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Bernués-Caudillo L, Albornos-Muñoz L, Rodrigo MPF, García MÁ, Benito MDR, Serrano MJR, Navarro PG, Pérez PL, Sotelo SG, Moreno-Casbas MT, Vrbová T, Klugar M, Klugarová J, Gonzalez-María E. Pain assessment and management among adult patients in a gynecology ward: a best practice implementation project. JBI Evid Implement 2023; 21:S1-S8. [PMID: 38037444 DOI: 10.1097/xeb.0000000000000387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVES This project aimed to improve compliance with evidence-based practice in pain assessment and management in a gynecology ward. INTRODUCTION Effective pain control is important to prevent the negative consequences of pain that is poorly managed. However, it remains undervalued and inadequately treated. Applying evidence-based practices to correctly evaluate and manage pain is essential to improve pain relief. METHODS This project followed the JBI Evidence Implementation Framework. A baseline audit of 41 women admitted to the gynecology ward was conducted and measured against 5 best practice criteria, along with a patient satisfaction questionnaire. Targeted strategies were then implemented and a follow-up audit was conducted using the same criteria, methods, and sample size as the baseline audit. RESULTS The baseline audit revealed gaps between current and best practice. Barriers to implementation were identified and strategies to resolve the barriers were designed and implemented (nurse education, informative materials, electronic patient records system improvements). Comprehensive pain assessment, including dynamic and static pain assessment, use of a validated tool, and education provided to patients and carers, improved in the follow-up audit. There was no change in patient satisfaction levels; however, the discrepancy between pain measured by nurses and pain measured by patients was reduced. CONCLUSIONS The JBI methodology was useful in improving compliance with evidence-based practice criteria. It also facilitated adaptation to new barriers, such as the COVID-19 pandemic. Improving nurses' knowledge of pain assessment can lead to more accurate assessment. Inadequate records systems also made it difficult to record the care that was provided. Subsequent audits will assess sustainability and the project will be escalated to other wards.
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Affiliation(s)
- Leticia Bernués-Caudillo
- Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Albornos-Muñoz
- Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Prevention and Promotion (RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | | | | | | | | | - M Teresa Moreno-Casbas
- Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Research Network Centre (CIBER) on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Tereza Vrbová
- Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miloslav Klugar
- Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jitka Klugarová
- Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Esther Gonzalez-María
- Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Research Network Centre (CIBER) on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
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Grommi S, Vaajoki A, Voutilainen A, Kankkunen P. Effect of Pain Education Interventions on Registered Nurses' Pain Management: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2023:S1524-9042(23)00061-9. [PMID: 37032260 DOI: 10.1016/j.pmn.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 01/27/2023] [Accepted: 03/09/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES This review and meta-analysis aims to reveal how pain education interventions affect registered nurses' pain management. DESIGN A systematic review and meta-analysis DATA SOURCES: PubMed, Scopus, CINAHL (EBSCOhost), and ERIC REVIEW METHODS: A systematic search of four electronic databases was conducted to identify relevant peer-reviewed English or Finnish-language articles published between 2008 and 2021. The review included a quality appraisal and a meta-analysis of articles providing group-level data before and after the intervention (n = 12). The methods followed the PRISMA guidelines. RESULTS Overall, 23 articles met the inclusion criteria for the review, of which 15 were evaluated as good quality. Based on the articles on document audits (n = 10), pain education interventions reduced the risk of not receiving the best pain management by 40%, whereas based on the articles on patients' experiences (n = 4), they reduced the risk by 25%. The study quality and design of these articles were considerably heterogenous. CONCLUSIONS Pain education study strategies varied widely among the included articles. These articles used multivariate interventions without systematization or sufficient opportunity to transfer the study protocols. It can be concluded that versatile pain nursing education interventions, as well as auditing of pain nursing and its documentation combined with feedback, can be effective to nurses in adapting pain management and assessment practices and increasing patient satisfaction. However, further research is required in this regard. In addition, well-designed, implemented, and reproducible evidence-based pain education intervention is required in the future.
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Affiliation(s)
- Salla Grommi
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
| | | | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Frescos N, Copnell B. Podiatrists' views of assessment and management of pain in diabetes-related foot ulcers: a focus group study. J Foot Ankle Res 2020; 13:29. [PMID: 32493455 PMCID: PMC7268326 DOI: 10.1186/s13047-020-00399-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/22/2020] [Indexed: 02/08/2023] Open
Abstract
Background Contrary to the belief that patients with diabetes-related foot ulcers (DRFU) do not experience wound related pain due to the presence of peripheral neuropathy there is increasing evidence that pain can be present. Subsequently, wound-related pain is often underestimated and undertreated. The aim of this study is to describe what influences pain assessment of DRFU. Methods A qualitative exploratory study was conducted with podiatrists who managed DRFU. Eight podiatrists were recruited through a professional organisation to participate in a focus group. A thematic analysis was conducted to identify themes that explored the barriers and enablers to pain assessment and management of DRFU. Results Three themes emerged. Observational and non-verbal cues were the preferred approaches used to assess wound pain. Assumptions and value judgments of the pain patients experienced and the relationships between podiatrists, patients and other health care practitioners were important influencers on the assessment and management of pain. Conclusion The perceived barriers to the assessment and management of wound related pain in DRFU were attitudes and beliefs about pain, lack of DRFU-specific validated assessment tools and lack of knowledge and skills to manage the pain.
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Affiliation(s)
- Nicoletta Frescos
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia.
| | - Bev Copnell
- Northern Clinical School, School of Nursing and Midwifery, Northern Centre for Health Education and Research, College of Science, Health and Engineering, La Trobe University, Melbourne, 3086, Australia
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