Download sedation - Munson Healthcare

April 14, 2015
SEDATION: EVERYTHING YOU WANTED TO KNOW?
Opioid Sedation Scale (POSS) is a standardized tool that can be used to
oPasero
screen patients for risk factors associated with sedation, such respiratory
depression. This tool will be implemented on April 21, 2015.
POSS Highlights

POSS will be tasked every 4 hours for patients
receiving PCA/PCEA, methadone, and fentanyl via
any route.

Patients with risk factors for over sedation such as
a high STOP-BANG score or concurrent sedating
medications regardless of opioid tolerance should
have a POSS completed.

Nurses have the autonomy to task the POSS if
they deem the patient is at risk for over sedation.

Exclusions from POSS include end of life/palliative
care, critical care patients with purposeful
sedation, and pediatric patients.

POSS will be available at the bottom of the Pain
Assess/Reassess form. It is not mandatory. It may
be used if patient condition warrants. ED, Urgent
Care, and Behavior Health Pain forms will not have
POSS available.

POSS score should be communicated during hand
off reports from PACU and shift to shift bedside
report.

A new question will be added to admission
profiles to capture if a patient takes opioids daily
(opioid tolerant) or not at all (opioid naïve).
EtCO2 Monitoring Highlights
On April 21, 2015 EtCO2 monitoring will be
implemented on all units (except Maternity).

EtCO2/SpO2 will be tasked every 4
hours while patients are on PCA/PCEA.

Nurses may use discretion based on
assessment of patient to initiate
EtCO2.



Use EtCO2 if a patient is opioid naïve
or new or increased doses of opioids
are started.
Standard EtCO2 setting parameters
(alarms) cannot be adjusted without a
physician order.
EtCO2 monitor will be delivered to unit
from CPD or VAST.
On March 17, 2015 the
Narcan Protocol and new
STOP-BANG sleep apnea
tool went live.
-Please remember to use the
communication type of POE
Co-Sign when ordering the
Narcan Protocol.
-The STOP-BANG form
replaced the OSA tool to
evaluate for sleep apnea.
-Below are the steps for
retrieving the education in
Krames.
PCA/PCEA Highlights

PCA/PCEA task will be every 4 hours
instead of every 8 hours.

The POSS form will task every 4 hours
while the patient in on PCA/PCEA.

A thorough respiratory assessment
should be completed and charted at
minimum every 4 hours.

Reference text for the narcan protocol
and EtCO2/SpO2 will be available within
the order or the form.
Kristi Noble MSN
RN OCN
Clinical EHR
Educator
Ext. 56386
For a reference or other information about the EHR,
PowerChart, or FirstNet go to:
http://www.munsonhealthcare.org/clinicalehreducation
[email protected]