American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Advancing Sedation and Respiratory Depression: Revisions
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ASPMN Guidelines Manuscript Feb ...
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Final Accepted Manuscript
Author
Jungquist, Carla RQuinlan-Colwell, Ann
Vallerand, April
Carlisle, Heather L
Cooney, Maureen
Dempsey, Susan J
Dunwoody, Danielle
Maly, Angelika
Meloche, Kathy
Meyers, Ashley
Sawyer, Jason
Singh, Navdeep
Sullivan, Denise
Watson, Chris
Polomano, Rosemary C
Affiliation
Univ ArizonaIssue Date
2019-07-31
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ELSEVIER SCIENCE INCCitation
Jungquist, C. R., Quinlan-Colwell, A., Vallerand, A., Carlisle, H. L., Cooney, M., Dempsey, S. J., … Polomano, R. C. (2020). American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Advancing Sedation and Respiratory Depression: Revisions. Pain Management Nursing, 21(1), 7–25. https://doi.org/10.1016/j.pmn.2019.06.007 Journal
PAIN MANAGEMENT NURSINGRights
Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
Objectives: This report presents up-to-date evidence and expert consensus-based revisions to the ASPMN 2011 guidelines that inform interprofessional clinical decision-making for hospitalized adults receiving opioid analgesics. Design: Systematic review of the literature. Methods: A 14-member expert panel was charged with reviewing and grading the strength of scientific evidence published in peer reviewed journals and revising the ASPMN 2011 existing guidelines. Panel members formulated recommendations based on the strength of evidence and reached consensus through discussion, reappraisal of evidence, and voting by majority when necessary. The American Society of Anesthesiologists evidence categories for grading and classifying the strength of the evidence were used. Recommendations were subjected to a critical review by ASPMN members as well as external reviews. Results: The 2011 guidelines were found to still be relevant to clinical practice, but new evidence substantiated refinement and more specific recommendations for electronic monitoring. The revised guidelines present risk factors divided into three categories: patient-specific, treatment-related, and environment of care. Specific recommendations for the use of electronic monitoring are delineated. Conclusions: All hospitalized patients that are administered opioids for acute pain are at risk of opioid induced advancing sedation and respiratory depression, but some patients are at high risk and require extra vigilance to prevent adverse events. All patients must be assessed for level of risk. Adaptations to the plan of care and monitoring strategies should be driven by iterative re-assessments according to level of risk. Nursing Practice Implications: Opioid medications continue to be a major component in the management of acute pain. Clinicians have the primary responsibility for safe and effective pain management. Evidence based monitoring strategies can improve patient safety with opioids. (C) 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.Note
12 month embargo; published online: 31 July 2019ISSN
1524-9042PubMed ID
31377031Version
Final accepted manuscriptae974a485f413a2113503eed53cd6c53
10.1016/j.pmn.2019.06.007
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