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Improving Patient Satisfaction through Patient Care Technician Pain Education
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Meeting Abstracts
pain. The purpose of this study was to identify common reasons for acute pain management consultations in an academic university practice. METHOD A retrospective IRB approved analysis of 107 de-identified acute pain consultations between April 2006 and February 2007 was performed. Of these, 100 had complete chart information available for review. A review was performed to identify the reasons for acute pain consultations. RESULTS Of the 100 pain consults performed, 95 were for uncontrolled pain that could not be effectively managed by the primary service. Of these 95 patients, 89.5% had pre-existing pain conditions, 76.8% were taking opioids pre-operatively, of which 79.4% were taking more than 20 milligrams of oxycodone or hydrocodone per day. In addition, 16.8% had recent or distant history of illicit drug or alcohol abuse. CONCLUSION A history of pre-existing pain and/or analgesic use (opioid or non opioid) prior to surgery is likely to result in uncontrolled post-operative pain. Patients who meet these criteria should be identified pre-operatively so that appropriate perioperative interventions can be initiated early, thus avoiding analgesic gaps. Results tables and demographic flowcharts are on the poster. This poster was presented at the American Society of Anesthesiologists Annual Meeting in San Francisco, CA on October 16, 2007. Poster 107:A1758.
Improving Patient Satisfaction through Patient Care Technician Pain Education Jane DeGooyer, RN, BC, MSN Mercy Medical Center, Des Moines, IA Sandra Caligiuri, RN, BC, MS; Joan Beard, RN, BC, MSN Acceptable pain management plays a significant role in patient satisfaction during hospitalization. Unmanaged pain is one of patients’ greatest fears. Ongoing dissatisfaction with this aspect of care has been reflected in the NRCþPickerÓ survey results at Mercy Medical Center, Des Moines, IA. Extensive education is provided to nurses, patients, families, and other members of the healthcare team, however there had not been an education program for the Patient Care Technician (PCT) who provides a considerable amount of hands on care. It was believed that a structured pain management education program for the PCTs would contribute to a more positive patient experience with pain management. The PCT pain education program consisted of a two-hour class that included the following topics: Introduction to project, harmful effects of uncontrolled pain, types of pain, manifestations, interventions, cultural and language aspects in pain management, role of PCT in facilitating pain management, and how to communicate with the nurse regarding patients’ pain. A laminated pocket card listing non-verbal indications of pain was provided to the PCTs.
Pre-test post-test analysis will consist of quarterly NRCþPickerÓ score data. This will consist of a one-tailed ttest for significance of the dependent variables with a level of significance of <.05. Program evaluation by the PCTs and unit nurses was completed following the presentation. Outcome data were pending. This information will direct future PCT pain education at Mercy Medical Center.
Ketamine: It’s Not Just for Sedation Anymore Katharyn Dispenza, MSN, RN, CPNP Childrens Medical Center Dallas, Dallas, TX Lynn Clark, MS, RN-BC, CPNP; Corianna Seelig-Gustafson, BSN, RN Pediatric pain management continues to be an ever evolving field. New medications and new uses of existing medications will continue to improve pain management for all patients. Low dose ketamine infusion provides an additional pain control option when opioids may not provide enough relief. Optimal pain management can be a challenge in pediatric patients who have chronic severe pain. When using opioid analgesics for pain control, analgesia must be balanced with side effects. When sedation or severe pruritus occurs, escalation of opioids is limited. If the patient’s pain remains severe, alternative methods must be implemented in order to optimize pain control.
Assessing Chronic Spine Pain: A Biobehavioral Approach for Patient Tailored Cognitive Behavioral Interventions A State of the Science Deborah Matteliano, RN, MS, ANP, FNP, BC SUNY at Buffalo, Buffalo, NY Considerable controversy exists regarding assessment and treatment of chronic spine pain (CSP), a disorder estimated to be the most costly ailment of working age adults worldwide. An expanded definition of CSP proposes that assessment of all biopsychosocial factors provides accurate predictive value to guide chronic pain treatment approaches. Cognitive behavioral treatment (CBT) is successful when tailored to biopsychosocial pain profiles. Because these factors are modifiable, they are targets for cognitive-behavioral pain management strategies. However, there has been great controversy over which of these factors to include in guiding CBT for CSP. Moreover, primary treatment of CSP does not include CBT, due to lack of easy to administer procedures and assessment tools. This literature review addresses the gap in the current literature by highlighting advancements made in the past 25 years of research regarding CSP assessment factors for profiled treatment, and systematically examines research focusing on the biopsychosocial pain profile of chronic spine pain. The question addressed is ‘‘What is the current State of the Science with regard to the biopsychosocial assessment of chronic spine pain, and what assessment factors are predictive for biopsychosocial profiled cognitive-behavioral treatment for chronic spine pain?’’ Findings reveal only three studies addressed all factors associated with biopsychosocial assessment of CSP. Psychosocial
Pain Management Nursing, Vol 10, No 1 (March), 2009: pp e1-e6
Meeting Abstracts
pain. The purpose of this study was to identify common reasons for acute pain management consultations in an academic university practice. METHOD A retrospective IRB approved analysis of 107 de-identified acute pain consultations between April 2006 and February 2007 was performed. Of these, 100 had complete chart information available for review. A review was performed to identify the reasons for acute pain consultations. RESULTS Of the 100 pain consults performed, 95 were for uncontrolled pain that could not be effectively managed by the primary service. Of these 95 patients, 89.5% had pre-existing pain conditions, 76.8% were taking opioids pre-operatively, of which 79.4% were taking more than 20 milligrams of oxycodone or hydrocodone per day. In addition, 16.8% had recent or distant history of illicit drug or alcohol abuse. CONCLUSION A history of pre-existing pain and/or analgesic use (opioid or non opioid) prior to surgery is likely to result in uncontrolled post-operative pain. Patients who meet these criteria should be identified pre-operatively so that appropriate perioperative interventions can be initiated early, thus avoiding analgesic gaps. Results tables and demographic flowcharts are on the poster. This poster was presented at the American Society of Anesthesiologists Annual Meeting in San Francisco, CA on October 16, 2007. Poster 107:A1758.
