How Capnography Supports Monitoring Patients Receiving Intravenous Opioid Pain Medications

As hospital nurses, we strive to give our patients the highest level of care and safety. But ongoing nursing shortages mean we have to spend more time on administrative and digital charting tasks. This becomes a particular challenge when patients require intravenous opioid pain medication — demanding that nurses pay closer attention to their respiratory signs.

That’s where continuous capnography monitoring comes in. As a noninvasive continuous monitoring solution, it helps nurses and other clinicians quickly identify changes in patient ventilation, and alarm management algorithms help reduce nonactionable alarms. In this blog post, we discuss:

  • Why some hospitals are slow to adopt capnography
  • How capnography helps clinicians assess patients for opioid-induced respiratory depression (OIRD)
  • Capnography benefits for clinicians
  • How to leverage cost-saving initiatives to implement capnography at your hospital

Capnography use in today’s medical environments

Sometimes capnography isn’t used due to a lack of understanding and education. There may also be misconceptions about equipment use and importance of capnography on helping you improve patient outcomes.1 Clinicians may even have limited opportunities to learn about etCO2 monitoring.

However, incidents of respiratory compromise ― respiratory insufficiency, failure, and arrest ― pose a genuine threat to your patients and your healthcare facility. Waveform capnography monitoring can help detect the signs of respiratory compromise, so you can intervene when needed. 2 When researching whether to invest in capnography, it’s important to consider these factors:

  • The health benefit to the patient
  • The financial impact to your bottom line
  • Costs associated with monitors, sampling lines, and warranties
  • Availability of purchasing programs
  • Maintenance and calibration fees
  • Reimbursement options

Related: Determine whether capnography monitoring is right ― and worth the cost ― for your healthcare organization. Read this blog post to learn more.

How capnography assesses for opioid-induced respiratory depression

Capnography helps make monitoring opioid-medicated patients easier. For example, it helps nurses monitor signs of respiratory inefficiency within the crucial first 24 hours post-surgery. In fact, continuous capnography monitoring is a crucial part of OIRD assessment and enables clinicians to effectively monitor patients receiving systemic opioids.2  

A patient safety study from Vizient found that capnography monitoring is “more effective to monitor ventilation status in patients with supplemental oxygen.”2

The study also notes that pulse oximetry isn’t the only monitoring device for patients requiring supplemental oxygen therapy. Using multiparameter measurement on patients supports improved outcomes.

Multiparameter ventilation measurement devices include:2

  • Capnography
  • Pulse oximetry (in combination with respiratory rate)

Supporting the detection of OIRD with early warning signs of respiratory change can help you improve patient safety.

Related:  Read this blog post to find out how PRODIGY can help reduce the risk of respiratory compromise for your patients.

Capnography monitoring benefits for clinicians

The use of continuous remote patient monitoring such as the Vital SyncTM system coupled with MicrostreamTM capnography and Nellcor™ pulse oximetry monitoring solutions can ease constraints on a nurse’s time. The Vital SyncTM system streams respiratory status data on the medical-surgical floor to a patient’s electronic medical record (EMR).

Related: Learn how patient and clinician centric innovations such as Vital Sync™ remote continuous monitoring, smart alarm management, and workflow services are designed to help you reclaim time on the medical-surgical floor.

Monetary opportunity for improved patient outcomes

Aside from the concerns of patient safety, continuous capnography monitoring may also support potential improved patient outcomes for hospitals. According to the study by Vizient, “OIRD results in devastating patient outcomes and substantial financial consequences for hospitals, with median litigation costs totaling $216,750 per claim in 2012 dollars.” 2  

The initial cost of investing in capnography solutions is still significant for those facing budgetary constraints. That’s why we help make it easier to invest in capnography solutions with our Outcomes Pledge Program.

Participants in the Medtronic Outcomes Pledge Program collaborate to reduce respiratory compromise in adult patients receiving intravenous opioids during medical surgical floor stays. We pledge to reduce respiratory compromise-related events by 20 percent. If that goal isn’t achieved, we will offer a 50 percent rebate on consumable purchases.

Related: How does the Medtronic Outcomes Pledge Program work? Check out this blog post for program details, associated costs, and how to get involved.

References
1. Richardson M, Moulton K, Rabb D, et al. Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Mar. (CADTH Health Technology Assessment, No. 142.) 6, Health Services Impact. Website: https://www.ncbi.nlm.nih.gov/books/NBK362361/
2. Vizient, Inc. Patient safety organization alert: Improve safety with lessons learned from opioid related events requiring naxolone. Vizient, Inc. Website. https://www.vizientinc.com/-/media/documents/sitecorepublishingdocuments/public/vizient_pso_opioid_public.pdf. Dec. 2019.

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TOPIC: Microstream™ Capnography

About the Author

Jamie Hallahan

Jamie Hallahan RN, BSN, PHRN, CCRN is a clinical product specialist for Medtronic’s Respiratory and Monitoring Solutions portfolio. Her experiences as a critical care nurse both inside intensive care units as well as in the critical care transport community help her bring practical applications of Microstream™ capnography to her customers.

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