Pain management nursing : official journal of the American Society of Pain Management Nurses
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The United States is experiencing an opioid overdose crisis. Research suggests prolonged postoperative opioid use, a common complication following surgery, is associated with opioid misuse, which, in turn, is the greatest risk factor of heroin misuse. The objective of this review is to evaluate how postoperative opioid exposure relates to prolonged use and to identify factors that predict prolonged postoperative opioid use. ⋯ Studies are needed to determine the predicting characteristics of prolonged postoperative opioid use, the type of surgeries that place patients at most risk, and the effect postoperative exposure to opioids has on prolonged use. This information can be used to develop and implement protocols to prevent misuse among high-risk patients.
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We created a multicomponent intervention to improve pain management in the immediate postoperative period with the goal of improving the quality of patient recovery. ⋯ After the combined intervention of a clinical pain pathway and interactive teaching workshop, we noted shortened PACU length of stay, reduced time to reach pain control, and improved overall patient satisfaction. Although we could not determine statistical significance, our findings suggest improved management of acute postoperative pain, especially for patients who are opioid tolerant. Because of the paucity of data, we were not able to conduct the analysis needed to evaluate quality improvement projects, as per SQUIRE 2.0. could be adopted by any institution.
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Pain is a common subjective symptom among older adults in general and among older adult residents in long-term geriatric facilities in particular. Pain diminishes older adults' quality of life and may impair their ability to recover from various illnesses. Therefore, the Israeli Ministry of Health has issued guidelines on effectively assessing and treating pain in this population. ⋯ There were discrepancies found between the Ministry of Health's pain assessment guidelines and documented practice by the nursing staff. An average of 13.8 out of 19 aspects of pain assessment and management were documented. As nurses' knowledge about pain assessment and management increased and as staffing ratios improved, the greater was the adherence to Ministry of Health guidelines, resulting in fewer discrepancies between the guidelines and documented practice. There was less pain assessment and management documentation for mechanically ventilated patients and for male patients.
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Breakthrough pain is an extremely painful symptom that impairs quality of life in cancer patients. It negatively impacts their emotional wellbeing, physical function, and mental health. The aim of this study is to use a qualitative methodology to examine the perception of cancer patients with breakthrough pain in the Northwest of China. ⋯ Although certain traditional cultural worldviews increase patients' acceptance of pain, healthcare providers need proper treatment guidelines to improve the quality of cancer patient care in Northwest China. We recommend that healthcare workers and hospital managers place cancer pain management in higher priority. Relevant pain management education programs should be provided to both healthcare providers and patients to improve their knowledge in these area. Healthcare professionals need to establish a mutual communication channel between patients and healthcare workers to meet patients' needs during breakthrough pain episodes in order to improve pain management. Nevertheless, the government and the healthcare system need to recognize the importance and urgency of palliative care services.
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Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. ⋯ Knowledge of pain management in nursing home patients and the practice of interprofessional cooperation should be included in pain curricula for health care professionals.