Medical inpatients were exposed to light levels insufficient for circadian entrainment. Nevertheless, higher light exposure was associated with less fatigue and lower total mood disturbance in participants with pain, suggesting the need for further investigation to determine if manipulating light exposure for medical inpatients would be beneficial in affecting sleep-wake disturbances, mood and pain.

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Background and purpose Hospital‐acquired pressure injuries (HAPIs) continue to be a persistent problem in the acute care arena. The purpose of this retrospective quality improvement study was to examine if the introduction of nurse practitioners (NPs), as wound care consultants (WCCs), without other interventions, impacted the HAPI rates in a community hospital. Methods A retrospective, comparison design was used; 48 months of HAPI data (May 2010–2014) reported on the monthly National Database for Nursing Quality Indicators (NDNQI) survey was abstracted from hospital records. Data included the assessment of 10,752 patients and were divided into two groups for comparison: 24 months before and 24 months after NP hiring. Conclusions There was a strong, inverse correlation between the presence of NPs and number of patients with HAPIs (r = −0.73, p < .01), indicating that HAPI rates were significantly lower after NPs took on the role of WCCs. The odds of a HAPI occurring following introduction of the NP WCCs were 20% of the odds in the previous years. Implications for practice Study findings suggest that NPs assuming a leadership role as WCCs may be instrumental in decreasing HAPI rates.

Pain is personal, subjective, and best treated when the patient's experience is fully understood. Hospitalization contributes to the physical and psychological complications of acute and chronic pain experienced by patients with inflammatory bowel disease (IBD). The purpose of this qualitative phenomenological study was to develop an understanding of the unique experience of pain in hospitalized patients with an admitting diagnosis of IBD and related care or surgery. Following institutional review board approval, purposeful sampling was used to recruit 16 patients (11 female, 5 male, mean age 41.8 years) from two 36-bed colorectal units of a large academic medical center in the Midwest. Individual, audio-recorded interviews were conducted by a researcher at each participant's bedside. Recordings and transcripts were systematically reviewed by the research team using Van Manen's approach to qualitative analysis. Subsequently, 5 major themes were identified among the data: feeling discredited and misunderstood, desire to dispel the stigma, frustration with constant pain, need for caregiver knowledge and understanding, and nurse as connector between patient and physician. Hospitalized patients with IBD have common issues with pain care. Nurses caring for them can provide better pain management when they understand these issues/themes. Further research into the themes discovered here is recommended.

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Based on the findings, a rudimentary understanding of rest emerged. Further research is necessary to develop an operational, evidence-based, definition of rest so it can be effectively studied and prescribed.

Bedside nurses care for patients with pain every day but the task is often challenging. A previous qualitative study that investigated nurses' experiences as they treated patients with pain suggested that nurses may suffer from moral distress if they are unsuccessful in providing adequate pain relief. As 20 of the original 48 nurses interviewed described frustration and distress when constrained from doing the right thing to provide pain relief for their patients, the purpose of this secondary qualitative analysis was to answer new research questions on nurse moral distress related to managing pain. Findings indicated that difficulties in nurse/physician communication and lack of pain education were contributors to nurses' frustrations and provided barriers to optimal pain management. Many participants indicated a need for interprofessional pain management education. Further investigation is needed to clarify the impact of moral distress on nurses managing hospitalized patients' pain.

All nurses care for patients with pain, and pain management knowledge and attitude surveys for nurses have been around since 1987. However, no validated knowledge test exists to measure postlicensure clinicians' knowledge of the core competencies of pain management in current complex patient populations. To develop and test the psychometric properties of an instrument designed to measure pain management knowledge of postlicensure nurses. Psychometric instrument validation. Four large Midwestern U.S. hospitals. Registered nurses employed full time and part time August 2015 to April 2016, aged M = 43.25 years; time as RN, M = 16.13 years. Prospective survey design using e-mail to invite nurses to take an electronic multiple choice pain knowledge test. Content validity of initial 36-item test "very good" (95.1% agreement). Completed tests that met analysis criteria, N = 747. Mean initial test score, 69.4% correct (range 27.8-97.2). After revision/removal of 13 unacceptable questions, mean test score was 50.4% correct (range 8.7-82.6). Initial test item percent difficulty range was 15.2%-98.1%; discrimination values range, 0.03-0.50; final test item percent difficulty range, 17.6%-91.1%, discrimination values range, -0.04 to 1.04. Split-half reliability final test was 0.66. A high decision consistency reliability was identified, with test cut-score of 75%. The final 23-item Clinical Pain Knowledge Test has acceptable discrimination, difficulty, decision consistency, reliability, and validity in the general clinical inpatient nurse population. This instrument will be useful in assessing pain management knowledge of clinical nurses to determine gaps in education, evaluate knowledge after pain management education, and measure research outcomes.