Colorado Alternatives to Opioids (ALTO) Project

Colorado Hospital Association

In 2017, CHA and its partners developed the Colorado Opioid Safety Pilot, a study that was conducted in 10 hospital emergency departments (EDs) over a six-month span with a goal of reducing the administration of opioids in those EDs by 15 percent. The cohort of 10 participating sites achieved an average 36 percent reduction in the administration of opioids during those six months, as well as a 31.4 percent increase in the administration of alternatives to opioids (ALTOs). Based on the success of the pilot, CHA has launched the Colorado ALTO Project to implement this program in all hospital EDs.

Pain Management Toolkit: Iowa’s Guide to Opioid Stewardship

Iowa Healthcare Collaborative

Resources is divided into sections that can stand alone for quick reference. Addresses the real-world situations practitioners face in daily patient care (difficult conversations, non-opioid treatment interventions, acute pain treatment, tapering, chronic pain care, managing ED patients, pain control for cancer and palliative care, etc.)

Reducing Adverse Drug Events Related to Opioids (RADEO) Implementation Guide

Society of Hospital Medicine (SHM)

Provides step-by-step guidance to assist hospital teams in implementing a quality improvement program to improve patient safety and reduce opioid-related adverse events for patients receiving opioids, including:

  • Instituting safer opioid prescribing practices resulting in fewer adverse events, like dangerous over sedation, respiratory depression and death
  • Focusing on hospitalized patients, with essential building blocks for developing a quality improvement initiative addressing the inpatient setting
  • Creating a quality improvement project team in your hospital, gaining institutional support and securing buy-in of frontline staff to ensure successful implementation
  • Developing strategies for evaluating current processes, facilitating policy formation, identifying best practices and tracking progress against implementation goals
  • Optimizing care transitions for patients on opioid therapy in the outpatient setting
  • Exploring a customized approach to address the specific needs of your hospital

Textbook of Patient Safety and Clinical Risk Management

Authors:

  1. London School of Hygiene and Tropical Medicine
  2. Department of Hygiene and Public Health Catholic University of the Sacred Heart Rome Italy
  3. The Society to Improve Diagnosis in Medicine.
  4. Italian Network for Safety in Healthcare

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems.

The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians’ and nurses’ behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties.  

This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.

Sepsis and Health Equity Fact Sheet

Sepsis Alliance

Highlights many racial, ethnic, and socioeconomic disparities related to sepsis. The fact sheet includes the following sepsis disparities:

  • Black and other nonwhite people have nearly twice the incidence of sepsis as whites
  • Non-Hispanic black children admitted to an emergency room are less likely to be treated for sepsis than non-Hispanic white children
  • Native Hawaiians have almost twice the burden of sepsis mortality compared to whites
  • Black children are 30% more likely than white children to develop sepsis after surgery
  • Children with severe sepsis or septic shock who are black or Hispanic are about 25% more likely to die than non-Hispanic white children
  • Adults below the poverty line have more than three to four times the risk of dying of sepsis compared to adults whose family income is at least five times the poverty line

Skin Manifestations with COVID-19

National Pressure Injury Advisory Panel (NPAIP)

Many reports are occurring concerning areas of purpuric/purple skin and purple toe lesions in patients diagnosed with COVID-19 (SARS-CoV-2). Wound care providers are being asked if these skin lesions are forms of Deep Tissue Pressure Injury and/or “skin failure”. Early reports of COVID-19 related
skin changes included rashes, acral areas of erythema with vesicles or pustules (pseudo-chilblain), other vesicular eruptions, urticarial lesions, maculopapular eruptions, and livedo or necrosis. The pattern and presentation of skin manifestations with COVID-19 is more than rashes. The purpose of this paper is to guide the wound care clinician in determining if the “purple skin” being seen is a deep tissue pressure injury or a cutaneous manifestation of COVID-19.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

Hospital Toolkit for Adult Sepsis Surveillance

Centers for Disease Control (CDC)

This toolkit allows healthcare professionals who are interested in using the sepsis surveillance methodology from the national burden study to track healthcare facility-level sepsis incidence and outcomes using an objective
definition based on clinical data. Necessary data may be obtained and processed directly from electronic health record, but could also be obtained using manual chart review. These data may be useful for understanding the effectiveness of local sepsis prevention, early recognition, and treatment programs.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.