- Email: [email protected]
NICHE solutions – Twelfth in a series: Focus on pain and palliative care
Geriatric Nursing 36 (2015) 81e82
Contents lists available at ScienceDirect
Geriatric Nursing journal homepage: www.gnjournal.com
NICHE Section
NICHE solutions e Twelfth in a series: Focus on pain and palliative care Barbara Bricoli, MPA
This twelfth entry in the NICHE Solutions series details success stories from NICHE hospitals involving pain and palliative care related to the treatment of older adult patients. These initiatives outline the successful application of best practice solutions that correlate with NICHE Clinical Improvement Models and other NICHE resources. Developed in collaboration with NICHE designated hospitals, the series covers a wide range of clinical and organizational topics. In addition to the pain and palliative care stories, the Solutions library contains these other geriatric specific categories: Acute Care, Catheters, Communication, Critical Care, Environment, Delirium, Dementia, Emergency Department, Function and Falls, Geriatric Practice, Geriatric Patient Care Associate, Geriatric Resource Nurse, Medication, Nutrition/Elimination, Orthopedics, Respiratory, Skin, Stroke, Transitions and Communications. New Solutions stories and categories offer additional improvement strategies to NICHE hospitals and other health care organizations.
Pain and palliative care From Evidence-Based Geriatric Nursing Protocols For Best Practice (4th ed.), edited by Boltz M, Capezuti E, Fulmer T & Zwicker D (eds.). New York: Springer Publishing. Pain has major implications for older adults’ health, functioning, and quality of life.1 Pain is associated with depression, social withdrawal, sleep disturbances, impaired mobility, decreased activity engagement, and increased health care use.2 Other geriatric conditions that can be exacerbated by pain include falls, cognitive decline, deconditioning, malnutrition, gate disturbances, and slowed rehabilitation.2 In the hospital setting, older adults suffering from acute pain have been reported to be at increased risk for thromboembolism, hospital-acquired pneumonia, and functional decline.1
E-mail address: [email protected]. 0197-4572/$ e see front matter Ó 2015 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.gerinurse.2014.12.007
Solution No. 15 Title: Educational Interventions to Increase Medication Knowledge and Safety in the Hospitalized Older Adult. Authors: Arlene Stoller, BSN, RN, and Susan Bellofatto, BSN, RN, Lahey Clinic, Burlington, Massachusetts. PROBLEM: Medication management related to pain, delirium, and constipation is a significant and common challenge in caring for the hospitalized older adult. SOLUTION: Increase nursing knowledge specific to delirium, uncontrolled pain, and constipation in the older adult hospital patient.
Solution No. 26 Title: Use of the Pasero Opioid-Induced Sedation Scale to Reduce Oversedation and Respiratory Depression. Author: Susan J. Dempsey, RN-BC, MN, CNS, Critical Care Clinical Nurse Specialist, Sharp Grossmont Hospital, La Mesa, California. PROBLEM: Older adults receiving opioids are at greater risk for developing unintended opioid-induced sedation that may progress to respiratory depression. SOLUTION: Provide nurses with an appropriate scale for monitoring of opioid-induced sedation. The goal is to facilitate early recognition and intervention to prevent serious adverse events related to unintended advancing sedation and opioid-induced respiratory depression.
Solution No. 32 Title: Impact of Palliative Education on ICU Nurses’ Moral Distress. Authors: Catherina Madani, RN, MSN; Cassia Chevillon, RN, MSN; Mary Hellyar RN, MSN; and Jane Georges, RN, PhD; UCSan Diego, Thornton ICU, San Diego, California. PROBLEM: Lack of emotional preparedness training nurses need to care for critical care patients over an extended period of time or at the end of life.
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NICHE Section / Geriatric Nursing 36 (2015) 81e82
SOLUTION: Initiative to educate nurses about the need and benefit of palliative care in an ICU setting.
SOLUTION: Develop a comprehensive, proactive approach to pain management.
Solution No. 35
References
A Multidisciplinary Effort to Improve Patient Care and Satisfaction with Pain Management. Authors: Megan Begnoche, MSN, RN, CNS, AOCN, and Martha Watson, MS, RN-BC, GCNS-BC, The Miriam Hospital, Providence, Rhode Island. PROBLEM: Quality indicator used to measure patient perception of effective pain management was below target.
1. Wells N, Pasero C, McCaffery M. Improving the quality of care through pain assessment and management. 2011/02/18. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-based Handbook for Nurses (Prepared with support from the Robert Wood Johnson Foundation). AHRQ Publication No. 08e0043. Rockville, MD: Agency for Healthcare Research and Quality; 2008. 2. AGS. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. Aug 2009;57(8):1331e1346.