Improving Patient Satisfaction through Patient Care Technician Pain Education Jane DeGooyer, RN, BC, MSN Mercy Medical Center, Des Moines, IA Sandra Caligiuri, RN, BC, MS; Joan Beard, RN, BC, MSN Acceptable pain management plays a significant role in patient satisfaction during hospitalization. Unmanaged pain is one of patients’ greatest fears. Ongoing dissatisfaction with this aspect of care has been reflected in the NRCþPickerÓ survey results at Mercy Medical Center, Des Moines, IA. Extensive education is provided to nurses, patients, families, and other members of the healthcare team, however there had not been an education program for the Patient Care Technician (PCT) who provides a considerable amount of hands on care. It was believed that a structured pain management education program for the PCTs would contribute to a more positive patient experience with pain management. The PCT pain education program consisted of a two-hour class that included the following topics: Introduction to project, harmful effects of uncontrolled pain, types of pain, manifestations, interventions, cultural and language aspects in pain management, role of PCT in facilitating pain management, and how to communicate with the nurse regarding patients’ pain. A laminated pocket card listing non-verbal indications of pain was provided to the PCTs.
Pre-test post-test analysis will consist of quarterly NRCþPickerÓ score data. This will consist of a one-tailed ttest for significance of the dependent variables with a level of significance of <.05. Program evaluation by the PCTs and unit nurses was completed following the presentation. Outcome data were pending. This information will direct future PCT pain education at Mercy Medical Center.
Ketamine: It’s Not Just for Sedation Anymore Katharyn Dispenza, MSN, RN, CPNP Childrens Medical Center Dallas, Dallas, TX Lynn Clark, MS, RN-BC, CPNP; Corianna Seelig-Gustafson, BSN, RN Pediatric pain management continues to be an ever evolving field. New medications and new uses of existing medications will continue to improve pain management for all patients. Low dose ketamine infusion provides an additional pain control option when opioids may not provide enough relief. Optimal pain management can be a challenge in pediatric patients who have chronic severe pain. When using opioid analgesics for pain control, analgesia must be balanced with side effects. When sedation or severe pruritus occurs, escalation of opioids is limited. If the patient’s pain remains severe, alternative methods must be implemented in order to optimize pain control.
Assessing Chronic Spine Pain: A Biobehavioral Approach for Patient Tailored Cognitive Behavioral Interventions A State of the Science Deborah Matteliano, RN, MS, ANP, FNP, BC SUNY at Buffalo, Buffalo, NY Considerable controversy exists regarding assessment and treatment of chronic spine pain (CSP), a disorder estimated to be the most costly ailment of working age adults worldwide. An expanded definition of CSP proposes that assessment of all biopsychosocial factors provides accurate predictive value to guide chronic pain treatment approaches. Cognitive behavioral treatment (CBT) is successful when tailored to biopsychosocial pain profiles. Because these factors are modifiable, they are targets for cognitive-behavioral pain management strategies. However, there has been great controversy over which of these factors to include in guiding CBT for CSP. Moreover, primary treatment of CSP does not include CBT, due to lack of easy to administer procedures and assessment tools. This literature review addresses the gap in the current literature by highlighting advancements made in the past 25 years of research regarding CSP assessment factors for profiled treatment, and systematically examines research focusing on the biopsychosocial pain profile of chronic spine pain. The question addressed is ‘‘What is the current State of the Science with regard to the biopsychosocial assessment of chronic spine pain, and what assessment factors are predictive for biopsychosocial profiled cognitive-behavioral treatment for chronic spine pain?’’ Findings reveal only three studies addressed all factors associated with biopsychosocial assessment of CSP. Psychosocial
Pain Management Nursing, Vol 10, No 1 (March), 2009: pp e1-e6