Opioid-induced respiratory depression (OIRD) is a life-threatening complication of
opioid analgesia. End-tidal carbon dioxide monitoring (capnography) has been shown
to detect early signs of OIRD earlier than other commonly used monitoring methods.
The goal of this evidence-based practice project was to promote the standardized use
of capnography to reduce the incidence of OIRD. The project included an updated nursing
protocol, an electronic order trigger, improved access to capnography monitors, and
staff education about OIRD risk assessment and the use of capnography. A survey of
registered nurses was also conducted to gather their perceptions on the ease of use
and effectiveness of capnography. Twelve months after introducing the intervention
there was an increase in monitoring frequency, with 2.56 times more patients at high
risk for OIRD being monitored with capnography than at baseline. Of the 171 registered
nurses surveyed during this project, 99% perceived the portable capnography monitors
as easy to use and interpret. However, 71% reported systems issues in obtaining the
monitoring equipment, and 65% reported problems with patient adherence. The intervention
succeeded in increasing the number of high-risk patients being monitored with capnography
and reducing the number of cases of OIRD.
Keywords
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Biography
Heather Carlisle, PhD, DNP, RN-BC, AGACNP-BC, FNP-BC, is a Clinical Assistant Professor of Nursing at the University of Arizona and an Adult-Gerontology Acute Care Nurse Practitioner, Tucson, AZ
Article info
Footnotes
Conflict of interest: None to report.
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© 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
