Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation.

Unlabelled: Quality improvement (QI) is a compilation of methods adapted from psychology, statistics, and operations research to identify factors that contribute to poor treatment outcomes and to design solutions for improvement. Valid and reliable measurement is essential to QI using rigorously developed and tested instruments. The purpose of this article is to describe the evolution of the American Pain Society Patient Outcome Questionnaire (APS-POQ) for QI purposes and present a revised version (R) including instrument psychometrics.

Comparison of perioperative oral multimodal analgesia versus IV PCA for spine surgery.

Study Design: A preintervention and postintervention design was used to examine a total of 200 patients.

Objective: After successful implementation at our institution of a perioperative oral multimodal analgesia protocol in major joint arthroplasty, a modified regimen was provided to patients undergoing spine procedures.

Summary Of Background Data: A proactive, multimodal approach is currently recommended for the management of acute postoperative pain.

Functional implications of long-term pain following outpatient inguinal herniorrhaphy--a prospective evaluation.

Background: The purpose of the present study is to assess pain and functional outcomes at 1 y following inguinal herniorrhaphy in which patients were randomized to receive a continuous wound infusion of bupivacaine to receiving a saline infusion.

Methods: Patients received saline or bupivacaine prior to incision and then for 60 h postoperatively. The incidence, severity, and functional interference of pain were assessed for five postoperative days, and at 1 y.

Developing new ways to address learning needs of adult abdominal organ transplant recipients.

Context: The degree to which patients are knowledgeable about posttransplant care can affect outcomes and patients' satisfaction. Transplant team members must identify knowledge gaps, contributory factors, and innovative methods to address learning needs.

Objective: To identify patients' perceptions of their knowledge gaps and identify ways to improve current approaches to patient education.

Improving reassessment and documentation of pain management.

Background: The Joint Commission standards on pain management address the documentation of assessment and reassessment. Yet, little has been published to describe when and how nurses perform and communicate reassessment of pain. In 2005, the University of Wisconsin Hospital & Clinics (UWHC) was inconsistently reassessing pain after interventions, and documented reassessments were primarily confined to pain-intensity ratings.

Nurses' opinions on appropriate administration of PRN range opioid analgesic orders for acute pain.

The use of "as needed" or "pro re nata" (PRN) range opioid analgesic orders is a common clinical practice in the management of acute pain, designed to provide flexibility in dosing to meet an individual's unique needs. