Contemp Nurse
-
Caring for patients with prolonged persistent pain remains one of nursing's greatest challenges. Increased knowledge and understanding of pain pathways, however, has enabled new treatments to be incorporated into pain management regimes. ⋯ This review will explore the physiological processes associated with these phenomena, and the use of NMDA receptor antagonists such as ketamine and dextromethorphan to prevent and treat persistent pain. The importance of nurses understanding the modes of action of these drugs will be illustrated through presentation of two case histories.
-
In this overview of paediatric pain management the physiological and psychological effects of untreated pain are described. Reasons for the undertreatment of pain are identified as incorrect assumptions about children and pain; personal attitudes of families, nurses and physicians; inadequate research and training; and assessment difficulties. The problems of paediatric pain assessment are considered and an assessment strategy known as QUESTT is presented. Pharmacological and nonpharmacological interventions are discussed and the conclusion reached that despite the difficulties, infant and child pain can be controlled by using adequate nursing knowledge and treatment.
-
Continuity of patient care between hospital and community is becoming increasingly important with a trend to shorter hospital stays and more care in the community. This paper describes how community nurses determine patient care provision after hospital discharge. ⋯ Semi-focused interviews were conducted with twelve community nurses to elicit their perceptions and experiences of discharge planning. The findings revealed that although discharge planning influenced continuity of care, community nurses make autonomous decisions about the provision of care to patients in the community setting.