Background: Acute care healthcare professionals continue to see an increase in the proportion of aging, high acuity patients resulting in on-going challenges in providing person-centred, evidence-based care to patients with delirium, dementia and behavioral issues. This study evaluates the impact of a 16-hour, three-workshop program on direct care staffs' capacity, confidence, and competence in caring for patients with behavioral issues related to delirium and dementia. Methods: A quantitative, prospective study was designed. Workshops utilized various teaching and learning modalities to foster knowledge acquisition and skill enhancement. Participants consisted of direct care staff with a background in geriatric care. Results: A total of 75 participants completed the workshops. Paired t-tests were conducted for survey question scores at the alpha level of 0.05. Ninety-five percent confidence intervals were assessed in addition to p-values for significance. No results were statistically significant. Conclusions: Positive clinical significance included improved participant knowledge in dementia pathophysiology; increased awareness of the impact of care strategies on patients and families through the use of case-based application and standardized patients; and a greater integration of the concept of personhood into patient care planning.
Acute pain is a common presenting complaint in the emergency department (ED) and is most often treated with opioid or nonopioid analgesia. However, studies have shown that receiving analgesia alone does not always influence patient satisfaction with pain management in the ED. Pain anxiety and catastrophizing have been shown to affect pain intensity and patients' response to analgesia. The objective of this study was to determine whether a brief therapeutic conversation would improve patient satisfaction with pain management compared with standard care for adult patients presenting to the ED with moderate to severe acute pain. Adult (18 years or older) patients presenting to the ED with moderate to severe acute pain were randomized to either the standard care group or the intervention group. Patients in the intervention group participated in a brief therapeutic conversation with an ED nurse to discuss their perceived cause of pain, level of anxiety, and expectations of their pain management. Prior to discharge, all patients were asked to complete a self-reported, 9-item questionnaire to assess their level of satisfaction with their overall ED experience. A total of 166 patients (83 in each group) were enrolled. Patient satisfaction with ED pain management and the proportion of patients who received analgesia in the ED were similar in both the control (n = 57; 68.7%) and intervention (n = 58; 69.9%) groups (Δ 1.2%; 95% CI [12.6, 15]). Qualitative findings demonstrate that patients place high importance on acknowledgment from ED staff and worry about the unknown cause of pain. This study suggests that patient satisfaction with pain management in the ED is multifactorial and complex. Further research should investigate additional methods of integrating nurse-led interventions into the care of patients in acute pain.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.