Pain management nursing : official journal of the American Society of Pain Management Nurses
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The Nociception Coma Scale (NCS) is a pain observation tool, developed for patients with disorders of consciousness (DOC) due to acquired brain injury (ABI). The aim of this study was to assess the interrater reliability of the NCS and NCS-R among nurses for the assessment of pain in ABI patients with DOC. A secondary aim was further validation of both scales by assessing its discriminating abilities for the presence or absence of pain. ⋯ Secondary analysis was performed to assess differences in ICCs among nurses' education and experience and to assess the scales discriminating properties for the presence of pain. The NCS and NCS-R are valid and reproducible scales that can be used by nurses with an associate (of science) in nursing degree or baccalaureate (of science) in nursing degree. It seems that more experience with ABI patients is not a predictor for good agreement in the assessment of the NCS(-R).
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Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. ⋯ However, the tool could be improved with slight modifications. Nevertheless, it was useful in assessing intensive care nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose.
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Comparative Study
Effects of white noise and holding on pain perception in newborns.
This experimental study on newborns was conducted to compare the effects of various atraumatic care procedures during an infant's crying response to pain. Included in this study were 120 newborns chosen from among healthy infants admitted to the Obstetrics Department of Çanakkale State Hospital between April 2010 and June 2010. The patients were divided into three physically homogeneous groups. ⋯ The highest behavioral reaction was reported by those infants who were held by their mothers but did not listen to white noise. According to the results, white noise is an effective nonpharmacologic method to control pain, reduce crying time, and positively effect vital signs. Therefore, it is recommended that the use of white noise be practiced on newborns when they undergo painful procedures.
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An ongoing concern in long-term care (LTC) is that pain problems are often not identified correctly. There is also evidence that behavioral disturbance due to pain is misattributed to psychiatric conditions and consequently frequently treated with psychotropic rather than analgesic medication. This can result in unnecessary polypharmacy and ineffective pain management. ⋯ At the end of the study, residents in the pain assessment group were administered fewer psychotropic medications than patients in the control group, helping address the problem of polypharmacy. Pain levels were comparable between the groups. Health care staff indicated that the protocol resulted in more careful evaluation of residents' pain and greater appropriateness of prescriptions including reductions in polypharmacy.
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Certification is the outcome of the demonstration of knowledge and skills, which is an important link to licensing and credentialing. Considering the essential role that Certified Registered Nurse Anesthetists play in the practice of nonsurgical pain management, it is important that a certification process be developed that provides the necessary support to licensing and credentialing at the local, state, and federal levels. The goal of this project was to develop the foundational elements for a specialty certification in nonsurgical pain management. ⋯ Results of the query were compiled, analyzed, and compared to feedback about the elements from a sample of certified registered nurse anesthetists involved in nonsurgical pain management to assess reliability. The results provided identification of a target population for competency evaluation, tools for evaluation, resources for knowledge and skills testing, and a table of specifications for testing. A valid process to develop a specialty certification for nurse anesthetists with demonstration of knowledge and skills will help bridge the gap between continuing education and an actual demonstration that an individual practitioner possesses the necessary knowledge and skills to practice nonsurgical pain management.