Managing Acute Respiratory Failure in Small, Rural, and Critical Access Hospitals: Non-Invasive Ventilation & High-Flow Nasal Cannula


Due to medical-surgical nurses’ limited exposure to managing acute respiratory failure, nurses in rural and critical access hospitals do not always have a comfort level with non-invasive ventilation (NIV) equipment and/or High-Flow Nasal Cannula (HFNC). Managing this situation on medical-surgical floors within these smaller hospitals created a void, especially without access to specialty staff who have advanced clinical respiratory experience, lack of critical care beds, and/or the lack of respiratory therapy resources. This is especially true in rural and critical access hospitals, possibly exacerbating adverse events and potentially increasing health disparities (due to access of specialty care issues). This electronic tool provides digestible information to support the front-line in CPAP, BiPAP, and HFNC management.

The Michigan Opioid Safety Score (MOSS): A Patient Safety and Nurse Empowerment Tool

Journal of PeriAnesthesia Nursing

The Michigan Opioid Safety Score (MOSS) was developed to incorporate patient risk, respiratory rate, and sedation into one bedside score that could be used to improve patient safety during inpatient opioid therapy. Scoring is based on a summation of risk data with objective bedside measures of over-sedation trumping a patient’s subjective reports of pain.