Home Monitoring of High-Risk Opioid Patients Literature Review

Pages: 35 (10474 words)  ·  Bibliography Sources: 15  ·  File: .docx  ·  Level: Doctorate  ·  Topic: Health  ·  Written: June 24, 2019

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[. . .] It produces a minute pharmacological actions that are detectable except when opioid agonists exist but requires a doctor’s prescription before administration. In America, Naloxone is utilized as a life-saving drug for the reversal of an opioid overdose in ambulance settings and hospitals (Schumann et al., 2019). Naloxone training and distribution programs have displayed efficiency in decreasing opioid-related deaths, but have largely concentrated on distribution of the drug to abusers of opioid.

5. Close monitoring

Close monitoring of opioid patients especially those in homecare is very important. When opioid is prescribed but the individual gets identified as a high-risk patient, treatment involving opioid might be cautiously tried with very close monitoring of the individual as well as specific measurable outcomes to gauge the efficiency and basis for continuing with the treatment. Continuous assessment of vigilance and efficiency for adverse effects is an approach applied to nearly all drugs prescribed for any condition; it is not only applied for opioid therapy (Subramani et al., 2017). Clinicians ought to often appraise the data from the state prescription medication monitoring program when continuing or even commencing opioid therapy among patients.

6. Oxygen saturation

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Pulse oximetry refers to a non-invasive technique for monitoring an individual’s pulse rate and levels of blood-oxygen saturation. According to research, pulse oximetry can be considered as a LATE pointer for respiratory depression, and its value is dependent in its capacity to offers an estimate of the extent of hypoxemia in the arterial blood. On the other hand, capnography refers to a non-invasive technique of approximating the partial carbon dioxide pressure in arterial blood (Lam et al., 2017). Additionally, desaturation among postoperative non-cardiac patients is usually common and prolonged, and readings of oxygen saturation are taken underscore the intensity desaturation and time after a surgical procedure.

Literature Review on Home Monitoring of High-Risk Opioid Patients Assignment

Opioid therapy utilized for the management of severe pain in a postoperative scenario could be misused. In case that occurs, it is vital for the care provider to possess important knowledge regarding how to handle such a situation, and other health connected complications as well. In case of opioid misuse, Naloxone can be used as a possible solution. It is important to note that all complications have their own specific solutions. Nothing, however, is comparable to increased monitoring of a high-risk patient, particularly within the first 24 to 48 hours after a surgical procedure.

7. Risk factors to high-risk opioid patients

Risk factors linked to OIRD comprise of current and past events of substance abuse, untreated psychiatric issues, younger age, along with family and social environments, which give rise to misuse. Prevalence of opioid mortality happens to be higher in individuals who suffer from psychiatric comorbidities and are middle aged. Suicidal rates even though are high, they are usually undercounted and frequently misclassified in medical reports of opioid-linked poisoning fatalities. Higher level of understanding as well as better evaluations are required of the risk linked with suicide in patients suffering from pain. 

i. Time duration after surgery

According to research, majority of opioid-induced respiratory depression (OIRD) is usually reported within the very first 12 to 24 hours and this accounts for 80 to 85 percent opioid-induced respiratory depression, respectively. The first six hours after a surgery is the highest OIRD risk period with 34 percent of the adverse events occurring here (Gupta et al., 2018), which is likely because of a mixture of the residual impacts of anesthetic drugs.

ii. Undiagnosed health complications’

Obstructive sleep apnea (OSA) is among the risk factors that contribute to heart complications. The main features of the therapeutic home is the application of a multi-disciplinary medical team in order to prevent the emergence of foreseeable health issues, intervene early enough when issues arise, operate using improved medical data, and track and manage patient symptoms (Cozowicz et al., 2018).

iii. Comorbidities and clinical ill-health conditions

Conditions such as obstructive sleep apnea as well as ill-health conditions such as depression are linked to increased misuse of opioid amidst high-risk patients involved in home care. Poor pain control in individuals suffering from obstructive sleep apnea is also connected to higher relapse incidence to addiction as well as poor life quality (Stierer et al., 2010). Individuals involved in methadone maintenance programs that have a pain history are most likely going to suffer from anxiety, suicidal ideation, and depression and have a greater psychiatric comorbidities incidence.

Before deciding to discharge an individual after a surgical procedure for homecare, it is vital to determine certain issues in order to avoid various health-related complications. This is vital in the sense that homecare is almost always not as advanced as hospital recovery unit care. Moreover, homecare will always lack professional nursing services. However, considering the fact that most post-surgery complications usually occur or present themselves within the first forty-eight hours, patients are usually not discharged before the first forty-eight hours elapse. This means that if a patient is discharged beyond the 48 hours, he or she is usually in a good enough condition to be taken care of in a homecare setting.

8. Postoperative complication

Extended use of opioids can lead to complications such as stroke, heart attacks, and endocarditis. Even though the mortality rates for these conditions are the same whether or not there is a history of opioid use, those with a history of opioid use usually have more serious complications, have to stay in hospitals for longer, and have to pay more for treatment (Lee et al., 2015). This means there is a need to adopt strong measures to deal with any such post-surgery complications in the postoperative period.

i. Detection of hypoventilation

Individuals who undergo operations on their lower half, have a high likelihood of developing hypoventilation. For the purpose of detecting hypoventilation, there is a need for them to take in room air. And then supplemental oxygenation needs to be provided for those… [END OF PREVIEW] . . . READ MORE

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