Examination of naloxone use can assist in the identification and stratification of patients at risk for opioid-induced respiratory depression and oversedation and can serve as a driver for improvements in hospital patient safety. This information can also guide other institutions interested in similar improvements.

Key Messages Purpose of ReviewTo determine optimal doses, routes of administration, and dosing strategies of naloxone for suspected opioid overdose in out-of-hospital settings, and whether transport to a hospital following successful opioid overdose reversal with naloxone is necessary. Key Messages• Higher concentration intranasal naloxone may be similarly effective and safe compared with intramuscular naloxone, but the available studies did not evaluate formulations approved by the Food and Drug Administration.• While field administration of naloxone is generally effective in reversing opioid overdose, there is not strong evidence concerning differences in effectiveness between doses or routes of administration.• More research is needed to determine optimal doses of naloxone, appropriate timing of repeat dosing, and whether it is necessary to dose patients to full consciousness.• More research is needed to determine whether transporting patients to a hospital after successful reversal of overdose is necessary.ii This report is based on research conducted by the Pacific Northwest Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00009-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.The information in this report is intended to help health care decisionmakers-patients and clinicians, health system leaders, and policymakers, among others-make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.This report may periodically be assessed for the currency...

Nurses have an essential role in the safe and effective use of IGIV, from educating patients about the rationale for and effects of therapy to administering the product and monitoring for adverse effects.

The aim of the study is to investigate the patient perceptions on the cost, quality, and access of health care services in Piura, Peru. Although one of the largest cities in Peru, Piura has one of the lowest densities of health care workers in the country which greatly impacts the population’s ability to receive medical treatment. Lack of financial resources and health literacy, among other health disparities exist. Modeled after CAHPS Health Plan Adult Commercial Survey 5.0 and the Patient Satisfaction Survey, a forty-four question English and Spanish survey was created with questions to study healthcare variables. As a correlational study with convenience sampling, the survey was administered to both patients and medical providers in eight city health centers. Over a period of twelve days, 107 surveys were collected. After eliminating subjects who did not meet the study criteria, 92 patients and 13 medical providers were included in the study. Findings from medical providers are not reported because of the small sample size. The results of this study suggests that 32% of subjects do not have health insurance, 24% of subjects rated their healthcare received as average, 18% of participants rated their healthcare as the best possible on a scale of zero to ten, and 29% of subjects had to wait an average of seven days for access to healthcare services when care is urgent. The results of this analysis can be used to better understand the Peruvian healthcare system and educate the Piura community and the Parish Santísimo Sacramento as they continue to improve and expand their health care services. KEYWORDS: Cost; Quality; Access; Healthcare; Piura; Peru; Satisfaction; Parroquia Santísimo Sacramento; EsSalud; SIS; MINSA

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