Current monitoring strategies for the early identification of postoperative respiratory compromise may be inadequate.
A comprehensive and continuous patient monitoring strategy encompassing respiratory rate, pulse oximetry and capnography has the potential to reduce the incidence and severity of postoperative respiratory compromise, and improve patient outcomes and reduce the cost of care.
A 2010 AHRQ statistical brief lists respiratory insufficiency, arrest and failure (RIAF) as one of the five conditions resulting in the most rapidly increasing hospital costs for Medicare-covered stays in the U.S.[1] In 2007, respiratory insufficiency, arrest and failure were related to 385,800 inpatient stays costing $7.7 billion.[1]
Inpatients with RIAF originating on the general care floor had higher mortality rates (34.6%) than non-RIAF cases (1.2%) and longer lengths of hospital and ICU stays (11.5, 5.8 days) than non-RIAF cases (4.1, 2.9 days).[2]
Postoperative respiratory failure has become a hospital focus under Medicare’s Inpatient Quality Reporting Program (Patient Safety Indicator #11).[3] Current monitoring regimens may be inadequate for preventing respiratory compromise and other adverse events.
Approximately 77% of patients suffering adverse events have at least one vital sign immediately before the event missing from documentation.[4]
Delayed interventions occur in 50% of patients with respiratory distress, with a median duration of delay of 12 hours.[5] Adverse events are frequently preceded by respiratory abnormalities.
Respiratory abnormalities are the most common abnormalities prior to ICU admission.[6]
Bradypnea on the general care floor is independently associated with a high risk for subsequent death.[7]