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    Area of Science:

    • Medical Research
    • Patient Safety
    • Anesthesiology

    Background:

    • Opioid-induced respiratory depression (OIRD) poses significant risks, yet lacks standardized national prevention and detection guidelines.
    • Identifying risk factors for OIRD is crucial for improving patient outcomes.

    Purpose of the Study:

    • To develop and implement an evidence-based enhanced monitoring (EM) program for surgical spine patients.
    • To mitigate the incidence and severity of opioid-induced respiratory depression.

    Main Methods:

    • Implemented an EM program involving risk stratification, STOP-BANG screening for sleep apnea, and capnography monitoring.
    • Included home positive airway pressure therapy, optimized capnography alarms, and interprofessional education.

    Main Results:

    • 17% of surgical spine patients were enrolled in the EM program.
    • Capnography monitoring revealed out-of-range end-tidal carbon dioxide levels in 56% of monitored patients.
    • A decrease in intensive care unit (ICU) transfers for OIRD was observed, though not statistically significant (p = .151).

    Conclusions:

    • The EM program, incorporating risk stratification, demonstrated a reduction in ICU transfers for OIRD.
    • The observed decrease in transfers was clinically significant, highlighting the program's potential impact.
    • Interprofessional collaboration and optimized capnography alarms improved alarm management and reduced nonactionable alerts.