1. Assess, Inform, Educate Using Google docs in reducing incidence of patient death related to prescription Opioids

2. 2010: Deaths due to prescription medications 74.3% Deaths: Unintentional 17.1% 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

3. 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

4. 2010 Deaths by medication classification

5. 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!

6. 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?

7. 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

8. 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

9. Big Picture Design comprehensive data gathering tool using google docs Inputs Evidence Based Practice, Research, QSEN Use google docs to screen for potential harm d/t opioids Activities 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 patient Outputs 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 research Long Term Outcomes