7/22/2014 FW: Patient Controlled Analgesia (PCA): Adult and Pediatric...

- Davis, Aurora
https://pod51038.outlook.com/owa/#viewmodel=ReadMessageItem&ItemID=AAMkADJmODRkNzU1LWY2MDAtNGYwYS1hZDViLWQ2ZWI2ZDg0NDEyMwBG 1/3
FW: Patient Controlled Analgesia (PCA): Adult and Pediatric Policy
and Procedure, Updated 6/4/14
Stakeholder emails for the PCA Policy and Procedure are as follows.
Thanks,
Aurora
Aurora Davis, RN, BA, BSN, OCN
Relief Charge Nurse, Oncology/BMT Unit
Co-Chair, Pain Champions Committee
University of Colorado Hospital
Aurora.Davis@uchealth.org
From: Montgomery, Robert <Robert.Montgomery@ucdenver.edu>
Sent: Sunday, June 8, 2014 9:44 PM
To: Davis, Aurora
Cc: Youngwerth, Jean M; Krumbach, Barbara; Levin, Dimitriy; Fiegel, Matthew; Johnson-Bortolotto, Shannon;
Swedhin, Amanda M
Subject: RE: Patient Controlled Analgesia (PCA): Adult and Pediatric Policy and Procedure, Updated 6/4/14

Hi Aurora,

Terrific job on the update. I agree with Shannon that it is ready for the policy committee.

One minor comment: Consider putting the sedation scales under item 4.B. instead of 4.A.4.

Jeanie: I took the lockout times from the UCH Analgesic Reference Guide. It has an IV PCA table for starting
doses in the opioid nave patient. I thought it best to be consistent with that document. We used numerous
references to support the guide

Thank you. -Rob

From: Youngwerth, Jean M
Sent: Sunday, June 08, 2014 9:52 AM
To: Davis, Aurora; Montgomery, Robert; Krumbach, Barbara; Levin, Dimitriy; Fiegel, Matthew; Johnson-
Bortolotto, Shannon; Swedhin, Amanda M
Subject: RE: Patient Controlled Analgesia (PCA): Adult and Pediatric Policy and Procedure, Updated 6/4/14
Davis, Aurora
Thu 7/3/2014 7:43 AM
To:UCH-Professional Practice Policy Proc Committee <UCH-ProfessionalPracticePolicyProcCommittee@uchealth.org>;
7/22/2014 FW: Patient Controlled Analgesia (PCA): Adult and Pediatric... - Davis, Aurora
https://pod51038.outlook.com/owa/#viewmodel=ReadMessageItem&ItemID=AAMkADJmODRkNzU1LWY2MDAtNGYwYS1hZDViLWQ2ZWI2ZDg0NDEyMwBG 2/3

Hi Aurora,

Thanks for doing this.

I have one suggestion- Rob M - can we put the lockout times on the PCA Chart back to 8-10 minutes for
morphine/hydromorphone and 6-10 for fentanyl? I'm concerned about shortening the lockouts.

thanks,

Jeanie

Jeanie Youngwerth, MD, FAAHPM
University of Colorado Denver
Assistant Professor of Medicine, Hospitalist
Associate Program Director, Colorado Palliative Medicine Fellowship
Director, UCH Palliative Care Consult Service

From: Davis, Aurora [Aurora.Davis@uchealth.org]
Sent: Friday, June 06, 2014 9:30 AM
To: Montgomery, Robert; Krumbach, Barbara; Youngwerth, Jean M; Levin, Dimitriy; Fiegel, Matthew; Johnson-Bortolotto,
Shannon; Swedhin, Amanda M
Subject: Patient Controlled Analgesia (PCA): Adult and Pediatric Policy and Procedure, Updated 6/4/14

Dear Clinical Stakeholders,

In response to the additional feedback from stakeholders, I have made more changes to the Patient
Controlled Analgesia (PCA): Adult and Pediatric Policy and Procedure. In addition to the changes noted in
my last two emails, I have now: added the RASS sedation scale for the ICUs sedation reference;
Shannon included the protected airway information for use in ICUs; verified the sedation scale levels at
which to notify physicians and stop PCAs/administer Narcan (these sedation levels have been approved by
the Acute Pain Service and are now in line with the levels used for notification/stopping at both the North
and South campuses); Barb Wenger updated the old references using the new Levels of Evidence; added a
Joint Commission Sentinal Event Report to the references; recommended removing the word "Pediatric"
from the title; and explicitly referenced the Pain Management Policy for appropriate pain level monitoring.

Regarding Barb K's concerns about monitoring patient's respiratory rate and quality, please note there's a
section under "sleeping patient" that talks about this in great detail. Also, FYI, this version, including all
changes, has been approved by the Kaizen Committee.

Please look over and review the attached policy. I am looking for either your approval as is or
suggestions/rationales for change. Please have all feedback to me by Friday, June 13th, 2014. If, by June
13th, 2014, your comments have not been received, your approval is assumed.
7/22/2014 FW: Patient Controlled Analgesia (PCA): Adult and Pediatric... - Davis, Aurora
https://pod51038.outlook.com/owa/#viewmodel=ReadMessageItem&ItemID=AAMkADJmODRkNzU1LWY2MDAtNGYwYS1hZDViLWQ2ZWI2ZDg0NDEyMwBG 3/3

Thank you.

Attached document:
1. Patient Controlled Analgesia (PCA): Adult and Pediatric Policy and Procedure, Updated 6/4/14
Aurora Davis, RN, BA, BSN, OCN
Relief Charge Nurse
Oncology and Bone Marrow Transplant Unit
University of Colorado Hospital
Aurora.Davis@uchealth.org