Evidence-Based Pain Assessment in Nonverbal Palliative Care Patients.

Background: Central to palliative care is the early assessment and treatment of pain, whether physical, psychosocial, or spiritual. Nonverbal palliative care patients are at risk for inadequate pain assessment leading to prolonged suffering.

Aims: The purpose of this project was to implement and evaluate an evidence-based pain assessment tool for nonverbal palliative care patients.

Iowa Implementation for Sustainability Framework.

Background: An application-oriented implementation framework designed for clinicians and based on the Diffusion of Innovations theory included 81 implementation strategies with suggested timing for use within four implementation phases. The purpose of this research was to evaluate and strengthen the framework for clinician use and propose its usefulness in implementation research.

Methods: A multi-step, iterative approach guided framework revisions.

Pain management prior to nasogastric tube placement: atomized lidocaine.

Nasogastric tube (NGT) insertion is often painful for patients of all ages. Randomized clinical trials in adult patients support the use of some form of topical lidocaine in reducing pain associated with NGT insertion. A review of pediatric evidence also confirms that NGT insertion is painful and provides guidance in determining lidocaine concentrations, dosages, and administration methods.

Sacred cow gone to pasture: a systematic evaluation and integration of evidence-based practice.

Background: Sacred cows (SC) are old habits in practice, considered routine and above dispute, regardless of evidence to the contrary.

Purpose: This is the first known report that aims to conduct a systematic evaluation of practices that have been described in the literature as SC and strategies for planned implementation of evidence-based practices (EBP).

Methods: A large, complex, academic medical center department of nursing compared SC to EBP.

Unruptured intracranial aneurysms: using evidence and outcomes to guide patient teaching.

It is estimated that approximately 10 to 15 million Americans have intracranial aneurysms. Intracranial aneurysms are classified as either unruptured or ruptured. Advances in knowledge and technology are enhancing diagnosis, management, and outcomes associated with unruptured intracranial aneurysms.