采用跨专业方法解决阿片类药物安全监测问题。
Addressing Safe Opioid Monitoring Practices Using an Interprofessional Approach.
作者信息
Durham Marianne L, Egan AnnMarie, Jankiewicz Ann, Murphy Marcia P, Nedved Patricia, Luvich Renee, Goh Ann, Fogg Louis
机构信息
Author Affiliations: Clinical Assistant Professor (Dr Durham), University of Illinois at Chicago College of Nursing; Nurse Practitioner, Critical Care Services (Dr Egan), NorthShore University HealthSystem, Evanston; Medication Safety Officer (Dr Jankiewicz), and Associate Vice President Professional Nursing Practice and Acting Administrator (Ms Nedved), Rush University Cancer Center; Assistant Unit Director 9 North Atrium (Ms Luvich), and Associate Professor/Adult Nurse Practitioner, Adult and Gero Nursing (Dr Murphy), Rush University Medical Center; Associate Professor (Dr Fogg), Rush University College of Nursing; and Assistant Professor of Medicine (Dr Goh), Rush University Medical School, Chicago, Illinois.
出版信息
J Nurs Adm. 2017 Nov;47(11):537-544. doi: 10.1097/NNA.0000000000000540.
OBJECTIVE
The aims of the project are to increase knowledge related to opioids and improve adherence to evidence-based interventions for sedation monitoring and assessment in adult inpatients receiving opioids for pain through delivery of an interprofessional online program.
BACKGROUND
Preventable opioid-induced respiratory depression is a patient safety risk in hospitals. Sedation and respiratory assessment and monitoring guidelines and tools are available to improve practice.
METHODS
An interprofessional team identified organization-specific drivers of opioid-induced sedation and respiratory depression using process improvement methodology, developed interventions, and evaluated clinician opioid knowledge and documentation practice.
RESULTS
Opioid knowledge survey responses improved after the interventions. Audits showing improved appropriate documentation by RNs of the correct sedation scale were performed over 2 separate 3-month periods.
CONCLUSIONS
Clinicians demonstrated increased knowledge about newly adopted sedation and monitoring practices targeted to prevent opioid-induced respiratory depression.
目的
该项目的目标是通过提供一个跨专业在线项目，增加与阿片类药物相关的知识，并提高接受阿片类药物治疗疼痛的成年住院患者在镇静监测和评估方面对循证干预措施的依从性。
背景
可预防的阿片类药物引起的呼吸抑制是医院中的患者安全风险。有镇静和呼吸评估及监测指南与工具可用于改进实践。
方法
一个跨专业团队使用流程改进方法确定了阿片类药物引起的镇静和呼吸抑制的组织特定驱动因素，制定了干预措施，并评估了临床医生的阿片类药物知识和记录实践。
结果
干预后阿片类药物知识调查的回复有所改善。在两个不同的3个月期间进行了审计，结果显示注册护士对正确镇静量表的适当记录有所改善。
结论
临床医生对新采用的旨在预防阿片类药物引起的呼吸抑制的镇静和监测实践的知识有所增加。
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