Pain management nursing : official journal of the American Society of Pain Management Nurses
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Patient safety related to medication infusion devices has received considerable attention recently. Critical adverse patient outcomes have resulted from misprogrammed delivery devices, inherent flaws in device design, and human error. A key strategy to improving patient safety is the development of an interdisciplinary team in product selection and the inclusion of registered nurses in the process. ⋯ No formal product selection guidelines exist which consider patient safety. This article outlines the process undertaken at University Health Network in the selection of its most recent patient-controlled analgesia device. Various available products were excluded from the selection process based on the interdisciplinary review.
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Severe pain experiences for children at home after tonsillectomy and adenoidectomy (T & A) have been described for more than a decade. Children and their parents are responsible for pain and symptom management during the postoperative home recovery. The purpose of this research was to more fully explore the pain experience and home management practices from the child's perspective. ⋯ Across the 3 postoperative days studied, pain remained severe and interventions offered minimal relief. Neither older children (chi(2) = 1.357, n = 13, df = 2, p = .259) nor younger children (chi(2) = 1.357, n = 12, df = 2, p = .507) reported significant differences in their mean pain intensity across the first 3 postoperative days. Results supported concerns for inadequate home pain management practices in the pediatric T & A population.
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The current trend of treating chronic nonmalignant pain with opioid therapy means that pain management nurses are increasingly involved in the care of patients who are prescribed and using potent opioid analgesics on a daily basis. Although demonstrated to be quite effective in certain patients, sanctioned access to these medications brings with it risks for abuse, addiction, and diversion. ⋯ It is emphasized that the results of urine toxicology analysis should never be used in isolation to identify abuse, addiction, or diversion, and that patterns of medication and other drug use should always be evaluated with respect to evidence of improved functionality. Nurses involved in the care of patients with chronic pain are encouraged to consider urine toxicology analysis as an integral component in care plan for those on chronic opioid therapy, and to knowledgeably implement and interpret this powerful tool in the practice of pain care.