Project Title
Date of Award
Summer 2023
Document Type
Final DNP Paper
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Faculty Chair
Cheryl Emich
Preceptor
Steve Croom
Mentor
Krystal Garrett
Abstract
Background: Opioids are commonly administered to hospitalized patients to treat acute pain and can cause serious adverse events such as unintended advanced sedation and respiratory depression, also known as opioid-induced respiratory depression (OIRD). Post-surgical patients are at increased risk of unintended advanced sedation and respiratory depression due to anesthesia and pre-and post-opioid administration. They have a greater risk because they have less monitoring than those in the intensive care unit because their care teams, typically nurses, have higher staff-to-patient ratios. The use of enhanced interventions, such as the use of sedation evaluation tools, can decrease the risk of OIRD.
Purpose: The purpose of this project was to evaluate if implementing the Pasero Opioid Sedation Scale (POSS) to assess sedation and respirations before opioid administration could decrease events of OIRD in post-surgical patients.
Methods: The overall intervention of this quality improvement project included using the POSS to monitor sedations and respirations before opioid administration. The nursing staff were trained on the new protocol, the use of the POSS, and how to document POSS elements in the electronic medical record (EMR). The EMR was audited weekly to evaluate adherence to the protocol. The two outcomes of interest were adherence to the protocol and naloxone use.
Results: The results of the chart review showed more than 99.9% of the time before an opioid medication was administered, the POSS elements were documented by the nursing staff correctly. The results of the naloxone events did not show to be statistically significant in reducing incidences of advanced sedation and respiratory depression.
Conclusion: Research suggests that the POSS has the potential to decrease adverse events of advanced sedation and respiratory depression.
Recommended Citation
Elliott, Angel, "Reducing the Incidence of Opioid-Induced Unintended Advanced Sedation and Respiratory Depression in Hospitalized Patients" (2023). Doctor of Nursing Practice Projects. 88.
https://digitalcommons.jsu.edu/etds_nursing/88