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A multidisciplinary team approach; Impact on postoperative pain management
15th NATIONAL
ASPAN
CONFERENCE
ABSTRACTS
A MULTlDISClPLlNARY TEAM APPROACH; IMPACT ON POSTOPERATIVE PAIN MANAGEMENT. DONNA DICKINSON, RN, MSN, CLINICAL NURSE EDUCATOR, CARONDELET ST. JOSEPH’S HOSPITAL, TUCSON, ARIZONA A multidisciplinary team CQI approach to the identification of specific organizational obstacles to optimal pain management and of opportunities for improvement is described Membership, goals, and strategies for organizational improvement are discussed in detail. Outcomes of an intervention plan are presented in relation to the following: appropriate choice of drug and treatment modality, patient pain scores, documentation, delays in treatment, patient satrsfactlon and adverse drug reactions.
18
HIV: ETHICS AND THE LAW. Pam Reid Duffy, RN, PhD, Associate Professor of Family and Community Medicine, The University of Arizona College of Medicine, Tucson Arizona Caring for persons infected with Human Immunodeticiency Virus (HIV) may involve not only multiple clinical management dilemmas, but may necessitate wrestling with complex social and ethical issues as well. Several elements contribute to the complexities of ethical decision-making in HIV care: biomedical “progress”, the uniquely social often predominant over biomedical - nature of the HIV threat, and historical changes in the provider-patient relationship. The nurse-provider may need to review the differences between legal and ethical dilemmas as well as the distinctions among ethics, virtue, and morality. As principled decision-making is an expectation of our profession, the bioethical principles of autonomy, nonmaleficence, beneficence, justice, and veracity merit our careful consideration. HIV/AIDS care vignettes offer special opportunities to examine ethical principles, as well as the time to discuss them (which is often lacking in clinical situations). A process model for use in managing ethical dilemmas in HIV/AIDS care is offered to help anticipate principled decision-making, including that required when two different courses of action - each representing ethics held equally and simultaneously - are in conflict.
ACCEEWNG THE HEALTH SCIENCES LITERATURE -FINDING THE INFORMATION YOU NEED vu THE INTERNET, BIOMEDICAL & NIJRSING DATABASES, & YOUR LOCAL LIBRARY Jacqueline D. Doyle, MS, AHIP
and Lenore K. Schnaitman, MLS, AHIP, Samaritan Health System, Phoenix, Arizona.
Today’s health professionals are bombarded with massive quantities of information from many sources, yet they freauentlv must locate suecfic information for informed patiknt c&e decisions. hiformation retrieval and management skills are essential for nurses and other health professionals needing to search the nursing, medical, and health administration literature effectively. Methods that improve the effectiveness of these skills include focusing the research question; breaking it into components; identifying appropriate resources in bibliographic databasesor the Internet; and assessingretrieval quality. These refinements to the process enable health professionals to locate current data and pertinent knowledge-based information for quality patient care and management decisions. Whether embarking on a research project, problem solving in clinical practice, or writing protocols, nurses benefit from the ability to fmd and retrieve relevant information. Electronic resources available include bibliographic databasessuch as MEDLARS, CINAHL, and Healthline, full-text databases such as PDQ, plus a myriad of information sources available via the Internet/World Wide Web. More traditional accessmethods are still valuable in some situations, but electronic resources are convenient, fast, and may elicit improved retrieval. Having the information management skills to determiue which resources tn use; how to accessthem; and what the implications are for cost, availability, and quality will be invaluable for nurses and other health professionals.
CARING FOR PATIENTS FROM DIFFERENT CULTURES. Geri-Ann Galanti, Ph.D. Division Nursing, California State University, Dominguez Hills.
of
American hospitals are increasingly reflecting the growing cultural diversity of the nation. This is true not only of the patient population, but that of the staff as well. This often results in confusion and misunderstanding, as well as sometimes less than optimal patient care. The emphasis was on identifying common cultural patterns, understanding the basis for cultural differences in behavior, and finding ways to avoid potential problems. Many case examples were presented. A prevalent source of misunderstanding is communication, both verbal (e.g., when “yes” means “no”) and nonverbal (gestures and eye contact). Cultures encourage different responses to pain and attitudes toward pain medication; unfamiliarity with cultural patterns can negatively affect patients. Other topics covered include visitors, female modesty, folk medicine, and the impact of sex roles on behavior. Reference: Galanti, Geri-Ann 1991 Caring Different Hospitals. Philadelphia: Pennsylvania Press.
