Pain management nursing : official journal of the American Society of Pain Management Nurses
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The purpose of this study was to determine the knowledge base of long-term care nurses regarding pain assessment and management in the elderly. Three specific themes related to long-term care nurses were investigated: personal beliefs regarding patients' self-reports of pain, documentation of patients' self-reports of pain, and choice of pain medication and dose. Eighty-nine long-term care nurses, from 6 rural counties in California, responded to a questionnaire that consisted of 2 patient scenarios. ⋯ Older nurses with more experience were less likely to believe or document their patient's self-report of pain than younger nurses with fewer years of experience. Less than half of the nurses would increase the analgesic dose for either patient scenario. Nursing implications include the importance of ongoing pain assessment and management education tailored to the geriatric population and long-term care.
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Multicenter Study
Nurses' personal opinions about patients' pain and their effect on recorded assessments and titration of opioid doses.
In many clinical settings, nurses have a vital role in pain assessment and titration of opioid doses. Surveys of nurses have revealed knowledge deficits in these areas that are thought to contribute to under-treatment of pain. ⋯ Nurses are less likely to increase a previously safe but ineffective dose of opioid for a smiling patient than a grimacing patient. Survey results reveal a tendency for nurses' personal opinions about the patients' pain, rather than their recorded assessments, to influence choice of opioid dose and to contribute to undertreatment of pain.
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The elderly population is one of the fastest growing groups in the United States. Pain is a significant problem for community-dwelling elders and for elderly persons in residential facilities. ⋯ Effective pain management of elderly individuals requires knowledge of the pharmacokinetic and pharmacodynamic changes that occur with aging. Both pharmacologic and nonpharmacologic approaches should be used to manage pain in the elderly.
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Although much has been done to promote pain assessment and management, pain remains a major, yet largely preventable, public health problem in the United States. A strategy that has been proposed to assure optimal pain management is the development of formal means within institutions to evaluate pain management practices and foster improved outcomes. ⋯ A Pain Management Task Force was charged with the development of a comprehensive pain management program. Its efforts to date and plans for the future position this institution as ready for the Joint Commission for the Accreditation of Healthcare Organizations' pain assessment and management standards that were introduced in 2000.