Monitoring for Opioid-Induced Advancing Sedation and Respiratory Depression: ASPMN Membership Survey of Current Practice

Identification des déterminants de l’intention des infirmières d’exercer la surveillance clinique lors du pic d’action des opioïdes sous-cutanés auprès d’adultes hospitalisés

“…Certaines études avancent une sous-estimation de l'importance d'exercer la surveillance clinique post-administration d'opioïdes chez certaines infirmières (Beaudoin et al, 2015;Blackman et al, 2015;Jarzyna et al, 2011;Kalisch & Williams, 2009;Tower & Chaboyer, 2014). En effet, seulement 66% des infirmières accordent de l'importance à la surveillance associée à l'administration d'opioïdes et 37% la voient comme une surcharge de travail (Jarzyna et al, 2011;Jungquist, Willens, Dunwoody, Klingman, & Polomano, 2014;Pretorius et al, 2015). Beaumont et al (2008) ont démontré que certaines infirmières considèrent l'observation directe de l'usager comme une tâche facilement réalisable, mais non prioritaire, puisqu'elles ne conceptualisent pas qu'un usager stable puisse développer des effets secondaires néfastes à bref intervalle.…”

Avoiding Adverse Events Secondary to Opioid-Induced Respiratory Depression

“…This report was published in 2011, 14 and 2 years later, another practice analysis study was conducted. 20 This subsequent survey involved ASPMN member respondents (n = 100) from unique US hospitals, which served as the unit of analysis. Findings indicated that less than 50% of hospitals had initiated best monitoring practices as identified, defined and recommended in the ASPMN expert consensus report.…”

Instituting Best Practice for Monitoring for Opioid‐Induced Advancing Sedation in Hospitalized Patients

“…Over the past 5 years, professional organizations, such as the Anesthesia Patient Safety Foundation (APSF), American Society for Pain Management Nursing (ASPMN), Society for Ambulatory Anesthesia (SAMBA), American Society of Anesthesiologists (ASA), and Emergency Nurses Association (ENA), have published recommendations and clinical practice guidelines to address opioid‐induced advancing sedation and respiratory depression (Horlocker, Burton, & Connis, ; Jarzyna et al., ; Joshi, Ankichetty, Gan, & Chung, ; Proehl et al., ; Weinger & Lee, ; Willens, Jungquist, Cohen, & Polomano, ). Despite growing national attention to opioid‐induced adverse events and guidelines to direct safe patient care, few changes in monitoring practices have occurred in hospital settings over the past 5 years (Jungquist, Willens, Dunwoody, Klingman, & Polomano, ). Causes for delays in implementing accepted safe and effective practices to prevent and minimize serious consequences of opioid therapy are complex, and are not fully understood.…”

“…In a 2013 survey performed by the ASPMN, representatives from 102 hospitals reported on institution‐specific structures and processes in place and individuals accountable for tracking events related to opioid‐induced advancing sedation and respiratory depression (Jungquist et al., ). Responses ranged from a single individual to the existence of committees or teams assuming responsibilities for surveillance and analysis of patient safety measures (Jungquist et al., ). Some examples of this accountability included (a) nursing or hospital quality committees, (b) pharmacy departments, (c) acute pain services, (d) rapid response teams, (e) pain oversight committees, (f) anesthesiology departments, or (g) nurses specializing in pain practice.…”

“…The unit‐based pain experts meet on a regular basis to network about pain and monitoring issues. According to the ASPMN survey, increasing monitoring and vigilance has the potential to impede opioid prescribing and adequate pain management (Jungquist et al., ). Thus one of the unit pain expert's jobs is to assess if newly instituted monitoring procedures have decreased opioid prescribing that resulted in inadequate pain management.…”