Pain management nursing : official journal of the American Society of Pain Management Nurses
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The American Society for Pain Management Nursing (ASPMN) has updated its 2007 position statement on the use of authorized agent controlled analgesia (AACA) for patients who are unable to independently utilize patient-controlled analgesia (PCA). ASPMN continues to support the use of AACA to provide timely and effective pain management while promoting equitable care for vulnerable patient populations who are unable to utilize PCA. ⋯ This position statement includes an updated review of the evidence related to AACA and a call for further research. Clinical practice recommendations for authorized agents, nurses, prescribers, and organizations are provided with an emphasis on the importance of appropriate authorized agent selection, education, diligent patient assessment and medication management.
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Case Reports
A transdisciplinary team approach to pain management in inpatient health care settings.
This paper will discuss the transition from multidisciplinary to interdisciplinary and transdisciplinary team approaches to pain management at New York University Langone Medical Center - Rusk Institute of Rehabilitation Medicine. A transdisciplinary team approach to pain management emphasizes mutual learning, training, and education, and the flexible exchange of discipline-specific roles. ⋯ Topics of exploration include the descriptions of three team approaches to patient care, including their practical, philosophical, and historical basis, strengths and challenges, research support, and cultural diversity. Case vignettes will highlight the strengths and limitations of the transdisciplinary team approach to pain management throughout a broad and diverse continuum of care, including acute medical, palliative, and perioperative care and acute inpatient rehabilitation services.
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Pain has been promoted as the fifth vital sign for a decade, but there is little empirical evidence to suggest that doing so has affected the care of individuals suffering pain. This was a three-stage audit of pain assessment in one large teaching hospital in the Northwest of England. Stage one measured the baseline pain assessment activity on surgical and medical wards and identified that the pain assessment tool was not visible to nurses. ⋯ Stage three identified that where a high pain score was recorded, analgesia was delivered in the majority of cases (88%). Introducing the philosophy of pain as the fifth vital sign and making pain assessment more visible on the patient observation chart improved the uptake of pain assessment. Pain management strategies were stimulated when high pain scores were identified.
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Meditation is gaining popularity as an effective means of managing and attenuating pain and has been particularly effective for migraines. Meditation additionally addresses the negative emotional states known to exist with migraines. The purpose of this study was to evaluate the effectiveness of meditation as an immediate intervention for reducing migraine pain as well as alleviating emotional tension, examined herein as a negative affect hypothesized to be correlated with pain. ⋯ The data suggest that a single exposure to a brief meditative technique can significantly reduce pain and tension, as well as offer several clinical implications. It can be concluded that single exposure to a meditative technique can significantly reduce pain and tension. The effectiveness and immediacy of this intervention offers several implications for nurses.