Pain management nursing : official journal of the American Society of Pain Management Nurses
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The impact of opioid-related sedation progressing to respiratory depression in the Post Anesthesia Care Unit (PACU) can be extensive; however, there is a paucity of research on the subject of standardized assessment tools to prevent adverse events. The purposes of this study were: (1) to measure the efficacy of a standardized method of assessing sedation and administering opioids for pain management via the Pasero Opioid-Induced Sedation Scale (POSS) with interventions in the PACU; (2) to increase PACU nurses' confidence in assessing sedation associated with opioid administration for pain management and in the quality of care provided in their clinical area; and (3) to facilitate PACU and postoperative clinical unit nurses' communications during patient handoffs regarding safe opioid administration. A quasi-experimental design was used to evaluate the POSS protocol. ⋯ The intervention did not significantly change PACU length of stay or amount of administered opioids and patients were noted to be more alert at time of discharge from the PACU. Nurses reported increased perceptions of quality of care and confidence in opioid administration. The findings from this study support the use of the POSS Scale with interventions in the PACU care protocols.
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This paper explores if nurses' personal responses to postoperative pain contribute to its continuing poor management. A descriptive qualitative design used a purposive sample of 16 registered nurses (RNs), from inpatient surgical areas in the United Kingdom, to participate in one semistructured interview. ⋯ Analysis used Morse and Field's four stages. A complex picture of collective and individual responses emerged; uncritical adoption of the medical model, with pain as normal and focus on technical aspects of management conforming to a "reference typology." However, individual RNs were also influenced by other personal factors, and findings indicate that scrutinizing individual competency is essential to improve individual and collective practice.
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Neuropathic pain is a complex, chronic, and disabling condition that has physical, functional, and psychosocial repercussions. Although the estimated prevalence of neuropathic pain in the general population ranges from 1.5% to 8%, neuropathic pain is frequently underdiagnosed and undertreated. The aims of this study were to examine the experience of patients treated with spinal cord stimulation as a pain-relieving treatment and how this may influence the patient's ability to participate in everyday life activities. ⋯ Spinal cord stimulation also may have disadvantages that should be considered before offering this treatment. It seems evident that extended information needs about working mechanism of SCS and precautions as well as follow-up are required to meet unexpected challenges in adaptation. Here the nurse has an important role when informing and following this patient group.
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Arterial punctures for arterial blood gases (ABGs) analysis are described as the most painful laboratory procedure and are performed without the benefit of pain management. This study originated from one nurse's concern about the level of pain her hospitalized patients endured when she drew their ABGs. A review of the literature found that ABG pain relief has not been studied in hospitalized patients. ⋯ Results showed that, although lidocaine and buffered lidocaine are effective in reducing the pain associated with the arterial puncture, plain lidocaine was the only intervention in which the pain rating score for the overall experience was significantly diminished. This study is limited by partial randomization, small sample size, and patient duress; however, it provides a foundation for further nursing research that explores methods to reduce the pain associated with this very painful procedure. Future studies should be directed at larger, diverse populations, multiple operators, and comparison of interventions to topical analgesics and nonpharmacological measures.