title: Monitoring Hospitalized Adult Patients for Opioid-Induced Sedation and Respiratory Depression.
abstract: : Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks. The authors review the literature on unintended advancing sedation and respiratory depression associated with opioid administration and present evidence-based recommendations for clinical decision making and patient monitoring, using both nursing assessments and electronic technologies.
authors.affiliation: Carla R. Jungquist is an assistant professor in the University at Buffalo School of Nursing, Buffalo, NY. Kirsten Smith is a clinical nurse specialist at Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia. Kelly L. Wiltse Nicely is an assistant professor of nurse anesthesia in the Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia. Rosemary C. Polomano is a professor of pain practice at the University of Pennsylvania School of Nursing. Contact author: Carla R. Jungquist, carlajun@buffalo.edu. Carla R. Jungquist has served on the advisory board of Mallinckrodt Pharmaceuticals; Rosemary C. Polomano has served on the advisory boards of Salix Pharmaceuticals, Daiichi Sankyo, and Mallinckrodt Pharmaceuticals. The authors have disclosed no potential conflicts of interest, financial or otherwise.
authors.forename: Carla R
authors.initials: CR
authors.lastname: Jungquist
authors.forename: Kirsten
authors.initials: K
authors.lastname: Smith
authors.forename: Kelly L Wiltse
authors.initials: KL
authors.lastname: Nicely
authors.forename: Rosemary C
authors.initials: RC
authors.lastname: Polomano
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007297:Inpatients; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000592:standards*; D010146:Pain / Q000188:drug therapy* / Q000451:nursing; D010348:Patient Care Team / Q000592:standards; D017410:Practice Guidelines as Topic; D012131:Respiratory Insufficiency / Q000139:chemically induced*
chemical_list: D000701:Analgesics, Opioid