Assess, Inform, Educate

Using Google docs in reducing incidence of patient death related to prescription Opioids

2010: Deaths due to prescription medications

Opioids; 75%Benzodi-

azepines; 29%

Antide-pressants;

18%

Antiepileptic and Antiparkinsonian; 8%

74.3% Deaths: Unintentional17.1% Deaths: Suicides 8.4% Deaths: Intention unknown

Summarized from data provided by: Jones CM, Mack KA, Paulozzi LJ. Pharmaceutical Deaths, United States. 2010. JAMA. 2013;309(7):657-659.doi10.1001/jama.2013.272

Nurses are the gatekeepers of patient safety

5 Rights of Medication Administration Understanding synergistic and cumulative effects of

prescription medication Management of pain Coordination, execution and monitoring of effects of

MD orders related to patient care Best positioned for close and careful assessment as

well as patient education

2010 Deaths by medication classification

77%58% 66% 58% 56% 54%

% of deaths: Opioids in combination with other prescription medications

1. Assess Gather patient

medication data and reconcile home and institutional prescriptions.

Portable tool that can be used out in the field as well as in hospitals and clinics.

Publicly accessable data housing technology, while maintaining patient privacy through individual care provider user ids

Google Docs!

Case Study Please go the following link and use the Google doc Opioid

risk assessment form: http://tinyurl.com/opioidscreen Rate the following patient:

You are the intake nurse at the local urgent care community clinic. Marta is a drop in client. Her friend drops her off on the way to the senior center and leaves. Marta says she did not want to bother her daughter to bring her in and does not want to go the hospital because she does not like them (“You can check-in, but you don’t check out”). She is coming in to see the doctor today because she felt very tired this morning and has had mild shortness of breath for last ½ hour. She has brought her ‘pills’ with her in her purse. Upon inspection you see that one is for Vicodin, that was ordered by her dentist for tooth pain related to recent a procedure for an impacted tooth. One is Cogentin for her Parkinson’s, which she received from her medicare provider and one is for Zoloft, which she says her daughters psychiatrist prescribed for her ‘blues’ after a consultation two days ago. Going just off this initial information, how would you rate this patient?

2. Inform

Send Google forms securely to primary care physician for medication reconciliation and consultation

Send Google forms between healthcare providers

Send copy of Google form to patient and authorized power of attorney

Gather and share data in confidential and controlled way for future studies

3. Educate

Assessment tool allows you to immediately identify and summarize data

Helps Nurses to formulate and determine educational goals

Can give to patient as data sheet that can be used on mobile devices on the go

Big Picture

Design comprehensive data gathering tool using google docsInputs• Evidence Based Practice, Research, QSEN

Use google docs to screen for potential harm d/t opioidsActivities• Use this mobile form to assess individual patients for risk factors related to pharmaceutical drug

overdose and death• Use this universal platform to gather data in a way where it is portable and easily translatable into

multiple systems and languages

Send secure information to other healthcare professionals and patientOutputs• Send link to report via google docs, a free web application. Can be downloaded into csv file for upload

into proprietary medical databases or viewed in report form on desktops, laptops, ipads, phones, etc.

Increased awareness about risks for overdose and death from prescription medications

Short Term Outcomes

Harm prevention, patient education and researchLong Term Outcomes