Although there are benefits to the use of opioids for the management of pain, particularly with patients post-operatively, there are risks of over-sedation and respiratory depression, as The Joint Commission cautions in its Sentinel Event Alert “Safe use of opioids in hospitals”:
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.
Assessing which patients are at risk of developing opioid-induced respiratory depression (OIRD) would be of benefit, as treatments could be altered or tailored to the particular patient to reduce the risk of opioid-related adverse events.
The Michigan Opioid Safety Score (MOSS) was “developed to incorporate patient risk, respiratory rate, and sedation into one bedside score that could be used to improve patient safety during inpatient opioid therapy. Scoring is based on a summation of risk data with objective bedside measures of over-sedation trumping a patient’s subjective reports of pain.” Read More
(This article first published in Advance for Nurses, which covers the issues that matter most to nurses practicing in all areas of the profession. As that publication winds down, we have archived some articles here.)
By Malinda Loflin, RN, BSN. Malinda is a certified case manager at a hospital in Oklahoma City. During her 22 years as a registered nurse, her clinical experience has been in many specialty areas including the operating room, post-anesthesia care unit, and the emergency department. In 2006, her father tragically died of opioid-induced respiratory depression after a routine surgery. She shared her experience and the impact that it has had on her and her family at the 2011 Anesthesia Patient Safety Conference.
Nursing spot checks on postoperative patients receiving opioids are not enough to ensure the safety of patients. I say this as both a registered nurse who works at a large medical center and as a daughter who has had the misfortune of seeing her own father die between nurses’ spot checks. Read More
by Michael Wong
PPAHS encourages the adoption of the Anesthesia Patient Safety Foundation (APSF) recently released recommendations to improve the safety of patients by continuously monitoring patients following surgery. Read More