and resources, Laura. You wouldn’t happen to have a link for that document, would you? I’d be happy to share it.
Hey Sean, just curious if Laura ever provided that link – I’d love to see it too – thanks!
Jeff
Here’s the link to the San Diego patient safety council materials: http://www.patientsafetycouncil.org/Publications.html