Articles: pain-management.
-
Proper coding and documentation for evaluation and management services continuously and progressively are becoming not only complicated, but also confusing. Although medical evaluation of patients has been a fact of life since the beginnings of medical history, medicine has been substantially influenced by federal regulations since the enactment of Medicare. Physicians' fear of being prosecuted is increasing. ⋯ While the history is the same for all types of visits except for the complexity for each level, four types of physical examination are available, either in a general multisystem examination or a single-system examination. However, the complexity of medical decision making is the essential factor in deciding to which level the evaluation and management belong. This review will discuss various aspects of evaluation and management guidelines in interventional practice and also guide the physician in performing these evaluations in an appropriate manner with proper documentation, thus avoiding the pitfalls of fraud and abuse.
-
Epidural neuroplasty (lysis of epidural adhesions) is an interventional technique that has emerged over the last 10 years as part of a multidisciplinary approach to treating radiculopathy with low back pain when conservative management has failed. Neuroplasty was at one time performed as a single-catheter technique using the caudal approach. It now has many variations, including placement of the catheter tip in the anterior epidural space. This article will discuss the evolution and refinement of epidural neuroplasty at our institution.
-
J Pain Symptom Manage · Jul 2000
Cancer pain education: the use of a structured clinical instruction module to enhance learning among medical students.
The Structured Clinical Instruction Module (SCIM) is an educational format developed for the teaching of clinical and interpersonal skills. The purpose of this study was to develop and pilot-test a SCIM to enhance medical students' learning and understanding about cancer pain assessment and management. The Cancer Pain SCIM was presented to 34 third-year medical students. ⋯ D.)] very strongly that the SCIM was a valuable educational experience [4.4 (0.56)] and that it was beneficial to use actual cancer patients in the SCIM [4.5 (0.63)]. Students believed their skills in the assessment and management of cancer pain significantly improved after the course. The SCIM is a valuable and novel instructional format to teach essential skills in the assessment and management of cancer pain to medical students.
-
MCN Am J Matern Child Nurs · Jul 2000
ReviewHydrotherapy during labor. An example of developing a practice policy.
Warm water has been used for centuries to treat many painful ailments. In perinatal clinical practice, hydrotherapy is being used to increase relaxation and decrease pain during labor. This article summarizes clinical studies evaluating hydrotherapy during labor, describing the current evidence which supports hydrotherapy as an effective method for managing intrapartal pain. The article also describes the process by which an institution established an evidence-based practice policy for the use of hydrotherapy in labor.