Avoiding adverse events secondary to opioid-induced respiratory depression: Implications for nurse executives and patient safety

Carla R. Jungquist, Darin J. Correll, Lee A. Fleisher, Jeffrey Gross, Rajnish Gupta, Chris Pasero, Robert Stoelting, Rosemary Polomano

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Guidelines with recommendations for monitoring type and timing of hospitalized patients for opioid-induced respiratory depression have been published, yet adverse events continue to occur. OBJECTIVE: This study reports on the monitoring practices of 8 hospitals that volunteered to pilot test a Centers for Medicare & Medicaid Services e-quality measure that was under development. Recommendations for nurse executives are provided to support patient safety. METHODS: Data on monitoring practices were collected retrospectively from the electronic medical records at 8 hospitals on all patients receiving intravenous (IV) opioids for more than 2.5 continuous hours via patient-controlled analgesia (PCA). Analysis included the percentage of patients who were monitored according to specific standards developed by a panel of technical experts with comparisons of naloxone use to monitoring practices. RESULTS: Recommended patient assessments occurred in only 8.3% of the patients. No patients who were assessed at least every 2.5 hours received naloxone. CONCLUSIONS: Care for patients receiving IV PCA is lacking in adherence to latest safety standards. Nurse executives must implement structures and processes to promote vigilance with evidence-based monitoring practices.

Original languageEnglish (US)
Pages (from-to)87-94
Number of pages8
JournalJournal of Nursing Administration
Volume46
Issue number2
DOIs
StatePublished - Feb 1 2016

ASJC Scopus subject areas

  • Leadership and Management

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