Patient Monitoring, Patient Safety, Post-Operative Monitoring

What Does New CMS Guidance on Monitoring Post-Operative Patients Receiving Opioids Mean for Hospital Practice?

by Michael Wong, JD (Executive Director, Physician-Patient Alliance for Health & Safety)

[This article first appeared in Patient Safety & Quality Healthcare. To read the full article, please click here.]

In its guidance, “Requirements for Hospital Medication Administration, Particularly Intravenous (IV) Medications and Post-Operative Care of Patients Receiving IV Opioids,” CMS explains the reason behind the issue for this guidance:

Each year, serious adverse events, including fatalities, associated with the use of IV opioid medications occur in hospitals. Opioid-induced respiratory depression has resulted in patient deaths that might have been prevented with appropriate risk assessment for adverse events as well as frequent monitoring of the patient’s respiration rate, oxygen and sedation levels. Hospital patients on IV opioids may be placed in units where vital signs and other monitoring typically is not performed as frequently as in post-anesthesia recovery or intensive care units, increasing the risk that patients may develop respiratory compromise that is not immediately recognized and treated. [page 2]

This guidance recommends “at a minimum” [page 19] that hospitals “have adequate provisions for immediate post-operative care, to emphasize the need for post-operative monitoring of patients receiving IV opioid medications, regardless of where they are in the hospital.” [page 1]

Clinicians and hospital executives trying to understand this new guidance may wonder what CMS means by “monitoring.” Does it mean intermittent monitoring?

To read the full article, please click here.

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