Joint Commission warns of opioid use at hospitals

The Joint Commission yesterday warned hospitals about the dangers of using opioids on inpatients, calling for greater staff education particularly on opioid analgesics, which are most commonly associated with adverse drug events.

Although the accrediting body acknowledged that opioids are generally safe for most patients, The Joint Commission pointed out the drugs, such as fentanyl, hydrocodone, hydromorphone, oxycodone, sufentanil, can cause side effects like sedation, falls, hypertension and aspiration pneumonia.

In a British study, 16 percent of inpatient adverse drug reactions were traced back to opioids, The Joint Commission said in the Sentinel Alert. Some reasons might be the lack of knowledge about the drugs' potency, improper prescribing and administering or inadequate monitoring.

"Assessing and managing pain is critical to patients who otherwise would suffer, but avoiding the harm that accompanies the adverse effects of powerful opioid analgesics is equally important," Joint Commission President Mark Chassin said in a statement. "Accidental opioid overuse in the hospital is absolutely preventable. Information in this Alert will help doctors and nurses keep patients safe."

Among recommendations, The Joint Commission urged the following:

  • Create and implement policies and procedures for ongoing clinic monitoring of patients on opioids and second-level review of pain management plans
  • Track and analyze opioid-related incidents
  • Use information technology to monitor prescribing, if available
  • Produce education to staff and patients  

For more information:
- read the Joint Commission alert (.pdf)
- see the announcement
- check out the Joint Commission's database of sentinel alerts

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