Pain management nursing : official journal of the American Society of Pain Management Nurses
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Pain management for premature infants raises challenging questions for nurses. This group of infants is often physiologically fragile and they may undergo frequent painful procedures on a daily basis. Contrary to ideas from the past, premature infants are able to feel pain, and nervous system elements required for the transmission of painful stimuli are functional by 24 weeks gestation. ⋯ Recent research shows that oral sucrose is a safe and effective analgesic for short-term procedures. Research studies to determine the most effective doses and modes of oral sucrose administration are ongoing. It is thought that the relief of pain is owing to the sweet taste of the sucrose that activates endogenous pain-modulating systems.
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As hospitals across the country work to improve pain management in the face of ever-shrinking resources, one challenge that must be addressed is the delineation of specialized pain management services. Although pain management is an interdisciplinary process, nurses are in a unique position to provide leadership in both the organization and delivery of clinical services. This article describes the development and 2-year experience of a nurse-run inpatient pain management consultation service in an academic tertiary care hospital. The structure of the service, and nature and volume of consults is discussed along with recommendations for institutions considering this strategy.
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Review Comparative Study
The checklist of nonverbal pain indicators (CNPI).
This article critiques the literature on existing pain assessment instruments for cognitively impaired elders and reports findings of pilot testing of the Checklist of Nonverbal Pain Indicators. This instrument was designed to measure pain behaviors in cognitively impaired elders. Instrument testing was conducted on a population of elderly patients with hip fractures. ⋯ Observed pain behaviors were positively correlated with self-report of pain. No differences between observed pain behaviors in cognitively intact versus cognitively impaired older adults with hip fractures were noted. Limitations of the instrument and recommendations for tool use are discussed.
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The newly approved Joint Commission on Accreditation of Healthcare Organizations (JCAHO) pain management standards present an important opportunity for widespread and sustainable improvement in pain assessment and management. Unrelieved pain is a major, yet avoidable, public health problem. Despite 20 years of work by educators, clinicians, and professional organizations and the publication of clinical practice guidelines, there have been, at best, modest improvements in pain management practices. ⋯ The revisions are published in the 2000-2001 standards manuals and will be effective January 1, 2001, for all patient care organizations accredited by JCAHO--ambulatory care, behavioral health, health care networks, home care, hospitals, long-term care, and long-term care pharmacies. An evaluation of the impact of the revisions is currently being completed, and education of the JCAHO surveyors and health care professionals is underway. Nurses, especially those with expertise in pain management, are valuable resources as health care organizations change their pain assessment and management processes to meet the new standards.