Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model

Introduction: Assessments of post-operative patients that have been carried out by health care providers before critical opioid-induced respiratory events often do not detect respiratory depression. We hypothesise that opioidinduced respiratory patterns present during sleep may not be properly reco...

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Main Authors: Natalia Tarasova, Usha Asirvatham, Robin Goetz, Mariela Rivera, Juraj Sprung, Toby Weingarten
Format: Article
Language:English
Published: Australian College of Perioperative Nurses 2024-02-01
Series:Journal of Perioperative Nursing
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Online Access:https://journal.acorn.org.au/index.php/jpn/article/view/97
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author Natalia Tarasova
Usha Asirvatham
Robin Goetz
Mariela Rivera
Juraj Sprung
Toby Weingarten
author_facet Natalia Tarasova
Usha Asirvatham
Robin Goetz
Mariela Rivera
Juraj Sprung
Toby Weingarten
author_sort Natalia Tarasova
collection DOAJ
description Introduction: Assessments of post-operative patients that have been carried out by health care providers before critical opioid-induced respiratory events often do not detect respiratory depression. We hypothesise that opioidinduced respiratory patterns present during sleep may not be properly recognised as providers typically awaken patients for vital sign checks, and awake state assessment is recorded. We used a simulation manikin model to test this hypothesis. Methods: Nurses who work on a standard post-operative hospital ward volunteered to participate in a study designed to record vital signs on an adult male manikin. None of the nurses had formal critical care or post-operative care unit education. This simulation consisted of an elderly male patient who had undergone a hernia repair and was randomised to have two breathing patterns while asleep – persistent bradypnoea (respiratory rate of six breaths per minute) and intermittent apnoea (respiratory rate of 18 breaths per minute with 30-second pauses); both breathing patterns terminated after nurses woke the patient. Results: Twenty-seven nurses participated: 14 in the bradypnoea scenario, and 13 in the intermittent apnoea scenario. Upon entering the room, 24 (89%) participants woke the patient to begin respiratory assessment, and three (11%) assessed respirations while the patient remained asleep. Eleven (79%) participants noted abnormal breathing in the bradypnoea scenario, while only one (4%) noted abnormal breathing in the intermittent apnoea scenario. Conclusion: This simulation model demonstrated that most nurses awaken patients before vital sign assessments, which could prevent detection of respiratory depression present during sleep. Nurses on hospital wards should be educated to follow respiratory status assessment guidelines not to wake the patient for respiratory status assessment.
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spelling doaj-art-e7f0069d001c4a3e9d15533bf7c628cd2025-08-20T02:29:29ZengAustralian College of Perioperative NursesJournal of Perioperative Nursing2209-10842209-10922024-02-0137110.26550/2209-1092.1289Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation modelNatalia Tarasova0Usha Asirvatham1Robin Goetz2Mariela Rivera3Juraj Sprung4Toby Weingarten5Mayo ClinicMayo ClinicMayo ClinicMayo ClinicMayo ClinicMayo Clinic Introduction: Assessments of post-operative patients that have been carried out by health care providers before critical opioid-induced respiratory events often do not detect respiratory depression. We hypothesise that opioidinduced respiratory patterns present during sleep may not be properly recognised as providers typically awaken patients for vital sign checks, and awake state assessment is recorded. We used a simulation manikin model to test this hypothesis. Methods: Nurses who work on a standard post-operative hospital ward volunteered to participate in a study designed to record vital signs on an adult male manikin. None of the nurses had formal critical care or post-operative care unit education. This simulation consisted of an elderly male patient who had undergone a hernia repair and was randomised to have two breathing patterns while asleep – persistent bradypnoea (respiratory rate of six breaths per minute) and intermittent apnoea (respiratory rate of 18 breaths per minute with 30-second pauses); both breathing patterns terminated after nurses woke the patient. Results: Twenty-seven nurses participated: 14 in the bradypnoea scenario, and 13 in the intermittent apnoea scenario. Upon entering the room, 24 (89%) participants woke the patient to begin respiratory assessment, and three (11%) assessed respirations while the patient remained asleep. Eleven (79%) participants noted abnormal breathing in the bradypnoea scenario, while only one (4%) noted abnormal breathing in the intermittent apnoea scenario. Conclusion: This simulation model demonstrated that most nurses awaken patients before vital sign assessments, which could prevent detection of respiratory depression present during sleep. Nurses on hospital wards should be educated to follow respiratory status assessment guidelines not to wake the patient for respiratory status assessment. https://journal.acorn.org.au/index.php/jpn/article/view/97opioid-induced respiratory depressionsimulation modelnursing assessmentapnoeabradypnoea
spellingShingle Natalia Tarasova
Usha Asirvatham
Robin Goetz
Mariela Rivera
Juraj Sprung
Toby Weingarten
Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model
Journal of Perioperative Nursing
opioid-induced respiratory depression
simulation model
nursing assessment
apnoea
bradypnoea
title Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model
title_full Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model
title_fullStr Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model
title_full_unstemmed Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model
title_short Evaluation of nursing approach to assessment of post-operative respiratory depression using a simulation model
title_sort evaluation of nursing approach to assessment of post operative respiratory depression using a simulation model
topic opioid-induced respiratory depression
simulation model
nursing assessment
apnoea
bradypnoea
url https://journal.acorn.org.au/index.php/jpn/article/view/97
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