Avoiding Adverse Events Secondary to Opioid-Induced Respiratory Depression: Implications for Nurse Executives and Patient Safety

The Journal of Nursing Administration
Carla R JungquistRosemary C Polomano

Abstract

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. 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. 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. Recommended patient assessments occurred in only 8.3% of the patients. No patients who were assessed at least every 2.5 hours received naloxone. 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.

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Citations

May 26, 2017·The American Journal of Nursing·Frank J OverdykJeanne Zack
Feb 18, 2017·The American Journal of Nursing·Carla R JungquistRosemary C Polomano
Oct 19, 2017·The Journal of Nursing Administration·Marianne L DurhamLouis Fogg
Mar 31, 2018·Current Opinion in Anaesthesiology·Brian J Anderson
Mar 23, 2019·Biomedical Instrumentation & Technology·Bruce FriedmanJohn R Zaleski
May 17, 2019·Journal of Nursing Care Quality·Josephine KamendatKathleen Richards-Weatherby
Dec 14, 2018·AACN Advanced Critical Care·John J Gallagher
Aug 5, 2019·Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses·Carla R JungquistRosemary C Polomano
Dec 4, 2020·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Tássia Marília Castelo Branco Freire CubaDanielle de Mendonça Henrique

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