Testing an Educational Nursing Intervention for Pain Assessment and Management in Older People

Manias, Elizabeth; Gibson, Stephen; Finch, Sue

doi:10.1111/j.1526-4637.2011.01181.x

Cited by 31 publications

(49 citation statements)

References 41 publications

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“…The only pain assessment tools nurses described were the 0–10 Numeric Pain Intensity Scale and Faces Pain Scale (Manias, Gibson, & Finch, 2011). No mention was made by nurses in this study of other validated non-verbal pain tools for advanced dementia such as the Pain Assessment in Advanced Dementia (PAINAD) Scale, Non-Communicative Patient’s Pain Assessment Instrument (NOPPAIN), or the Pain Assessment Checklist for Seniors with Limited Ability to Communicative (PACSLAC) (Herr, et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Understanding Nurses’ Decisions to Treat Pain in Nursing Home Residents with Dementia

Gilmore‐Bykovskyi

Bowers²

2013

Research in Gerontological Nursing

101

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Nursing home (NH) residents with dementia continue to receive inadequate pain treatment. The purpose of this qualitative study was to examine how nurses make decisions to pharmacologically treat pain in NH residents with dementia. Using Grounded Dimensional Analysis, 15 in-depth interviews were conducted with 13 nurses from 4 Skilled Nursing Facilities in Wisconsin. Nurses experienced varying levels of certainty regarding suspected pain in response to certain resident characteristics and whether pain was perceived as visible/obvious or non-visible/not obvious. Nurses felt highly uncertain about pain in residents with dementia. Suspected pain in residents with dementia was nearly always conceptualized as a change in behavior which nurses responded to by trialing multiple interventions in attempts to return the resident to baseline, which despite current recommendations, did not include pain relief trials. Residents with dementia were described as being at greatest risk for experiencing underassessment, undertreatment and delayed treatment for pain.

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Section: Discussionmentioning

confidence: 99%

Understanding Nurses’ Decisions to Treat Pain in Nursing Home Residents with Dementia

Gilmore‐Bykovskyi

Bowers²

2013

Research in Gerontological Nursing

101

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“…Fifteen interventions involved surgical inpatients, 3 were implemented in the intensive care unit, 7 were conducted in the ED, 5 involved geriatric inpatients (≥65 years), and the remaining 7 studies were conducted in all inpatients, and those receiving patient‐controlled analgesia (PCA) or transdermal fentanyl …”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐one studies examined the effect of interventions to improve prescribing or clinical outcomes related to opioid use. Interventions used to improve appropriate opioid use for analgesia included 16 articles which employed a multifaceted intervention to educate health providers (such as prescribers, nurses, pharmacists) and patients to change opioid use, 5 studies using decision‐making tools to guide opioid prescribing and 10 that targeted pain monitoring and response to analgesic treatment . Predominant prescribing outcomes included the quantity of opioids prescribed and compliance to published guidelines, while clinical outcomes included pain intensity, opioid‐related ADEs and patient satisfaction with adequate pain control.…”

Section: Resultsmentioning

confidence: 99%

“…These studies reported significantly increased use of morphine by 12.7% ( P < .05) and tramadol by 12.0% ( P < .05), as well as reduced pain intensity; however, no changes in opioid‐related ADEs or LOS were shown. In contrast, 4 studies used pain scales to assess pain severity and provide treatment using multimodal strategies including nonpharmacological and nonopioid methods . The use of opioid analgesics varied in these studies, however, significantly increased use of nonpharmacological pain management (60.0 vs 96.0%; P < 0.05) and nonopioid analgesia (38.8 vs 66.2%; P < 0.05) were reported .…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of interventions on the appropriate use of opioids for noncancer pain among hospital inpatients: A systematic review

Liu

Gnjidic

Nguyen

et al. 2020

Brit J Clinical Pharma

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Aims To summarise the effectiveness of interventions on appropriate opioid use for noncancer pain among hospital inpatients. Methods Two reviewers independently searched 6 databases up to March 2018 original research articles reporting on quantitative outcomes of interventions on appropriate opioid use among hospital inpatients. Appropriate opioid use was measured by changes in prescribing, such as the lowest effective opioid dose and duration, or clinical outcomes such as adequate pain control. Quality and intervention complexity assessments were performed by 2 independent reviewers. The full methodological approach was published on PROSPERO (ID: CRD42019145947). Results Of 398 full‐text articles assessed for eligibility, 37 articles were included in the review. Most articles had a moderate or high risk of bias (27 of 37 studies). Thirty‐one articles primarily addressed appropriate opioid use and 6 articles targeted opioid safety as a secondary outcome. A multifaceted approach was the most common primary intervention (16 studies) and adequate pain control was the main outcome measured (14 studies). Health provider education, reinforced by hard‐copy material and feedback, was associated with a 13.0 to 29.5% increase in the proportion of opioid prescriptions written in concordance with local guidelines and reduced pain scores ranging from 7.0 to 34.5%. Interventions to improve opioid safety in patient‐controlled analgesia reduced medication errors by up to 89.1%. Conclusion Interventions involving academic detailing and education, especially when reinforced by feedback, show positive effects on appropriate opioid use among hospital inpatients. Future studies investigating the impact of administrative interventions on opioid use and related outcomes are warranted.

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“…In this condition both blood pressure and pulse rate are increased (29)(30)(31)(32) but the volume of lungs is decreased. Finally this marker can cause incidence of myocardial ischemia (33). Therefore, biologic response to stress can increase the possibility of cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

An Epidemiological Study of Cardiovascular Risk Factors in Patients with Myocardial Infarction: A Prospective Study

Moghaddam¹,

Avazeh²,

Saifi³

et al. 2015

Arch Crit Care Med

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Background: Stress is one of the most important factors that may be accompanied with increased possible prevalence of cardiovascular diseases including myocardial infarction. Objectives: The purpose of this study was to investigate the correlation between perceived stress intensity and some cardiovascular risk factors in myocardial infarctions' patients. Methods: The design of the study was cross sectional. Overall, 2400 patients with myocardial infarction were chosen through multistage random sampling. A three-part questionnaire including demographic characteristics, perceived stress, and a checklist to record laboratorial test and electrocardiography changes were used for data collection. Results:The results of the present study showed that 45% of the patients had moderate and 55% had severe stress. Moreover, findings of the research indicated that there were significant differences between the mean stress level in various categories of the variable including gender, education, history of hypertension, blood pressure, diabetes, cigarette smoking, exercising, job, and family history of myocardial diseases. Conclusions: Regarding the high level of perceived stress in patients with myocardial infarction, it is necessary to devise a program and determine stressor factors to modify and decrease them.

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Testing an Educational Nursing Intervention for Pain Assessment and Management in Older People

Abstract: The comprehensive intervention enabled change in practice and improvements in pain intensity, and the assessment and management of pain. Future research is needed on implementing the intervention with a multidisciplinary team of health professionals in a subacute environment.

Cited by 31 publications

References 41 publications

Understanding Nurses’ Decisions to Treat Pain in Nursing Home Residents with Dementia

Understanding Nurses’ Decisions to Treat Pain in Nursing Home Residents with Dementia

Effectiveness of interventions on the appropriate use of opioids for noncancer pain among hospital inpatients: A systematic review

An Epidemiological Study of Cardiovascular Risk Factors in Patients with Myocardial Infarction: A Prospective Study

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