scholarly journals Balancing Knowledge Among Resident Specialties: Lecture-Based Training and the OUCH Card to Treat Children's Pain

2010 ◽  
Vol 2 (1) ◽  
pp. 73-80 ◽  
Author(s):  
John M. Saroyan ◽  
William S. Schechter ◽  
Mary Ellen Tresgallo ◽  
Adrienne G. Pica ◽  
Matthew D. Erlich ◽  
...  
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Clinical Care ◽  
Assessment Tools ◽  
Repeated Measure ◽  
Pediatric Pain ◽  
Convenience Sample ◽  
Assessment And Treatment ◽  
Children's Pain ◽  
Resident Learning

Abstract Background There are well-established deficiencies in residents' knowledge of acute-pain assessment and treatment in hospitalized children. Methods Among residents in 3 specialties (anesthesiology, orthopedics, and pediatrics), we investigated whether a pediatric pain management (PPM) curriculum that offered a lecture combined with a demonstration of how to use the OUCH card would yield higher performance on a subsequent PPM knowledge assessment. The OUCH card was created as a portable reference tool for trainees to provide analgesic dosing information, pain-assessment tools, and treatment of opioid-induced adverse effects. There was an initial convenience sample of 60 residents randomized to Form A or B of the pretest. From this, 39 residents (15 anesthesiology, 13 orthopedic, 11 pediatric) completed a PPM knowledge posttest approximately 4 weeks after the pretest, PPM lecture, and OUCH card instruction. Results Using a repeated measure design, the interaction of resident specialty and pretest to posttest scores was significant (P  =  .01) along with the covariate of residency year (P  =  .026). Conclusions These preliminary data based on a convenience sample of residents suggest that PPM training along with use of the OUCH card may help to reduce knowledge differences among residents. Faculty whose clinical practice includes children with acute pain should consider including learning or performance aids like the OUCH card in education and clinical care for its potential benefit in resident learning.

Considerations for neonatal and pediatric pain management

2019 ◽  
Vol 76 (19) ◽  
pp. 1511-1520 ◽  
Author(s):  
Pooja Shah ◽  
Anita Siu
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Pediatric Patients ◽  
Safety Data ◽  
Clinical Situation ◽  
Assessment Tools ◽  
Patient Specific ◽  
Pediatric Pain ◽  
Unique Challenge

Abstract Purpose Current literature and clinical practice guidelines on pediatric pain management are reviewed. Summary Acute pain is commonly present in neonatal and pediatric patients due to underlying disease states or procedures. Especially in institutions with limited pediatric pain services, it is imperative to describe the appropriate management of pain and pharmacotherapy options that are effective and safe in pediatric patients. Despite the knowledge of pain being an important aspect in the management of children, barriers exist, leading to suboptimal treatment. Addressing these barriers through education of healthcare practitioners, families, and patients will lead to optimizing the patient pain experience. Tools for pain assessment vary depending on the type of pain, the child’s age and understanding of pain, and the clinical situation. Pharmacotherapy options for pain management in neonates and pediatric patients include opioid and nonopioid agents. Efficacy and safety data on the use of medications for the treatment of pain in pediatric patients is described. The delivery of medication encompasses patient-specific factors and preferences. Strategies for opioid stewardship and management of iatrogenic withdrawal pose a unique challenge in pediatric patients. Conclusion The management of acute pain in neonates and pediatric patients should be a priority for all practitioners caring for these patients. Use of age-appropriate pain assessment tools and understanding of the mechanisms of action and roles in therapy of various nonopioid and opioid therapies can help optimize treatment of pain in neonatal and pediatric patients.

scholarly journals How hospitalized patients evaluate and report their pain together with nurses: A scoping review

2021 ◽  
pp. 205715852110134
Author(s):  
Bente Dale Malones ◽  
Sindre Sylte Kallmyr ◽  
Vera Hage ◽  
Trude Fløystad Eines
Keyword(s):  
Scoping Review ◽  
Pain Assessment ◽  
Health Professionals ◽  
Clinical Care ◽  
Hospitalized Patients ◽  
Assessment Tools ◽  
Post Surgery ◽  
Reliable Assessment ◽  
Scoping Reviews ◽  
The Relationship

Pain assessment tools are often used by patients to report their pain and by health professionals to assess patients’ reported pain. Although valid and reliable assessment of pain is essential for high-quality clinical care, there are still many patients who experience inappropriate pain management. The aim of this scoping review is to examine an overview of how hospitalized patients evaluate and report their pain in collaboration with nurses. Systematic searches were conducted, and ten research articles were included using the PRISMA guidelines for scoping reviews. Content analysis revealed four main themes: 1) the relationship between the patient and nurse is an important factor of how hospitalized patients evaluate and report their post-surgery pain, 2) the patient’s feelings of inconsistency in how pain assessments are administered by nurses, 3) the challenge of hospitalized patients reporting post-surgery pain numerically, and 4) previous experiences and attitudes affect how hospitalized patients report their pain. Pain assessment tools are suitable for nurses to observe and assess pain in patients. Nevertheless, just using pain assessment tools is not sufficient for nurses to obtain a comprehensive clinical picture of each individual patient with pain.

