Pain management nursing : official journal of the American Society of Pain Management Nurses
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CAPA is a multifaceted pain assessment tool that was adopted at a large tertiary Midwest hospital to replace the numeric scale for adult patients who could self-report their pain experience. This article describes the process of implementation and the effect on patient satisfaction scores. ⋯ Patient reports that "staff did everything to manage pain" had the biggest gains and were sustained for more than 2 years. The CAPA tool meets regulatory requirements for pain assessment.
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An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. ⋯ The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed.
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This paper examined hospital characteristics, staffing, and nursing care factors associated with patient perception of poor pain control by conducting a secondary analysis of the Hospital Consumer Assessment of Health Care Providers Systems (HCAHPS) survey in California, Massachusetts, and New York hospitals. Analysis of variance was used to analyze the relationship between nurse, hospitalist, physician, and resident staffing and patients' perception of pain control. Twenty-one factors correlated with patients' reports of pain control were included in the stepwise linear regression analysis. ⋯ Nurse staffing and nurse-patient communication are highly predictive of patients' perception of pain management. In teaching hospitals, with rotating intern/resident assignments, patients reported less satisfaction with pain management. This study provides new evidence for the importance of continuity of care in controlling the pain of hospitalized patients.
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Randomized Controlled Trial
Management of Sickle Cell Pain Using Pregabalin: A Pilot Study.
Sickle cell disease (SCD) pain may have a neuropathic component. Adjuvant drugs used to treat neuropathic pain have not been studied for the treatment of adults with SCD. To determine the safety and feasibility of using pregabalin for chronic SCD pain. ⋯ Mean quality-of-life scores increased slightly over time (representing better quality of life) in 7 of 8 domains for the pregabalin group and decreased in 4 of 8 domains for the placebo control group. Small sample size made it difficult to interpret quality-of-life findings. This pilot study provided sufficient evidence that further investigation of pregabalin's potential efficacy for treatment of chronic SCD pain in adults is warranted.
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Heart failure (HF) is a costly and growing health problem that is routinely complicated by chronic pain and depression. The purpose of this paper is to describe the characteristics of pain and pain management in depressed HF patients. In this descriptive cross-sectional study, we analyzed data from 62 participants with depression and class II-IV HF. ⋯ Women were more likely to have higher levels of pain intensity and more pain interference than men, suggesting that additional screening for the impact of pain is especially important in women. The wide variety of body areas affected, along with moderate to high intensity pain and considerable interference scores reported, indicate that pain was ineffectively treated. Nonpharmacologic treatments should be considered to decrease the impact of pain.