Hello all! My name is Arjun Gupta, and I am a senior at BASIS Scottsdale conducting research as a part of the AP Research Capstone course. Over the next few months, I will implement a research plan and analyze my results, finishing my senior year off with a complete research paper, presentation on my findings, and oral defense. My research focuses on selection protocols for PCA pumps, medical devices commonly used for post-surgical pain management in healthcare institutions all around the world. While there is an abundance of research available on the pumps themselves, there is not nearly enough on the patients being given these pumps, a surprising deficiency that I hope to address with this study.
PCA pumps work by delivering a preset dose of opiates directly into the bloodstream when the patient presses a button (called a “dosing button”). The idea behind these pumps is that patients can receive medication whenever they feel pain (up to a certain preset amount) and won’t be able to over-sedate themselves, as they will not be physically capable of pressing the dosing button when they are close to becoming over-sedated (Physician-Patient Alliance for Health Safety). PCA pumps are now the most common method of postoperative pain management, as several NIH-funded clinical trials have shown they drastically reduce the risk of over-sedation while also providing the highest level of patient comfort (Fitzgibbon, Ready, and Ching).
While PCA pumps are very common in post-operative care today, they are not the ideal pain management devices for everybody. Patients who cannot handle the responsibility of the PCA pump include infants, confused/obstinate patients, and substance abusers (D’Arcy). Patients who cannot medically handle the PCA pumps include asthmatic patients, obese patients, patients on other specific medications, and patients with sleep apnea. Studies by the Institute for Safe Medical Practices have shown that harmful errors are more likely to impact patients in these specific groups (Vicente, Kada-Bekhaled, Hillel, et al.).
With all the patient groups ill-suited for PCA pumps, errors with this form of opioid administration have a big impact on our healthcare institutions. While PCA pumps are still the most effective form of postoperative pain management for most patients (Fitzgibbon, Ready, and Ching), complications from these pumps can lead to negative economic consequences and loss of life.
Most of the risk factors for PCA pumps and complications associated with the medications can all be minimized through aggressive patient selection. Taking a detailed medical history from patients and creating a list of factors to examine before prescribing a PCA pump can easily prevent complications regarding sleep apnea, conflicting medications, and confusion/delirium. While bypassing these precautions may allow healthcare facilities to save resources and may also reduce the amount of time a patient suffers in pain, there has been limited research on how much exactly it saves. This research study will determine whether or not the current practice of doctors using personal judgement to determine whether or not a patient can handle a PCA pump is enough to ensure patient safety or if the development and implementation of an official protocol would be safer, taking into account the heightened burden that such a protocol might have on a hospital's time and resources.
PCA pumps work by delivering a preset dose of opiates directly into the bloodstream when the patient presses a button (called a “dosing button”). The idea behind these pumps is that patients can receive medication whenever they feel pain (up to a certain preset amount) and won’t be able to over-sedate themselves, as they will not be physically capable of pressing the dosing button when they are close to becoming over-sedated (Physician-Patient Alliance for Health Safety). PCA pumps are now the most common method of postoperative pain management, as several NIH-funded clinical trials have shown they drastically reduce the risk of over-sedation while also providing the highest level of patient comfort (Fitzgibbon, Ready, and Ching).
While PCA pumps are very common in post-operative care today, they are not the ideal pain management devices for everybody. Patients who cannot handle the responsibility of the PCA pump include infants, confused/obstinate patients, and substance abusers (D’Arcy). Patients who cannot medically handle the PCA pumps include asthmatic patients, obese patients, patients on other specific medications, and patients with sleep apnea. Studies by the Institute for Safe Medical Practices have shown that harmful errors are more likely to impact patients in these specific groups (Vicente, Kada-Bekhaled, Hillel, et al.).
With all the patient groups ill-suited for PCA pumps, errors with this form of opioid administration have a big impact on our healthcare institutions. While PCA pumps are still the most effective form of postoperative pain management for most patients (Fitzgibbon, Ready, and Ching), complications from these pumps can lead to negative economic consequences and loss of life.
Most of the risk factors for PCA pumps and complications associated with the medications can all be minimized through aggressive patient selection. Taking a detailed medical history from patients and creating a list of factors to examine before prescribing a PCA pump can easily prevent complications regarding sleep apnea, conflicting medications, and confusion/delirium. While bypassing these precautions may allow healthcare facilities to save resources and may also reduce the amount of time a patient suffers in pain, there has been limited research on how much exactly it saves. This research study will determine whether or not the current practice of doctors using personal judgement to determine whether or not a patient can handle a PCA pump is enough to ensure patient safety or if the development and implementation of an official protocol would be safer, taking into account the heightened burden that such a protocol might have on a hospital's time and resources.
No comments:
Post a Comment