Applied nursing research : ANR
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Randomized Controlled Trial Clinical Trial
Transdermal fentanyl for the management of acute pancreatitis pain.
Although the hazards of using Demerol for pain management is well documented, physicians at a 350-bed tertiary-care center in the upper midwest continued to follow the antiquated practice of ordering intramuscular Demerol and Vistaril to manage pain for patients with acute pancreatitis. Their reasoning was based on early evidence that Demerol, unlike morphine, does not cause biliary-tract spasms resulting in epigastric or right upper quadrant pain. In an effort to change practice patterns, a multidisciplinary team was formed to study the efficacy of using Transdermal Therapeutic System (TTS) fentanyl to manage pain in this patient population. ⋯ Although not statistically significant, trends in the data revealed that the experimental group had lower self-reported pain intensity scores than the control group throughout the course of hospitalization. Even though the experimental group had significantly more previous hospitalizations for acute pancreatitis and a higher pain intensity score on admission, this group had a significantly shorter length of stay in the hospital c2 (1, N = 31) = 4.3706 p <.05. There was no statistically significant difference between the two groups for self-reported satisfaction with pain management.
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This investigation sought to describe and compare dependency among dying persons. To accomplish this, healthcare records of all deceased persons who received care over a 6-month period in one Canadian hospital (n = 150) and one home care department (n = 59) were reviewed. Only 36% of the home care clients died at home; all others (n = 38) were hospitalized. ⋯ The duration of complete dependency varied between and among subject groups, which explains why a significant difference in lengths of complete dependency between hospital inpatients (M = 8.3 days) and home care clients who died at home (M = 4.1 days) was not found. In light of a dearth of research-based knowledge, this information should facilitate an improved understanding of the dependency needs of dying persons. Ultimately, it should assist end-of-life care planning and policy making.