2.50
Hdl Handle:
http://hdl.handle.net/10755/161852
Category:
Abstract
Type:
Presentation
Title:
High Risk Protocol: Preventing Respiratory Complications
Author(s):
Johnson, Judy M.; Cumicek, Jennifer L.
Author Details:
Judy M. Johnson, BSN, RN, Bellin Health, DePere, Wisconsin, USA, email: pj4482@sbcglobal.net; Jennifer L. Cumicek, RN, BSN, CPAN
Abstract:
Poster presented at AORN's 58th Annual Congress: Clinical Issue: Prevent death from over-sedation and respiratory compromise in patients receiving sedation, anesthesia, or opioids. Team: Physicians, Nurses, Respiratory Therapists, Pharmacists. Assessment: Death related to over-sedation and respiratory compromise has been documented. No clear guidelines identify the patients at highest risk for these complications. Preparation and Planning: Literature review and expert consultations were conducted. The hospital's sentinel and near-miss events were studied. A "huddle" with the bedside team was performed after emergent naloxone administration. A list of contributing risk factors were assembled into a communication tool and reviewed at each transition of patient care. A High Risk Protocol was developed and implemented. Outcome measurements include emergent naloxone use and occurrence of over-sedation respiratory events. Implementation: The following protocol was implemented after risk identified: (a) hourly observation, (b) positioning for adequate air exchange, (c) patient controlled analgesia (PCA) monitoring hourly for first four hours, (d) exhaled carbon dioxide monitoring (ETCO2) with respiratory therapist consult, and (e) appropriate nursing assignments based on acuity and patient's geographical placement on nursing unit. The protocol was tested on the orthopedic unit. Outcome: No deaths or sentinel events from over-sedation related compromise have occurred since protocol implementation. Naloxone use decreased by 85% on the orthopedic unit. The protocol is slotted for spread to patient care areas hospital wide. Implications for Perioperative Nursing: Identification of risk combined with integration of ETCO2 monitoring in a structured protocol is valuable in preventing respiratory complications during and after sedation, anesthesia, or opioid pain management.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2011
Conference Name:
AORN 58th Annual Congress
Conference Host:
Association of periOperative Registered Nurses
Conference Location:
Philadelphia, Pennsylvania, USA
Description:
AORN 58th Annual Congress, 2011 held March 18, 2011 - March 24, 2011 in Philadelphia Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHigh Risk Protocol: Preventing Respiratory Complicationsen_GB
dc.contributor.authorJohnson, Judy M.en_US
dc.contributor.authorCumicek, Jennifer L.en_US
dc.author.detailsJudy M. Johnson, BSN, RN, Bellin Health, DePere, Wisconsin, USA, email: pj4482@sbcglobal.net; Jennifer L. Cumicek, RN, BSN, CPANen_US
dc.identifier.urihttp://hdl.handle.net/10755/161852-
dc.description.abstractPoster presented at AORN's 58th Annual Congress: Clinical Issue: Prevent death from over-sedation and respiratory compromise in patients receiving sedation, anesthesia, or opioids. Team: Physicians, Nurses, Respiratory Therapists, Pharmacists. Assessment: Death related to over-sedation and respiratory compromise has been documented. No clear guidelines identify the patients at highest risk for these complications. Preparation and Planning: Literature review and expert consultations were conducted. The hospital's sentinel and near-miss events were studied. A "huddle" with the bedside team was performed after emergent naloxone administration. A list of contributing risk factors were assembled into a communication tool and reviewed at each transition of patient care. A High Risk Protocol was developed and implemented. Outcome measurements include emergent naloxone use and occurrence of over-sedation respiratory events. Implementation: The following protocol was implemented after risk identified: (a) hourly observation, (b) positioning for adequate air exchange, (c) patient controlled analgesia (PCA) monitoring hourly for first four hours, (d) exhaled carbon dioxide monitoring (ETCO2) with respiratory therapist consult, and (e) appropriate nursing assignments based on acuity and patient's geographical placement on nursing unit. The protocol was tested on the orthopedic unit. Outcome: No deaths or sentinel events from over-sedation related compromise have occurred since protocol implementation. Naloxone use decreased by 85% on the orthopedic unit. The protocol is slotted for spread to patient care areas hospital wide. Implications for Perioperative Nursing: Identification of risk combined with integration of ETCO2 monitoring in a structured protocol is valuable in preventing respiratory complications during and after sedation, anesthesia, or opioid pain management.en_GB
dc.date.available2011-10-27T08:41:41Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T08:41:41Z-
dc.conference.date2011en_US
dc.conference.nameAORN 58th Annual Congressen_US
dc.conference.hostAssociation of periOperative Registered Nursesen_US
dc.conference.locationPhiladelphia, Pennsylvania, USAen_US
dc.descriptionAORN 58th Annual Congress, 2011 held March 18, 2011 - March 24, 2011 in Philadelphia Convention Centeren_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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