Here are five observations on the tool.
1. The tool will enable medical staff to better monitor at-risk patients, which ultimately may reduce adverse events, enhance patient safety and increase patient satisfaction.
2. Based on their analysis, researchers found risk factors for OIRD include individual and iatrogenic risk factors. Individual risk factors included age, airway obstruction, surgery type as well as cardiac, hepatic, pulmonary and renal function. Iatrogenic risk factors include the percentage of patients taking naloxone on postoperative day zero versus postoperative days one and two the percentage of patients receiving intravenous opioids and sedatives within 12 hours of receiving naloxone and the percentage of patients receiving long-acting opioids.
3. Researchers developed weights for the various risk factors. If a patient had a higher score, that patient would be more likely to need naloxone. Of the patients analyzed in the study, 7,400 patients in the low-score category accounted for 53 percent of the patient population and accounted for only .32 percent of those receiving naloxone. The 229 very-high-score patients accounted for only 1.65 percent of the patient population but 4.37 percent of patients receiving naloxone.
4. Researchers found patients that fell in the very-high-risk or high-risk categories needed to be closely monitored for OIRD. Such patients may need to undergo more assessments of vital signs and pulse oximetry monitoring.
5. Lead researcher, Nicole Humbert, PharmD, emphasized the pertinence of transitioning patients from IV to oral opioids. IV opioids may contribute to OIRD risk.
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