We’re bringing back a weekly review of the trending topics in patient safety from PPAHS and around the world. In this week, we highlight 2 guest contributors to PPAHS, the latest in opioid monitoring technology, and developments to the culture of patient safety. Continue reading “Patient Safety Weekly Must Reads (Aug 26, 2016)”
Tag: opioid
Why Number of Opioid Prescriptions Written May Not Be as Important as Patient Assessment and Monitoring
The NY Times recently reported:
“After years of relentless growth, the number of opioid prescriptions in the United States is finally falling, the first sustained drop since OxyContin hit the market in 1996 … Experts say the drop is an important early signal that the long-running prescription opioid epidemic may be peaking, that doctors have begun heeding a drumbeat of warnings about the highly addictive nature of the drugs and that federal and state efforts to curb them are having an effect.” Continue reading “Why Number of Opioid Prescriptions Written May Not Be as Important as Patient Assessment and Monitoring”
Overdose Risk Assessment in Chronic Opioid Therapy
Before recommending opioid therapy, assess patients for risk of overdose. In this article, Peggie L. Powell, MSN, APRN, FNP-BC a family nurse practitioner, discusses using RIOSORD, the first tool intended to provide clinicians with the clinical decision support to assess the risk of OSORD and determine the possible need for naloxone.
By Peggie L. Powell, MSN, APRN, FNP-BC
Over 100 million people suffer from chronic pain in the United States, and for some of these people, chronic opioid therapy (COT) may be appropriate. Despite the limited availability of strong scientific evidence to support long-term opioid therapy for chronic noncancer pain, COT has increased substantially over the years along with an increase in drug related deaths.
Prescription opioid related deaths have quadrupled since 1999 in the United States and approximately 80% of deaths are due to unintentional overdose. The addictive nature of opioids makes them vulnerable to misuse and abuse. Persons whom take opioids for their intended purpose can risk significant adverse events if they do not take them as prescribed (e.g., taking more than prescribed and taking them in combination with other psychotropic medications and/or alcohol). Opioids can depress the central nervous system and result in serious, life-threatening consequences such as respiratory depression, sedation, coma, and potentially death. Continue reading “Overdose Risk Assessment in Chronic Opioid Therapy”
Drawn Curtains, Muted Alarms, And Diverted Attention Lead To Tragedy In The Postanesthesia Care Unit
By Institute for Safe Medication Practices (ISMP)
Editor’s Note: This article first appeared on the ISMP website. It discusses the role that inadequate monitoring and muted alarms played in the recent tragic recent death of a 17-year old following a tonsillectomy. PPAHS has previously discussed deaths of pediatric patients following dental or oral procedures. We welcome your thoughts and comments on this issue.
Problem: Last April, a 17-year-old girl died following an uncomplicated tonsillectomy performed in an outpatient ambulatory surgery center after receiving a dose of IV fentaNYL in the postanesthesia care unit (PACU). The case made headline news again recently when a civil lawsuit filed by the teen’s parents was resolved. While it is too late to reverse the tragic outcome of this case, we call upon all hospitals and outpatient surgery centers to learn from the event and take action to prevent a similar tragedy in your facility. Continue reading “Drawn Curtains, Muted Alarms, And Diverted Attention Lead To Tragedy In The Postanesthesia Care Unit”
Reducing the Opioid Abuse Epidemic
by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)
Congress has been busy trying to pass a slew of bills that may help reduce the prescription drug abuse and heroin epidemic.
To better understand why diversion, misuse, abuse, and overdose of opioids is a bipartisan issue that requires people from both sides of the aisle to come together, I interviewed Michael C. Barnes, Esq. (Executive Director, Center for Lawful Access and Abuse Deterrence). Continue reading “Reducing the Opioid Abuse Epidemic”
Two Key TakeAways from New American Pain Society Guideline for Post-Surgical Pain Management
By the Physician-Patient Alliance for Health & Safety (PPAHS)
The American Pain Society (APS) recently released Clinical Practice Guideline for Post-Surgical Pain Management sets forth recommendations from an interdisciplinary expert panel. The APS commissioned the panel which received input from the American Society of Anesthesiologists (ASA), and the guideline was approved by the American Society of Regional Anesthesia and Pain Management (ASRA).
Roger Chou, MD, lead author and head of the Oregon Evidence-based Practice Center, says that the guideline targets at all clinicians involved with post-surgical pain:
The intent of the guideline is to provide evidence-based recommendations for better management of postoperative pain, and the target audience is all clinicians who manage pain resulting from surgery
Here are two key takeaways from the 32 recommendations: Continue reading “Two Key TakeAways from New American Pain Society Guideline for Post-Surgical Pain Management”
The Epidemic of Opioid OverPrescribing Suggests the Need for Caution and Careful Monitoring
Recent research has found that opioids are being overprescribed to patients.
A study at the Johns Hopkins University School of Medicine has found that opioids are being overprescribed to children.
Myron Yaster, MD (Richard J. Traystman Distinguished Professor, Departments of Anesthesiology, Critical Care Medicine and Pediatrics, Johns Hopkins University School of Medicine) and his colleagues interviewed the patients of pediatric patients who had been given opioids upon discharge from hospital. They were looking to determine: Continue reading “The Epidemic of Opioid OverPrescribing Suggests the Need for Caution and Careful Monitoring”
How much safer are we? – Weekly Must Reads in Patient Safety (Jan 29, 2016)
In a recent article, Peter Pronovost, MD, PhD, FCCM (Professor, Departments of Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University School of Medicine and Medical Director, Center for Innovation in Quality Patient; Member of the Physician-Patient Alliance for Health & Safety PCA Safety Panel and OB VTE Recommendations Working Group) asks a great question, “Patient Safety at 15: How Much Have We Grown?”.
Dr. Pronovost reflects on the past 15 years:
Continue reading “How much safer are we? – Weekly Must Reads in Patient Safety (Jan 29, 2016)”
Lack of Prescriber Opioid Knowledge May Lead to Adverse Events or Death
A recent survey shows that a lack of knowledge of opioids among medical students, residents, and attending physicians could lead to adverse events or death. The survey was conducted at the anesthesiology, surgery, obstetrics and medicine departments at Thomas Jefferson University Hospital.
Continue reading “Lack of Prescriber Opioid Knowledge May Lead to Adverse Events or Death”
Can Clinicians Reduce Opioid Dependence Through Multimodal Approaches to Pain Management?
By Sean Power
November 17, 2015
Mary Rechtoris, writer at Becker’s Healthcare, reported on the North American Spine Society’s 30th Annual Meeting held in Chicago, at which experts discussed whether multimodal pain management approaches could reduce opioid dependence.