Clinical nursing research
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Clinical nursing research · Nov 2000
Clinical Trial Controlled Clinical TrialEffects of performance feedback on patient pain outcomes.
The purpose of this study was to examine the effects of an individual feedback intervention provided to nurses on selected patient outcomes related to postoperative pain management Individual performance feedback served as the intervention. Thirty orthopedic staff nurses received feedback information on their past performance of recommended pain management practices. ⋯ An improvement was noted in all pain outcomes following the feedback intervention. Results indicate that providing nurses with feedback on their past performance of pain management practices may contribute to decreased postoperative pain.
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This study compares behaviors that differed across levels of established (e.g., nonprocedural) infant pain with those that differed between periods of greater and lesser distress within any level of infant pain. Sixty-four videotaped infants of two ages (0 to 3 months and 7 to 12 months) and four levels of established infant pain (none, mild, moderate, and severe) were used. Pain was from medical or surgical causes. ⋯ Many behaviors were indicative of high levels of established pain and greater distress. Others increased with greater distress but lower levels of pain. Findings suggest that many behaviors indicative of high distress that constitute the immediate infant pain response are not good indicators of levels of established infant pain.
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Clinical nursing research · May 2000
ReviewValidity and reliability of a practice-based infant pain assessment instrument.
The purpose of this study was to determine the validity and reliability of an infantpain assessment instrument. This instrument is an algorithm derived from a model of infant pain assessment that emerged from interviews with pediatric nurses and includes methods for evaluating clinical data that suggest the Iikelihood of pain. Unlike other instruments, this instrument is not restricted to use in clinical situations where the likelihood of pain is evident. ⋯ Content validity was determined by obtaining and incorporating feedback from a focus group of practicing pediatric nurses on various developmental stages of the instrument. Criterion-like validity was excellent: Mean Pearson correlations between the pain ratings of 18 videotaped infants by 24 nursing students using the instrument with ratings performed by a panel of 5 expert nurses not using any instrument was 0.96. Test-retest reliability, as measured by Pearson correlations between pain ratings 3 months apart, was also excellent (r = 0.91).
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A patient-controlled analgesia (PCA) program was established on a surgical unit with children age 7 years and older. The primary objectives for the PCA program were safety and efficacy. ⋯ A chart review of these patients indicated that the relation between the number of failed administration attempts, the total hourly analgesic intake, and the pain intensity score was key to optimizing the use of PCA. Recommendations to strengthen the PCA program were implemented based on information gained from these 4 patients with poorly controlled pain.
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Clinical nursing research · Aug 1999
Clinical Trial Controlled Clinical TrialChanging clinical practice through research: the case of delirium.
Promoting application of study findings to the clinical setting is a constant challenge for nurse researchers. This project used change theory to include staff RNs in a research study on delirium and to use relevant findings. ⋯ Intervention unit nurses demonstrated an improved ability to identify the presence and absence of delirium, and voluntarily requested to continue using the protocol after the study was terminated. Use of a theoretical model to include nurses in the study promoted the successful conduct of the research and subsequent use of findings.