Pain management nursing : official journal of the American Society of Pain Management Nurses
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The purpose of this paper was to assess undergraduate nursing students' pain knowledge after participation in a simulation scenario. The Knowledge and Attitudes of Survey Regarding Pain (KASRP) was used to assess pain knowledge. In addition, reflective questions related to the simulation were examined. ⋯ The students' overall KASRP score post simulation was slightly better than previous studies of nursing students. These results suggest that educators should consider simulations to educate about pain assessment and patient/family education. Future pain simulations should include more opportunities for students to choose appropriate pain medications when provided PRN orders.
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The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. ⋯ A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p < .05). This controlled pilot study indicates benefits of TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery.
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Observational Study
Parental Analgesic Knowledge and Decision Making for Children With and Without Obstructive Sleep Apnea After Tonsillectomy and Adenoidectomy.
Tonsillectomy is a common and painful procedure often indicated for children with obstructive sleep apnea (OSA) who are at risk for opioid-related toxicity. Whether parents whose children have OSA understand the risks of opioids is unknown. The purpose of this study was to examine whether parents whose children have OSA have greater opioid risk understanding and would be less likely to give an opioid to a child exhibiting oversedation compared to parents whose children do not have OSA. ⋯ Similar amounts of opioids were given at home. OSA did not predict parents' opioid decisions; however, around-the-clock instruction predicted greater opioid use at home. Parents whose children had OSA had a similar understanding of opioid-related oversedation compared to other parents, and half would give a prescribed opioid when signs of oversedation were present, suggesting a need for improved understanding and recognition of this sign of toxicity, and of what to do should this symptom present.
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In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. ⋯ A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice.