May Issue: Addressing Nurse Burnout, New Chest Pain Assessment Guidelines, More

“This is the third Nurses Day celebrated since the start of the pandemic and nurses’ work has gotten more recognition than ever. But is that recognition enough?”—AJN senior clinical editor Christine Moffa in her editorial, “Honoring Nurses Where They Need It”

The May issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

Original Research: Combating the Opioid Epidemic Through Nurse Use of Multimodal Analgesia: An Integrative Literature Review

This review presents strong evidence on the benefits of multimodal analgesia in reducing opioid use for pain management in the acute care setting.

CE: Chemicals in the Home That Can Exacerbate Asthma

The authors describe how the use of cleaning and disinfectant products may affect asthma and asthma-related symptoms and report the findings of a recent study they conducted that identified how these products could reduce asthma control in older adults.

Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19

This quality improvement project evaluated the use of serenity lounges—dedicated rooms where nurses can take workday breaks to relax and rejuvenate—and massage chairs on nurses’ anxiety, stress, and burnout.

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2022-04-25T09:32:36-04:00April 25th, 2022|Nursing|0 Comments

Is This Child in Pain?

When the child is nonverbal.

Nurses regularly assess patients’ pain. It’s a much more difficult task when the patient is unable to articulate what they’re feeling or even where they hurt. How much more difficult is it when the patient is a nonverbal child with a complex medical history?

In this month’s AJN, Brenna Quinn and colleagues share their research on pain in these children. They define “children with medical complexity” as “those having a cognitive-chronological age mismatch, profound developmental delays, limited or no verbal abilities, and multisystem diagnoses, and who are completely dependent on others for care.” These kids tend to experience pain more frequently (often, daily or weekly), and are more likely to be hospitalized than are neurotypical children.

A ‘wide range of pain-associated behaviors.’

While it is often harder to assess pain in children than in adults, most children have a narrow range of “pain behaviors” that are easily identifiable. This isn’t true of children with medical complexity; some may even seem, from their expressions, to be laughing when they are in pain.

“More than 40 pain assessment tools have been developed for use in infants and children who cannot provide self-report. Despite the availability of these tools, the evaluation of pain in children with medical complexity remains challenging, […]

Poor Assessment of Nursing Home Residents’ Pain — What Can Be Done?

A recent study sought to find out whether relatives and caregivers (proxies) understood residents’ pain well enough to assist in pain assessment and to discover what factors affected their judgments of pain. The findings showed, however, that their reports didn’t consistently match the pain ratings of nursing home residents themselves.

It’s particularly difficult to assess pain in cognitively impaired nursing home residents. This means that there’s a lot of suffering that goes untreated. This AJN article in the December issue discusses the findings of a new study on the topic and offers some recommendations we obtained from the study authors. Here’s another excerpt:

The authors suggest that pain management in nursing homes could be improved through caregiver education, including the implementation of pain assessment education in combination with treatment. They recommend basic training for nurses and nursing assistants on pain, pain behavior, and pharmacologic and nonpharmacologic pain treatment, such as “massage, applying warmth, mobility[, and] distractions with music or story telling.” They also suggest that “treatment effects could be determined more easily using a pain observation scale.”

So check out the article, and also let us know what else can we do to more accurately assess the pain of nursing home residents.

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