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    Naloxone Utilization in a Tertiary Care Medical Center

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    Thesis
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    Author
    Shah, Ruby
    Affiliation
    The University of Arizona College of Medicine - Phoenix
    Issue Date
    2013-03
    MeSH Subjects
    Pain Management
    Naloxone
    Medication Systems, Hospital
    
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    Publisher
    The University of Arizona.
    Description
    A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
    URI
    http://hdl.handle.net/10150/281779
    Abstract
    The purpose of this research project was to review the use of naloxone for oversedation events from 2008-2011 at the Mayo Clinic Hospital in Phoenix, Arizona. Opiates are generally an accepted form of acute and chronic pain management. Opiate analgesic use has increased in past decades due to several factors including cultural and healthcare ideas on the importance of pain management, as well as the availability, cost, and marketing of the drugs. Concomitant with the increased use of opiates has been a rise in addiction, diversion, and abuse. In addition, opiate overdose is a potentially lethal consequence. Balancing the use of opiates for effective pain control and the possible risks of opiates is a constant effort for healthcare professionals. Monitoring the use of naloxone has arisen as an effective metric to examine the safety and outcomes of opiate utilization in a hospital setting. Reviewing every dose of naloxone delivered over the years 2008-2011 has allowed us to recognize trends that have led to improvements in patient safety. 154 cases of naloxone use for sedation events were reviewed in a retrospective case controlled unmatched chart review. We were able to determine that patient risk for oversedation is greatest within our surgical practices, especially general and orthopedic, and that the overall risk is greatest within the first 24 hours in all surgical patients. In addition, we were able to determine statistically significant increase in risk with elevated creatinine level, American Society of Anesthesiology (ASA) Class, and patient controlled analgesia (PCA) use compared to our unmatched control group. The significance of these findings is that it identifies certain risk groups and factors that carry increased risk for sedation events, and therefore can lead to improvements in quality and education across the institution.
    Type
    text; Electronic Thesis
    Language
    en_US
    Collections
    College of Medicine - Phoenix, Scholarly Projects

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