Contents lists available at ScienceDirect
Geriatric Nursing journal homepage: www.gnjournal.com
NICHE Section
NICHE solutions e Twelfth in a series: Focus on pain and palliative care Barbara Bricoli, MPA
This twelfth entry in the NICHE Solutions series details success stories from NICHE hospitals involving pain and palliative care related to the treatment of older adult patients. These initiatives outline the successful application of best practice solutions that correlate with NICHE Clinical Improvement Models and other NICHE resources. Developed in collaboration with NICHE designated hospitals, the series covers a wide range of clinical and organizational topics. In addition to the pain and palliative care stories, the Solutions library contains these other geriatric specific categories: Acute Care, Catheters, Communication, Critical Care, Environment, Delirium, Dementia, Emergency Department, Function and Falls, Geriatric Practice, Geriatric Patient Care Associate, Geriatric Resource Nurse, Medication, Nutrition/Elimination, Orthopedics, Respiratory, Skin, Stroke, Transitions and Communications. New Solutions stories and categories offer additional improvement strategies to NICHE hospitals and other health care organizations.
Pain and palliative care From Evidence-Based Geriatric Nursing Protocols For Best Practice (4th ed.), edited by Boltz M, Capezuti E, Fulmer T & Zwicker D (eds.). New York: Springer Publishing. Pain has major implications for older adults’ health, functioning, and quality of life.1 Pain is associated with depression, social withdrawal, sleep disturbances, impaired mobility, decreased activity engagement, and increased health care use.2 Other geriatric conditions that can be exacerbated by pain include falls, cognitive decline, deconditioning, malnutrition, gate disturbances, and slowed rehabilitation.2 In the hospital setting, older adults suffering from acute pain have been reported to be at increased risk for thromboembolism, hospital-acquired pneumonia, and functional decline.1
E-mail address: [email protected]. 0197-4572/$ e see front matter Ó 2015 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.gerinurse.2014.12.007
Solution No. 15 Title: Educational Interventions to Increase Medication Knowledge and Safety in the Hospitalized Older Adult. Authors: Arlene Stoller, BSN, RN, and Susan Bellofatto, BSN, RN, Lahey Clinic, Burlington, Massachusetts. PROBLEM: Medication management related to pain, delirium, and constipation is a significant and common challenge in caring for the hospitalized older adult. SOLUTION: Increase nursing knowledge specific to delirium, uncontrolled pain, and constipation in the older adult hospital patient.
Solution No. 26 Title: Use of the Pasero Opioid-Induced Sedation Scale to Reduce Oversedation and Respiratory Depression. Author: Susan J. Dempsey, RN-BC, MN, CNS, Critical Care Clinical Nurse Specialist, Sharp Grossmont Hospital, La Mesa, California. PROBLEM: Older adults receiving opioids are at greater risk for developing unintended opioid-induced sedation that may progress to respiratory depression. SOLUTION: Provide nurses with an appropriate scale for monitoring of opioid-induced sedation. The goal is to facilitate early recognition and intervention to prevent serious adverse events related to unintended advancing sedation and opioid-induced respiratory depression.
Solution No. 32 Title: Impact of Palliative Education on ICU Nurses’ Moral Distress. Authors: Catherina Madani, RN, MSN; Cassia Chevillon, RN, MSN; Mary Hellyar RN, MSN; and Jane Georges, RN, PhD; UCSan Diego, Thornton ICU, San Diego, California. PROBLEM: Lack of emotional preparedness training nurses need to care for critical care patients over an extended period of time or at the end of life.
82
NICHE Section / Geriatric Nursing 36 (2015) 81e82
SOLUTION: Initiative to educate nurses about the need and benefit of palliative care in an ICU setting.
SOLUTION: Develop a comprehensive, proactive approach to pain management.
Solution No. 35
References
A Multidisciplinary Effort to Improve Patient Care and Satisfaction with Pain Management. Authors: Megan Begnoche, MSN, RN, CNS, AOCN, and Martha Watson, MS, RN-BC, GCNS-BC, The Miriam Hospital, Providence, Rhode Island. PROBLEM: Quality indicator used to measure patient perception of effective pain management was below target.
1. Wells N, Pasero C, McCaffery M. Improving the quality of care through pain assessment and management. 2011/02/18. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-based Handbook for Nurses (Prepared with support from the Robert Wood Johnson Foundation). AHRQ Publication No. 08e0043. Rockville, MD: Agency for Healthcare Research and Quality; 2008. 2. AGS. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. Aug 2009;57(8):1331e1346.