Articles: pain-clinics.
-
Ann Fr Anesth Reanim · Oct 2012
[Postoperative pain management on surgical wards; impact of using a validated reference tool in a short, medium and long term].
To evaluate the short medium and long-term impact of a quality-improvement program (QIP) in a university hospital using a validated reference tool. ⋯ Audits should be performed regularly (at least every two years) for detecting postoperative pain management degradation. Lack of targeted training sessions can explain partially this degradation.
-
A retrospective cohort study. ⋯ Referral to a PTC/SC did not yield improved functional outcomes in this cohort. A major factor contributing to this finding was the length of time to referral to PTC/SC after the initial injury.
-
Social science & medicine · Sep 2012
The struggle to improve patient care in the face of professional boundaries.
Professional boundaries make inter-professional communication, collaboration and teamwork more challenging and can jeopardise the provision of safe, high quality patient care. This in-depth interview study conducted in three UK acute hospital organisations in 2003-2004 explored how professional boundaries affected efforts to improve routine practice by acute pain services (small specialist teams set up to drive improvements in postoperative pain management through education, training, standard-setting and audit). The study found that many anaesthetists and to a lesser extent nursing staff saw postoperative pain management as a new and unjustified addition to their professional role. ⋯ The inter-professional boundaries led to the acute pain services devoting a substantial part of their time to performing a 'go-between' function between nurses and doctors. The intra-professional boundaries hindered collaborative working among doctors and limited the influence that the acute pain service nurses could have on improving the practice of other nurses. Further work is needed to address the underlying fears that can lead to resistance around role changes and to develop effective strategies to minimise the impact of professional boundaries on patient care.
-
Pain management should be warranted for all children in every situation. Italian legislation proposes a model for pain assistance based on specialized tertiary centers which provide direct clinical management for complex cases and assure continuous cooperation with hospitals and family pediatricians for managing painful conditions every day. The Procedural Pain Service of the University of Padua Department of Pediatrics applies such model for procedural pain management. ⋯ Most frequently administered drug combinations were local analgesia + intravenous midazolam alone or midazolam and propofol or midazolam and propofol and ketamine; most frequently used non-pharmacological methods were distraction using cartoons and bubbles. Minor adverse events were recorded in 281 cases (2.5%), the most common being desaturation (2.1%). In conclusion, our model functions on two integrated levels, and it can be considered generally applicable as a solution for pain management.
-
The primary goal of this investigation was to survey military health care professionals at a Camp Bastion, Afghanistan, regarding their perceptions of care delivered by an anesthesiologist-directed acute pain service (APS) at a British Combat Support Hospital (CSH)-Role 3. ⋯ Overall, the majority of military health care survey responders indicated support for an APS team as part of a CSH care, and confirmed its contributions to improving trauma care.