for Patients University
from of
ASPAN
CONFERENCE
ABSTRACTS
A MULTlDISClPLlNARY TEAM APPROACH; IMPACT ON POSTOPERATIVE PAIN MANAGEMENT. DONNA DICKINSON, RN, MSN, CLINICAL NURSE EDUCATOR, CARONDELET ST. JOSEPH’S HOSPITAL, TUCSON, ARIZONA A multidisciplinary team CQI approach to the identification of specific organizational obstacles to optimal pain management and of opportunities for improvement is described Membership, goals, and strategies for organizational improvement are discussed in detail. Outcomes of an intervention plan are presented in relation to the following: appropriate choice of drug and treatment modality, patient pain scores, documentation, delays in treatment, patient satrsfactlon and adverse drug reactions.
18
HIV: ETHICS AND THE LAW. Pam Reid Duffy, RN, PhD, Associate Professor of Family and Community Medicine, The University of Arizona College of Medicine, Tucson Arizona Caring for persons infected with Human Immunodeticiency Virus (HIV) may involve not only multiple clinical management dilemmas, but may necessitate wrestling with complex social and ethical issues as well. Several elements contribute to the complexities of ethical decision-making in HIV care: biomedical “progress”, the uniquely social often predominant over biomedical - nature of the HIV threat, and historical changes in the provider-patient relationship. The nurse-provider may need to review the differences between legal and ethical dilemmas as well as the distinctions among ethics, virtue, and morality. As principled decision-making is an expectation of our profession, the bioethical principles of autonomy, nonmaleficence, beneficence, justice, and veracity merit our careful consideration. HIV/AIDS care vignettes offer special opportunities to examine ethical principles, as well as the time to discuss them (which is often lacking in clinical situations). A process model for use in managing ethical dilemmas in HIV/AIDS care is offered to help anticipate principled decision-making, including that required when two different courses of action - each representing ethics held equally and simultaneously - are in conflict.
ACCEEWNG THE HEALTH SCIENCES LITERATURE -FINDING THE INFORMATION YOU NEED vu THE INTERNET, BIOMEDICAL & NIJRSING DATABASES, & YOUR LOCAL LIBRARY Jacqueline D. Doyle, MS, AHIP
and Lenore K. Schnaitman, MLS, AHIP, Samaritan Health System, Phoenix, Arizona.
Today’s health professionals are bombarded with massive quantities of information from many sources, yet they freauentlv must locate suecfic information for informed patiknt c&e decisions. hiformation retrieval and management skills are essential for nurses and other health professionals needing to search the nursing, medical, and health administration literature effectively. Methods that improve the effectiveness of these skills include focusing the research question; breaking it into components; identifying appropriate resources in bibliographic databasesor the Internet; and assessingretrieval quality. These refinements to the process enable health professionals to locate current data and pertinent knowledge-based information for quality patient care and management decisions. Whether embarking on a research project, problem solving in clinical practice, or writing protocols, nurses benefit from the ability to fmd and retrieve relevant information. Electronic resources available include bibliographic databasessuch as MEDLARS, CINAHL, and Healthline, full-text databases such as PDQ, plus a myriad of information sources available via the Internet/World Wide Web. More traditional accessmethods are still valuable in some situations, but electronic resources are convenient, fast, and may elicit improved retrieval. Having the information management skills to determiue which resources tn use; how to accessthem; and what the implications are for cost, availability, and quality will be invaluable for nurses and other health professionals.
CARING FOR PATIENTS FROM DIFFERENT CULTURES. Geri-Ann Galanti, Ph.D. Division Nursing, California State University, Dominguez Hills.
of
American hospitals are increasingly reflecting the growing cultural diversity of the nation. This is true not only of the patient population, but that of the staff as well. This often results in confusion and misunderstanding, as well as sometimes less than optimal patient care. The emphasis was on identifying common cultural patterns, understanding the basis for cultural differences in behavior, and finding ways to avoid potential problems. Many case examples were presented. A prevalent source of misunderstanding is communication, both verbal (e.g., when “yes” means “no”) and nonverbal (gestures and eye contact). Cultures encourage different responses to pain and attitudes toward pain medication; unfamiliarity with cultural patterns can negatively affect patients. Other topics covered include visitors, female modesty, folk medicine, and the impact of sex roles on behavior. Reference: Galanti, Geri-Ann 1991 Caring Different Hospitals. Philadelphia: Pennsylvania Press.
for Patients University
from of