Implementation of Capnography Monitoring to Improve Outcomes among Intensive Care Unit Patients on Patient-Controlled Analgesia or Opioids

Authors

Leslie Smith, MSN, BMTCN, AOCNS, APRN-CNS, George Washington University

Document Type

DNP Project

Department

School of Nursing

Date of Degree

Spring 2021

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Karen Whitt, PhD, FNP-C, AGN-BC, FAANP; Deborah Kolakowski, DNP, RN

Keywords

Capnography; Monitoring; Intensive Care Unit Patients; Patient-Controlled Analgesia; Opioids

Abstract

Background: Patient-controlled analgesia (PCA) administration of opioids is associated with risk for respiratory depression. Capnography is a non-invasive way to identify early respiratory depression and prevent adverse patient events.

Purpose: This project evaluated the effectiveness of capnography versus standard monitoring in reducing adverse events among patients admitted to an intensive care unit (ICU) who were prescribed PCA opioids and evaluated patients at high-risk for respiratory depression according to age, gender, diagnosis, co-morbidities, and type of opioid prescribed.

Methods: This project used a pre- and post-intervention design to compare differences in the number of adverse events among 20 adult patients admitted to an ICU during a six-month period who were prescribed PCA opioids and received either capnography monitoring or standard monitoring. A chi-square test was conducted to evaluate group differences.

Results: The number of adverse events was not significantly different between patients who received standard monitoring versus those who received capnography (X²=0.00, df=1, N=20, p>0.05). Adverse events were not significantly associated with age, gender, number of co-morbidities, type of opioid, and diagnosis (p>0.05).

Conclusions: Implementation of capnography among ICU patients on PCAs did not decrease the number of adverse events. However, there were favorable trends noted with regards to sedation level and a decrease in the occurrence of bradypnea in patients receiving capnography. Results from this project will guide the implementation of capnography throughout the institution.

Copyright Notice

©2021 Leslie Smith. All rights reserved.

Recommended Citation

Smith, MSN, BMTCN, AOCNS, APRN-CNS, L. (2021). Implementation of Capnography Monitoring to Improve Outcomes among Intensive Care Unit Patients on Patient-Controlled Analgesia or Opioids. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/85

Open Access

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