Journal article
Opioid errors in inpatient palliative care services: a retrospective review
BMJ supportive & palliative care, Vol.8, pp.175-179
04/01/2018
PMID: 29307863
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Source: InCites
Abstract
Opioids are a high-risk medicine frequently used to manage palliative patients’ cancer-related pain and other symptoms. Despite the high volume of opioid use in inpatient palliative care services, and the potential for patient harm, few studies have focused on opioid errors in this population.
Objectives To (i) identify the number of opioid errors reported by inpatient palliative care services, (ii) identify reported opioid error characteristics and (iii) determine the impact of opioid errors on palliative patient outcomes.
Methods A 24-month retrospective review of opioid errors reported in three inpatient palliative care services in one Australian state.
Results Of the 55 opioid errors identified, 84% reached the patient. Most errors involved morphine (35%) or hydromorphone (29%). Opioid administration errors accounted for 76% of reported opioid errors, largely due to omitted dose (33%) or wrong dose (24%) errors. Patients were more likely to receive a lower dose of opioid than ordered as a direct result of an opioid error (57%), with errors adversely impacting pain and/or symptom management in 42% of patients. Half (53%) of the affected patients required additional treatment and/or care as a direct consequence of the opioid error.
Conclusion This retrospective review has provided valuable insights into the patterns and impact of opioid errors in inpatient palliative care services. Iatrogenic harm related to opioid underdosing errors contributed to palliative patients’ unrelieved pain. Better understanding the factors that contribute to opioid errors and the role of safety culture in the palliative care service context warrants further investigation.
Details
- Title
- Opioid errors in inpatient palliative care services: a retrospective review
- Creators
- Nicole Heneka - The University of Notre Dame AustraliaTim Shaw - University of SydneyDebra Rowett - University of South AustraliaSamuel Lapkin - St George HospitalJane L. Phillips - University of Technology Sydney
- Publication Details
- BMJ supportive & palliative care, Vol.8, pp.175-179
- Publisher
- Bmj Publishing Group
- Number of pages
- 5
- Grant note
- Australian government, Collaborative Research Networks (CRN) programme scholarship
- Identifiers
- 991013092674202368
- Copyright
- © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved.
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Journal article