A recent proposal sets forth a seven-step framework for monitoring patients receiving opioids.
In their article, “Instituting Best Practice for Monitoring for Opioid-Induced Advancing Sedation in Hospitalized Patients”, Carla R. Jungquist, RN, PhD and her colleagues propose a seven-step framework “to translate evidence based guidelines and recommended best practices into an action-oriented stepwise process to recognize and systematically address the surveillance and prevention of opioid-induced unintended advancing sedation and respiratory depression adverse events in hospital settings.”
Highlighting growing concerns about about opioid-induced respiratory depression, The Joint Commission issued the Sentinel Event Alert #49, “Safe use of opioids in hospitals” that called for a safer health care environment for patients receiving opioids:
While opioid use is generally safe for most patients, opioid analgesics may be associated with adverse effects, the most serious effect being respiratory depression, which is generally preceded by sedation … Adverse events can occur with the use of any opioid; among these are fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, and sufentanil.
Through recommendations and clinical practice guidelines, leading health and medical organizations have also called for safer health care for patients receiving opioids. These organizations include Anesthesia Patient Safety Foundation (APSF), American Society for Pain Management Nursing (ASPMN), Society for Ambulatory Anesthesia (SAMBA), American Society of Anesthesiologists (ASA), and Emergency Nurses Association (ENA).
However, these organizations’ appeals have resulted in few changes in the way patients receiving opioids are monitored.
In their article, Ms. Jungquist and her colleagues set forth the following seven step framework for monitoring patients receiving opioids:
What do you think of these seven steps? Could they be implemented in your hospital?