Pain management nursing : official journal of the American Society of Pain Management Nurses
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Review Practice Guideline Guideline
Pain management in sickle cell disease.
The unpredictable, recurrent, intense, and frequently persistent nature of pain associated with sickle cell disease poses a difficult challenge in terms of management. A wide variability exists in the way painful episodes are managed. Variations in practice reflect different views about the suitability of opioids, the efficacy of parenteral administration, and the risk of dependence on opioids. ⋯ The American Pain Society recognized that the undertreatment of pain and inappropriate management of pain in sickle cell disease seem to be common. A Clinical Practice Guideline was developed to provide evidence-based recommendations that could potentially improve pain management. The purpose of this report is to describe the pharmacologic strategies used to manage pain associated with sickle cell disease, examine issues and challenges related to pain management as well as concerns and fears related to addiction, and explain the administration of opioids as recommended by the American Pain Society.
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This descriptive study was designed to identify attitudes regarding pain as well as pain assessment and management practices of nurses working with elderly residents in 10 long-term care facilities. Twenty-seven nurses from 10 facilities in the Midwest responded to a questionnaire. Findings indicate that more than half of the respondents reported that residents should be pain free; however, only 5 respondents defined pain free as no pain. ⋯ Changes in weight, recreational activity, and concentration, as well as coping skills were assessed less than half of the time. When first learning residents were in pain, nurses reported doing further assessments, offering medication, giving emotional reassurance, and changing the resident's position. They reported substantial familiarity with basic nonpharmacologic practices but only asked residents to try these interventions (in addition to medication) an average of 38% of the time.