The Risk Management Quarterly, the peer-reviewed journal for The Association for Healthcare Risk Management of New York, Inc. (the NY chapter of the American Society for Healthcare Risk Management), recently published in its Summer 2013 edition an article by Michael Wong, executive director of the Physician-Patient Alliance for Health & Safety, on managing risk with patient-controlled analgesia (PCA).
Mr. Wong writes:
Use of patient-controlled analgesia to manage patients’ pain is accepted medical practice and is generally considered safe and effective.
Unfortunately, the statistics and the tragic patient stories noted above [please read the article for these patient stories] remind us that without proper protocols and technology in place (such as, using a PCA with integrated capnography), adverse events and patient deaths may occur.
In his recent presentation at a patient safety conference, Dr. Robert Stoelting [president, Anesthesia Patient Safety Foundation] estimated that 13 million patients will use PCA each year. The incidence of opioid-induced respiratory depression ranges from 16% to 5.2%. This means that each year up to 676,000 patients using PCA will experience opioid-induced respiratory depression. This number excludes other forms of opioid administration.
Fortunately, as the experience of St. Joseph/Candler has demonstrated, PCA adverse events can be reduced, if not eliminated, and putting into place proper risk management and patient safety measures can provide a significant return on investment.
Hospitals and healthcare professionals are, therefore, encouraged to use the PCA Safety Checklist as a tool to use to assist with this risk management and reduction.
For a pdf copy of the PCA Safety Checklist referred to in the article, please click here.
To read the article in its entirety, please click Michael Wong article RMQ-Summer 2013.