2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats

2021 ◽  
Vol 24 (1) ◽  
pp. 4-30
Author(s):  
Paulo V Steagall ◽  
Sheilah Robertson ◽  
Bradley Simon ◽  
Leon N Warne ◽  
Yael Shilo-Benjamini ◽  
...  
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Multimodal Analgesia ◽  
Evidence Base ◽  
Pharmacological Therapy ◽  
Assessment Tools ◽  
Mental Wellbeing ◽  
Team Approach ◽  
Analgesic Drugs

Practical relevance: Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer. Clinical challenges: Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management. Evidence base: These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors’ experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.

Topical Review: State of the Field of Child Self-Report of Acute Pain

2019 ◽  
Author(s):  
Lindsey L Cohen ◽  
Matthew R Donati ◽  
Sharon Shih ◽  
Soumitri Sil
Keyword(s):  
Acute Pain ◽  
Pain Assessment ◽  
Comprehensive Evaluation ◽  
Clinical Care ◽  
Preschool Age ◽  
Self Report ◽  
Common Features ◽  
Topical Review ◽  
Review State ◽  
State Of The Field

Abstract Objective Children experience acute pain with routine and emergent healthcare, and untreated pain can lead to a range of repercussions. Assessment is vital to diagnosing and treating acute pain. Given the internal nature of pain, self-report is predominant. This topical review reflects on the state of the field of pediatric acute pain self-report, and proposes a framework for acute pain assessment via self-report. Method We examine self-report of acute pain in preschool-age children through adolescents, and we detail a three-step process to optimize acute pain assessment. Results The first step is to decide between a pain screening or assessment. Several 0–10 self-report scales are available for pain screenings. Assessment requires specification of the goals and domains to target. Core criteria, common features, modulating factors, and consequences of acute pain provide a framework for a comprehensive pain assessment. Whereas there are some measures available to assess aspects of these domains, there are considerable gaps. Last, it is important to integrate the data to guide clinical care of acute pain. Conclusions Self-report of acute pain is dominated by single-item intensity scales, which are useful for pain screening but inadequate for pain assessment. We propose a three-step approach to acute pain assessment in children. However, there is a need for measure development for a comprehensive evaluation of the core criteria, common features, modulating factors, and consequences of pediatric acute pain. In addition, there is limited guidance in merging data found in multifaceted evaluations of pediatric acute pain.

Acute Pain Management

2018 ◽  
Author(s):  
Nihar Patel
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Treatment Options ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Age Appropriate ◽  
Short And Long Term ◽  
Inflammatory Drugs ◽  
Postoperative Setting

Age-appropriate pain assessment and management is vital in the care of children with acute pain. Pain in children should be routinely and regularly assessed, documented, treated and reassessed with clear documentation. Poor pain management in the acute and postoperative setting can result in both short- and long-term consequences. The most effective analgesia plans are multimodal. This chapter focuses on the variety of treatment options for pain in the acute setting. Topics covered include age-appropriate pain assessment tools for children; the basics of age-appropriate pain management in children; as well as the role of opioids, nonsteroidal anti-inflammatory drugs, and patient-controlled analgesia in acute and postoperative pain management in children.

Pain in children

2018 ◽  
Author(s):  
Julia Wager ◽  
Boris Zernikow
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Education For All ◽  
Special Focus ◽  
Assessment And Treatment ◽  
Specialized Service ◽  
Pain Patients

Pain management in children is a specialized service. Pain aetiology, assessment, and treatment vary at every age from pre-term foetuses at 23 weeks gestation to adolescence. In this chapter of European Pain Management advances in our understanding of pain assessment are reviewed, particularly in the use of developmentally relevant technology. Advances in acute pain, cancer pain, and in chronic pain are also reviewed, with a special focus on innovations in multidisciplinary treatments for chronic pain. There is a need to raise awareness and understanding of the needs of paediatric pain patients, and their family members. Education for all professionals who interact with pain patients is essential, as is the need to invest in specialized pain management services, and professionals, across Europe.

Knowledge and practice regarding neonatal pain management in the opinion of nurses and midwives working in Polish neonatal units

Ból ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 1-9
Author(s):  
Magdalena Panek ◽  
Przemko Kwinta
Keyword(s):  
Pain Assessment ◽  
Pain Treatment ◽  
Assessment Tools ◽  
Basic Knowledge ◽  
Significance Level ◽  
Neonatal Pain ◽  
Frequent Use ◽  
Frequency Of Use ◽  
Assessment And Treatment ◽  
Nurses And Midwives

