Weekly Must Reads in Patient Safety (Oct 17, 2014)

Monitoring is the catch word for this week’s must reads. It keeps patients safe and prevents avoidable patient harm. While St Joseph/Candler Hospital just celebrated 10 years of being “event free”, each year an estimated 20,800 to 678,000 patients managing their pain with patient-controlled analgesia will experience life-threatening, opioid-induced respiratory depression. If you are scared about asking your caregivers about monitoring, just say Dr. Robert Stoelting (President, Anesthesia Patient Safety Foundation) told you to.

But, in monitoring, be mindful of alarm alerts and alarm fatigue. We offer advice from members of our advisory board.

Monitor to Stay Safe

St. Joseph/Candler just celebrated 10 years of being “event free”. Starting with capnography monitoring for patients using patient-controlled analgesia, “monitoring technology is now utilized for both non-intubated and intubated patients, in the ICU, on the general floor wherever patients are receiving opioids, in the emergency room and for patients who are having procedural sedation”, says Harold Oglesby, Registered Respiratory Therapist (RRT), Manager, The Center for Pulmonary Health, Candler Hospital, and St. Joseph’s/Candler Health System.

All hospitals should follow the best practice example of St. Joseph’s/Candler.

So, the next time you are going to receive a sedative, opioid or analgesic, just say Dr. Stoelting told you to ask about monitoring in your pre-procedure discussion with your physician before receiving the dose.

Dr. Robert Stoelting (President, Anesthesia Patient Safety Foundation) says that patients about to go undergo endoscopies or colonoscopies might consider asking three questions:

  • How will I be monitored?
  • Who will be responsible for my monitoring, and will that person have other responsibilities?
  • What are the qualifications/training for the person responsible for my monitoring?

Helping Hospitals Fight The Battle Against Alarm Fatigue

However, monitoring may result in alarm fatigue. Hats off to @BN3WS, @rohitnnayak, @thebigbusman, @androworldnews and many others for tweeting about this.

According to Robert J. Szczerba at Forbes, “One of the top technologies hazards in the healthcare system is the problem of alarm fatigue, in which the sheer number, variety, and frequency of machine alarms in a hospital room leads to many of them being ignored or muted. The negative results range from annoyance to patient deaths.”

To help reduce alarm fatigue, we offer advice from members of our advisory board:

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