Einstein Montgomery Receives First Place Safety Award
Opioids can be dangerous even under the best of circumstances: hospitalized patients who receive medically prescribed doses for pain can lapse into respiratory depression and cardiac arrest. That fact motivated nursing leaders at Einstein Medical Center Montgomery to institute a program that sounds an alarm in seconds when a patient is in respiratory distress.
The program won first place in the 2018 Delaware Valley Patient Safety and Quality Award, which was presented Friday, Nov. 2, to registered nurses Scott D. Alcott, MSN, Director of Nursing Education at Einstein Montgomery, and Thomas P. Cleary, BSN, clinical manager of the medical-surgical unit. The project, funded by the Albert Einstein Society, Einstein’s internal foundation, enabled the purchase of 10 devices that monitor breathing rate and carbon dioxide in a patient’s exhalation.
“This award reflects Einstein Montgomery’s commitment to patient safety and innovative care,” said AnnMarie Papa, vice president and chief nursing officer at Einstein Montgomery. “We’re proud to have an outstanding interprofessional team who bring evidence-based practices forward in innovative and creative ways to mitigate safety risks.”
Capnography – measuring how much CO2 is exhaled – detects breathing problems much quicker than the traditional assessment tool of pulse oximeter, which measures oxygen in the blood: seconds versus minutes. It’s routinely used in the operating room when a patient is undergoing anesthesia, in the ICU and other settings. But Einstein Montgomery was among the first in the region to use it for patients on the medical/surgical floor who were deemed high-risk for respiratory arrest.
“At the end of the day, there are countless patients whose lives have been positively impacted,” Alcott said.
During the program’s six-month evaluation period, from July to December, 2017, not one patient who was monitored after receiving opioids needed emergency intervention such as intubation, administration of a reversal agent such as Narcan, or transfer to the intensive care unit. By contrast, 62 patients were transferred to the ICU in 2015 for opioid-induced respiratory depression.
When the CO2 alarm sounded, the intervention was simple: a nurse would arouse a patient with a simple shoulder shake. The program was expanded to both medical/surgical units after the pilot program, and eventually will expand throughout the hospital.
“For us at Einstein Montgomery who’ve only been visible in the community for the last five years, receiving this award is an amazing accomplishment not just for ourselves but the hospital and the whole Einstein network,” Cleary said.