Nurses and midwives working in neonatal units play a key role in the assessment and treatment of pain. Due to their nature of work, which is based on continuous observation of the patient, they constitute a professional group that responds to changes in the child’s general condition. Thanks to this, the physicians get information about pain intensity or the need of pain treatment, which is relevant among patients who cannot report any symptoms of pain by themselves. The aim of the study was to describe nurses’ and midwives’ basic knowledge about pain and the practice regarding procedural pain assessment and management in Polish neonatal care units. The studies were carried out among 617 nurses and midwives working in neonatal units in Poland. We collected data by using a researcher-developed questionnaire. The significance level was set at p<0.5. 30% of nurses never used non-pharmacological methods of pain relief before painful procedures. Moreover, the higher the level of reference, the more often no non-pharmacological methods were used. Knowledge related to the basic problems associated with pain can be described as insufficient (Me = 4). Frequent use of sedation drugs has also been reported (III level NICU: phenobarbital po / pr: 72.8% of respondents, opioids - 34.9%, II level NICU: phenobarbital po / pr 45.2%, opioids: 4.5%). The longer nurses and midwives worked, the lower the frequency of use of pain assessment tools was (p = 0.0048, R = -0.113). The lack of appropriate pharmacological and nonpharmacological pain treatment and lack of use of pain scales are a significant problem in the care of newborns. Our research indicates the need for education in the field of pain assessment and treatment methods in newborns.

Knowledge and practice regarding neonatal pain management in the opinion of nurses and midwives working in Polish neonatal units

Ból ◽  
2019 ◽  
Vol 19 (4) ◽  
pp. 1-9
Author(s):  
Magdalena Panek ◽  
Przemko Kwinta
Keyword(s):  
Pain Assessment ◽  
Pain Treatment ◽  
Assessment Tools ◽  
Basic Knowledge ◽  
Significance Level ◽  
Neonatal Pain ◽  
Frequent Use ◽  
Frequency Of Use ◽  
Assessment And Treatment ◽  
Nurses And Midwives

Nurses and midwives working in neonatal units play a key role in the assessment and treatment of pain. Due to their nature of work, which is based on continuous observation of the patient, they constitute a professional group that responds to changes in the child’s general condition. Thanks to this, the physicians get information about pain intensity or the need of pain treatment, which is relevant among patients who cannot report any symptoms of pain by themselves. The aim of the study was to describe nurses’ and midwives’ basic knowledge about pain and the practice regarding procedural pain assessment and management in Polish neonatal care units. The studies were carried out among 617 nurses and midwives working in neonatal units in Poland. We collected data by using a researcher-developed questionnaire. The significance level was set at p<0.5. 30% of nurses never used nonpharmacological methods of pain relief before painful procedures. Moreover, the higher the level of reference, the more often no non-pharmacological methods were used. Knowledge related to the basic problems associated with pain can be described as insufficient (Me = 4). Frequent use of sedation drugs has also been reported (III level NICU: phenobarbital per os/per rectum 72.8% of respondents, opioids – 34.9%, II level NICU: phenobarbital per os/ per rectum 45.2%, opioids: 4.5%). The longer nurses and midwives worked, the lower the frequency of use of pain assessment tools was (p = 0.0048, R = -0.113). The lack of appropriate pharmacological and non-pharmacological pain treatment and lack of use of pain scales are a significant problem in the care of newborns. Our research indicates the need for education in the field of pain assessment and treatment methods in newborns.

scholarly journals Pain assessment and management in care homes: understanding the context through a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Pringle ◽  
Ana Sofia Alvarado Vázquez Mellado ◽  
Erna Haraldsdottir ◽  
Fiona Kelly ◽  
Jo Hockley
Keyword(s):  
Cognitive Impairment ◽  
Scoping Review ◽  
Pain Assessment ◽  
Care Home ◽  
Nursing Home Residents ◽  
Assessment Tools ◽  
Care Staff ◽  
Care Homes ◽  
Cochrane Library ◽  
Assessment And Treatment

Abstract Background Internationally, 2–5% of people live in residential or nursing homes, many with multi-morbidities, including severe cognitive impairment. Pain is frequently considered an expected part of old age and morbidity, and may often be either under-reported by care home residents, or go unrecognized by care staff. We conducted a systematic scoping review to explore the complexity of pain recognition, assessment and treatment for residents living in care homes, and to understand the contexts that might influence its management. Methods Scoping review using the methodological framework of Levac and colleagues. Articles were included if they examined pain assessment and/or management, for care or nursing home residents. We searched Medline, CINAHL, ASSIA, PsycINFO, EMBASE, Cochrane Library, and Google Scholar; reference lists were also screened, and website searches carried out of key organisations. Conversations with 16 local care home managers were included to gain an understanding of their perspective. Results Inclusion criteria were met by 109 studies. Three overarching themes were identified: Staff factors and beliefs - in relation to pain assessment and management (e.g. experience, qualifications) and beliefs and perceptions relating to pain. Pain assessment – including use of pain assessment tools and assessment/management for residents with cognitive impairment. Interventions - including efficacy/effects (pharmaceutical/non pharmaceutical), and pain training interventions and their outcomes. Overall findings from the review indicated a lack of training and staff confidence in relation to pain assessment and management. This was particularly the case for residents with dementia. Conclusions Further training and detailed guidelines for the appropriate assessment and treatment of pain are required by care home staff. Professionals external to the care home environment need to be aware of the issues facing care homes staff and residents in order to target their input in the most appropriate way.

Sign in / Sign up

Export Citation Format

Share Document