ASPMN 2024 Position Statement: Pain Assessment in the Patient Unable to Self-Report.

Recognizing and managing pain is especially challenging for vulnerable populations who cannot communicate their discomfort. Because there is no valid and reliable objective measure of pain, the American Society for Pain Management Nursing advocates for comprehensive assessment practices articulated in a Hierarchy of Pain Assessment. These practices require gathering relevant information to infer the presence of pain and evaluate a patient's response to treatment.

Pain Assessment in the Patient Unable to Self- Report: Clinical Practice Recommendations in Support of the ASPMN 2024 Position Statement.

Recognizing and managing pain is especially challenging for vulnerable populations who cannot communicate their discomfort. Because there is no valid and reliable objective measure of pain, the American Society for Pain Management Nursing advocates for comprehensive assessment practices articulated in a Hierarchy of Pain Assessment. These practices must gather relevant information to infer the presence of pain and evaluate a patient's response to treatment.

Delivering the National Diabetes Prevention Program: Assessment of Retention, Physical Activity, and Weight Loss Outcomes by Participant Characteristics and Delivery Modes.

Type 2 diabetes disproportionately affects older adults, persons from racial and ethnic minority groups, and persons of low socioeconomic status. It can be prevented or delayed through evidence-based interventions such as the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). This analysis is aimed at evaluating the outcomes (i.

Delivering the National Diabetes Prevention Program: Assessment of Outcomes in In-Person and Virtual Organizations.

The Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program (DPRP) has helped organizations deliver the National Diabetes Prevention Program (National DPP) lifestyle change program for over 10 years. Four delivery modes are now approved: in person, online (self-paced, asynchronous delivery), distance learning (remote, synchronous delivery), and combination (hybrid delivery using more than one delivery mode). We assessed outcomes using data from 333,715 participants who started the 12-month program between January 1, 2012, and December 31, 2018.

Transitioning to Independent Nursing Practice during COVID-19: A Mixed Methods Study.

The COVID-19 pandemic presented challenges to onboard and support new graduate nurses (NGNs). This study sought to explore the perceptions of nurses entering clinical practice during the COVID-19 pandemic. Using mixed methods, we investigated the experiences of NGNs entering the field during the pandemic and how a nurse residency program (NRP) adapted to meet their needs.

Predicting Who Receives Nonpharmacologic Pain Interventions in the Pediatric Intensive Care Unit.

Aims: The majority of patients in the pediatric intensive care unit (PICU) experience pain daily, while nonpharmacologic interventions are indicated for pain management in children, there is limited information on which nonpharmacologic interventions are provided in the PICU and which patients receive those interventions. The aim of this descriptive correlational secondary data analysis was to determine what nonpharmacologic interventions were recorded in the electronic health record of PICU patients and patterns in use by patient demographics.

Setting/subjects: All patients hospitalized in 15 participating PICUs are located within 12 unique children's hospitals across the United States were eligible for participation.

Delivering the National Diabetes Prevention Program: Assessment of Enrollment in In-Person and Virtual Organizations.

The aim of the US Centers for Disease Control and Prevention's (CDC) National Diabetes Prevention Program (National DPP) is to make an evidence-based lifestyle change program widely available to the more than 88 million American adults at risk for developing type 2 diabetes. The National DPP allows for program delivery using four delivery modes: in person, online, distance learning, and combination. The objective of this study was to analyze cumulative enrollment in the National DPP by delivery mode.

Implementing Prone Positioning for COVID-19 Patients Outside the Intensive Care Unit.

Background: Proning intubated intensive care unit patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the intensive care unit.

Local Problem: Nursing units previously designated for medical/surgical populations had to adjust quickly to provide evidence-based care for COVID-19 patients attempting self-proning.

Retention Among Participants in the National Diabetes Prevention Program Lifestyle Change Program, 2012-2017.

Objective: To assess retention in the National Diabetes Prevention Program (DPP) lifestyle change program, which seeks to prevent type 2 diabetes in adults at high risk.

Research Design And Methods: We analyzed retention among 41,203 individuals who enrolled in Centers for Disease Control and Prevention (CDC)-recognized in-person lifestyle change programs at organizations that submitted data to CDC's Diabetes Prevention Recognition Program during January 2012-February 2017.

Results: Weekly attrition rates were typically <1-2% but were between 3.

The Pediatric American Pain Society Patient Outcomes Questionnaire (Pediatric APS-POQ): Development and Initial Psychometric Evaluation of a Brief and Comprehensive Measure of Pain and Pain Outcomes in Hospitalized Youth.

Pediatric pain assessment in the hospital traditionally involves the patient's self-report of pain intensity using a numeric rating scale, which does not capture the complexity of the pain experience. No valid, comprehensive measure of pain in hospitalized youth exists. This study was designed to develop and conduct initial psychometric testing of the Pediatric American Pain Society Patient Outcomes Questionnaire (Pediatric APS-POQ), a comprehensive patient-reported measure of pain and pain outcomes in hospitalized youth.

Pain Assessment in the Patient Unable to Self-Report: Clinical Practice Recommendations in Support of the ASPMN 2019 Position Statement.

Pain is a subjective experience, unfortunately, some patients cannot provide a self-report of pain verbally, in writing, or by other means. In patients who are unable to self-report pain, other strategies must be used to infer pain and evaluate interventions. In support of the ASPMN position statement "Pain Assessment in the Patient Unable to Self-Report", this paper provides clinical practice recommendations for five populations in which difficulty communicating pain often exists: neonates, toddlers and young children, persons with intellectual disabilities, critically ill/unconscious patients, older adults with advanced dementia, and patients at the end of life.

