A Multisite Retrospective Study Evaluating the Implementation of the Pasero Opioid-Induced Sedation Scale (POSS) and Its Effect on Patient Safety Outcomes.

The Joint Commission recommended the Pasero Opioid-induced Sedation Scale (POSS) to minimize opioid-induced respiratory depression. However, there is a paucity of data describing its impact on patient safety. This study assessed the impact of POSS implementation or reeducation on naloxone use in patients receiving hydromorphone.

How Is Physician Work Valued?

Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued.

Critical care in the surgical global period.

This article explores the rules and regulations from Current Procedural Terminology (CPT) code set and US Medicare and Medicaid Services (Medicare) regarding multiple physicians reporting critical care services during the global period. The article takes into account the critical care definitions, regulations, documentation requirements, and services each provider can report to Medicare. A clinical scenario based on literature supporting the types of complications and care that might typically be included in the post-operative period for a patient who is surgically treated for a type A aortic dissection was analyzed.

Intravascular therapy process improvement in a multihospital system: don't get stuck with substandard care.

Using the process of FOCUS PDSA (a quality improvement format), two clinical nurse specialists reviewed the delivery of intravenous care at a multihospital (4-hospital) system. The clinical nurse specialists formed a multi-facility nursing team to lead the assessment, develop a plan, implement changes, and evaluate the process. This process reflects the use of clinical nurse specialists as experts in using research-based data, national recommendations, and benchmark data to ultimately improve practice and reduce risks and overall costs.