Articles we have been reading this past week of April 23, 2018 discuss eight ways to improve patient safety and health outcomes.
#1 Way to Improve Patient Safety and Health Outcomes- Use Opioid-Sparing Strategies and More Precise Monitoring
In new research by Dr. Igor Izrailtyan and his colleagues, “Risk factors for cardiopulmonary and respiratory arrest in medical and surgical hospital patients on opioid analgesics and sedatives” found that “Opioids and sedatives had an independent and additive effect on the risk of developing CPRA [cardiopulmonary and respiratory arrest].”
The researchers concluded that opioid-sparing strategies and more precise monitoring may prevent adverse events and patient deaths:
“judicious use of the combination of opioids with sedative medications, opioids sparing analgesic techniques, and more precise monitoring of selected high-risk patients may help prevent these catastrophic events”
#2 Way to Improve Patient Safety and Health Outcomes – Pledge to Make Patient Safety a Priority
In Taiwan, 16 healthcare organizations, including fourteen hospitals, committed to implement evidence-based actionable patient safety solutions, which have been proven to improve healthcare quality and eliminate preventable harm, and deaths, in hospitals.
Dr. Mingi Chan Liao M.D., Ph.D. (Jen Ai Hospital, Tali-Taichung Taiwan) said:
“To improve patient safety, we must not only listen but act. I am thrilled by the commitment of all sixteen committed hospitals and partners who have shown great leadership by implementing evidence-based processes proven to improve patient safety. The combined commitments from our two rallies means that 19 out of 22 administrative regions have embraced patient safety with the commitment to ZERO preventable deaths by 2020.”
#3 Way to Improve Patient Safety and Health Outcomes – Put Predictive Analytics to Work
Virtua Memorial Hospital has been able to nearly eliminate respiratory depression alerts, enhance care and lower costs.
Explained Leah Baron, MD (Chief, Department of Anesthesiology, Virtua Memorial Hospital) explained:
“in every observed case of opioid-induced respiratory depression, the in-room audible annunciation had no effect on waking or stirring the patients. Hence, the need for a remote monitoring capability to catch such instances is motivated more strongly to ensure patients do not slip through the cracks.”
To listen to an interview with Dr. Baron about her hospital’s experience, please click here.
#4 Way to Improve Patient Safety and Health Outcomes – Listen to the Patient
When the voice of the Patient is placed at the center of care delivery amazing things happen, says Lisa Romano RN, MSN:
“As an industry, we talk a lot about creating great patient experiences. While we have made tremendous strides around this important initiative, many patients still feel as if they aren’t “heard” and their issues are not taken seriously and/or addressed. But, what if the “prime mover” to improving the patient experience was as simple as recognizing communication is an essential practice and is even a clinical intervention? When the voice of the Patient is placed at the center of care delivery amazing things happen.”
#5 Way to Improve Patient Safety and Health Outcomes – Prevent Infection Control
The Joint Commission says that there are two reasons why organizations struggle with infection control standards – (1) increasing use of robotics and (2) discarding manufacturer’s guidelines. Says Sylvia Garcia-Houchins (infection control director, The Joint Commission):
“If, for example, an organization has been preliminarily trained on how to clean a new piece of surgical equipment by that manufacturer’s sales representative, rather than following the manufacturer’s guidelines or undergoing a more robust training with a technical representative, they may not be following the new guidelines correctly, and that can lead to insufficient implementation of appropriate infection control processes.”
#6 Way to Improve Patient Safety and Health Outcomes – Understand The Relationship Between Opioids and Respiratory Compromise
21-year old, Parker Stewart, died after being prescribed opioids following a tonsillectomy. A resolution recently passed in Utah hopes that future patient deaths may be avoided by understanding the relationship between opioids and respiratory compromise:
“The resolution urges the state Health Department, hospitals, doctors, and medical researchers to examine and identify a possible link between prescribed opiate painkillers and respiratory depression following surgery that could lead to death. It also encourages doctors to send postoperative patients home with an oxygen monitoring device when opioids are prescribed, if appropriate.”
#7 Way to Improve Patient Safety and Health Outcomes – Using High Doses of Opioids During Surgery May Increase 30-Day Readmissions
In a recent study published in British Journal of Anaesthesia, researchers found that “Intraoperative use of high (27-41 MME) vs lower doses of opioids was found to be associated with increased odds of 30-day hospital readmission.”
#8 Way to Improve Patient Safety and Health Outcomes – Prescribing Opioids May Increase Falls and Death in Older Patients
A recent study in Quebec, Canada, looked at 67,929 patients who were 65 years of age or older and who had been admitted for injury to a trauma center.
According to one of the co-authors, Dr. Raoul Daoust (Hôpital du Sacré-Cœur de Montréal and the Université de Montréal), the researchers found an association between opioid use and falls:
“This study confirms an association between recent opioid use and fall-related injury in a large trauma population of older adults. Physicians should be aware that prescribing opioids to older patients is not only associated with an increased risk of falls, but also, if these patients do fall, a higher in-hospital mortality rate.”