Nursing Research Priorities in the Pediatric Emergency Care Applied Research Network (PECARN): Reaching Consensus Through the Delphi Method.

Introduction: Pediatric emergency nurses who are directly involved in clinical care are in key positions to identify the needs and concerns of patients and their families. The 2010 Institute of Medicine report on the future of nursing supports the active participation of nurses in the design and implementation of solutions to improve health outcomes. Although prior efforts have assessed the need for research education within the Pediatric Emergency Care Applied Research Network (PECARN), no systematic efforts have assessed nursing priorities for research in the pediatric ED setting.

ASPMN 2019 Position Statement: Pain Assessment in the Patient Unable to Self-Report.

Managing pain in those vulnerable populations who are unable to self-report or communicate is challenging due to difficulty recognizing pain presence and severity. As no valid and reliable objective measure of pain exists, the ASPMN supports assessment practice recommendations that gather relevant information to infer presence of pain and evaluate response to intervention. Nurses and other healthcare professionals must be advocates for those who are unable to speak for themselves regarding their pain experience.

Sedation Practices of Neonates Receiving Extracorporeal Membrane Oxygenation.

Neonatal sedation practices during extracorporeal membrane oxygenation (ECMO) are not well described and no universal guidelines exist. Current literature describes types of medications used in adult and pediatric ECMO patients, but to our knowledge no data is published on neonatal specific median daily dose requirements or descriptions of sedation practices. The objective of this study is to examine the types and median doses of sedation utilized and to describe sedation practices for neonatal patients requiring ECMO support.

The Experience of Pain and Pain Tool Preferences of Hospitalized Youth.

Background: An accurate holistic pediatric pain assessment is necessary for quality pain management. Evidence continues to be published indicating inadequacies in pediatric pain management. It is important for clinicians to consider the pain assessment process while caring for youth.

The Association of the Nurse Work Environment and Patient Safety in Pediatric Acute Care.

Objectives: Eighteen years ago, the Institute of Medicine estimated that medical errors in hospital were a major cause of mortality. Since that time, reducing patient harm and improving the culture of patient safety have been national health care priorities. The study objectives were to describe the current state of patient safety in pediatric acute care settings and to assess whether modifiable features of organizations are associated with better safety culture.

Safety Huddle Intervention for Reducing Physiologic Monitor Alarms: A Hybrid Effectiveness-Implementation Cluster Randomized Trial.

Background: Monitor alarms occur frequently but rarely warrant intervention.

Objective: This study aimed to determine if a safety huddle-based intervention reduces unit-level alarm rates or alarm rates of individual patients whose alarms are discussed, as well as evaluate implementation outcomes.

Design: Unit-level, cluster randomized, hybrid effectiveness-implementation trial with a secondary patient-level analysis.

A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDC's National Diabetes Prevention Program.

Objective: To assess participant-level results from the first 4 years of implementation of the National Diabetes Prevention Program (National DPP), a national effort to prevent type 2 diabetes in those at risk through structured lifestyle change programs.

Research Design And Methods: Descriptive analysis was performed on data from 14,747 adults enrolled in year-long type 2 diabetes prevention programs during the period February 2012 through January 2016. Data on attendance, weight, and physical activity minutes were summarized and predictors of weight loss were examined using a mixed linear model.

Bedside Placement of the Postpyloric Tube in Infants.

Background: Patients in the neonatal intensive care unit are a vulnerable population with specific nutritional requirements, which include increased protein and caloric needs for adequate growth. Some infants cannot tolerate gastric feeds and need to have postpyloric feeds to grow. Placement of a postpyloric tube can be done by gastric insufflation.

Pain Assessment of Children with Autism Spectrum Disorders.

Objective: Pain assessment of individuals with autism spectrum disorder (ASD) is largely unexplored. The core deficits of ASD may interfere with this population's ability to effectively use traditional pain assessment tools. Accurate pain assessment is essential to providing quality care.

Systematic Review of Physiologic Monitor Alarm Characteristics and Pragmatic Interventions to Reduce Alarm Frequency.

Background: Alarm fatigue from frequent nonactionable physiologic monitor alarms is frequently named as a threat to patient safety.

Purpose: To critically examine the available literature relevant to alarm fatigue.

Data Sources: Articles published in English, Spanish, or French between January 1980 and April 2015 indexed in PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Cochrane Library, Google Scholar, and ClinicalTrials.

Safety of a 1-Day Polyethylene Glycol 3350 Bowel Preparation for Colonoscopy in Children.

Objectives: Electrolyte-free polyethylene glycol powder (PEG-3350) has been widely used for colonoscopy preparation (prep); however, limited safety data on electrolyte changes exists with 1-day prep regimens. The primary aim of this study was to determine the proportion of patients with significant serum chemistry abnormalities before and at the time of colonoscopy. Secondary aims included evaluation of prep tolerance and bowel cleansing efficacy.

Patient, family, and provider complex care situations in pediatric acute medical care: Creation of the Red Flags Situation Assessment Tool.

Purpose: To develop and test a questionnaire to identify situations among patients, families, and providers that lead to complex pediatric medical care in a tertiary hospital setting.

Design: A mixed methods approach was used. Qualitative content analysis of hospital documents was conducted to develop questionnaire items.