Pain management nursing : official journal of the American Society of Pain Management Nurses
-
A role delineation study was carried out by the American Society of Pain Management Nurses (ASPMN) to determine the activities performed by nurses involved in pain management. Demographic characteristics of pain management nurses and differences in practice based on educational preparation and specialty affiliation were identified. The role delineation survey was developed based on Nursing Intervention Classifications. ⋯ Nurses with diploma and Associate Degree preparation rated assessment and nonpharmacologic management higher and communication and collaboration lower than nurses with higher educational preparation. Activities varied somewhat as a reflection of respondents' nursing specialty. The results of the study will be used to refine standards of care, develop nursing education curricula, develop research priorities, and develop a blueprint for a certification examination in pain management nursing.
-
This study examined whether nurses who currently provide direct patient care would perceive and treat pain differently in patients whose pain resulted from activities involving different levels of socially acceptable behavior. Clinical vignettes (differing only with respect to information provided about the patient's behavior at the time of injury) were randomly distributed to all medical/surgical, critical care, and emergency room nurses at this institution. Nurses were asked to record their perception of the patient's pain level and to indicate how much morphine should be given. ⋯ However, medical/surgical nurses indicated that they would give significantly less morphine to the patient who was presented as engaging in less socially acceptable behavior at the time of injury (p =.03). Overall, significantly more nurses correctly increased the next dose of morphine for the patient who was presented as having injured him or herself while participating in more socially acceptable behavior (p =.003). Thus, although the level of social acceptability of the patient's behavior at the time of injury did not significantly affect the average pain rating or morphine dose that the nurse would have reportedly given, there is evidence that the nurses would have been less aggressive in ensuring adequate pain treatment in the patient exhibiting less socially acceptable behavior.
-
This descriptive study was designed to identify attitudes regarding pain as well as pain assessment and management practices of nurses working with elderly residents in 10 long-term care facilities. Twenty-seven nurses from 10 facilities in the Midwest responded to a questionnaire. Findings indicate that more than half of the respondents reported that residents should be pain free; however, only 5 respondents defined pain free as no pain. ⋯ Changes in weight, recreational activity, and concentration, as well as coping skills were assessed less than half of the time. When first learning residents were in pain, nurses reported doing further assessments, offering medication, giving emotional reassurance, and changing the resident's position. They reported substantial familiarity with basic nonpharmacologic practices but only asked residents to try these interventions (in addition to medication) an average of 38% of the time.
-
Review Practice Guideline Guideline
Pain management in sickle cell disease.
The unpredictable, recurrent, intense, and frequently persistent nature of pain associated with sickle cell disease poses a difficult challenge in terms of management. A wide variability exists in the way painful episodes are managed. Variations in practice reflect different views about the suitability of opioids, the efficacy of parenteral administration, and the risk of dependence on opioids. ⋯ The American Pain Society recognized that the undertreatment of pain and inappropriate management of pain in sickle cell disease seem to be common. A Clinical Practice Guideline was developed to provide evidence-based recommendations that could potentially improve pain management. The purpose of this report is to describe the pharmacologic strategies used to manage pain associated with sickle cell disease, examine issues and challenges related to pain management as well as concerns and fears related to addiction, and explain the administration of opioids as recommended by the American Pain Society.