Pain management nursing : official journal of the American Society of Pain Management Nurses
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Adherence monitoring for prescription opioid use is a clinical imperative for individuals prescribed opioids for chronic pain. Urine drug testing (UDT) provides objective evidence for prescription opioid adherence, as recommended by national guidelines to be part of adherence monitoring. The aim of this study was to describe prescription opioid adherence using UDT results in chronic pain patients and to examine the association between demographic characteristics and adherence to their prescribed opiate regimens. ⋯ Patients' age, pain level, sex, ethnicity, and injury compensation were not associated with UDT results. UDT results could be useful to educate and guide patients on the proper use of controlled medications. Results from UDT are highly contextual and easily misinterpreted, requiring comparison with a variety of clinical indicators over time before deciding if there is adherence to a prescribed opiate regimen for individuals with chronic pain.
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For hospital executives and clinicians to improve pain management, organizations must examine the current pain experience of in-patients beyond simply measuring patient satisfaction. The aim of this study was to quantify the prevalence of pain among adult in-patients and the degree of interference pain had on daily activities. A descriptive, cross-sectional study was undertaken in a 530 bed tertiary care, teaching hospital in central Canada. ⋯ Significant positive correlations were found between pain intensity ratings and pain interference on all daily activities (p < 0.001). Pain prevalence remains high with a significant relationship between pain and activities of daily living. The study provides baseline data to direct future initiatives at improving pain management.
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Randomized Controlled Trial
Effectiveness of external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients.
The aim of this study was to investigate the effect of external cold and vibration stimulation via Buzzy on the pain and anxiety level of children during peripheral intravenous (IV) cannulation. This study was a prospective, randomized controlled trial. The sample consisted of 176 children ages 7 to 12 years who were randomly assigned to two groups: a control group that received no peripheral IV cannulation intervention and an experimental group that received external cold and vibration via Buzzy. ⋯ Comparison of the two groups showed significantly lower pain and anxiety levels in the experimental group than in the control group during the peripheral IV cannulation. Buzzy can be considered to provide an effective combination of coldness and vibration. This method can be used during pediatric peripheral IV cannulation by pediatric nurses.
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Undertreatment of postoperative pain can aggravate patient outcomes and is associated with attending nurses' knowledge deficits or negative attitudes toward pain. The aim of this study was to investigate knowledge and attitudes toward postoperative pain of surgical department nurses and to identify predictors of their knowledge and attitudes. This was a descriptive, cross-sectional survey that took place in the departments of general surgery, orthopedics, neurosurgery, ear-nose-throat surgery, and obstetrics/gynecology at five Greek hospitals. ⋯ More previous personal experience of postoperative pain (p = .002) and being a registered nurse (p = .015) predicted higher modified KASRP tool score. Participation in continuing education programs and department of employment were also associated with differences in the modified tool score. The knowledge deficits and negative attitudes of the nurses toward postoperative pain highlight the role of pregraduate and continuing education, appropriately specialized for each surgical department, in the development of empathy toward patients in pain and of clinical competency regarding pain assessment and administration of analgesics.
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Comparative Study
Differences between nurses' and care workers' estimations of pain prevalence among older residents.
A high prevalence of pain and difficulties with pain assessment has been widely reported among residents of long-term-care facilities. We explored nurses' and care workers' estimations of residents' pain (both general and chronic) and the number of residents with unknown pain status. We also examined the relationship between the prevalence of pain and assessment strategies undertaken by nurses and care workers. ⋯ Estimations of pain prevalence were significantly higher among nurses who had observed signs of pain among residents in the previous month (p = .04) and who applied a multidisciplinary approach to pain assessment and management (p = .007) than among nurses who did not do either. Nurses and care workers had relatively low estimations of the prevalence of pain among their residents. Staff should undertake appropriate and sufficient pain assessments in order to improve their understanding of residents' pain.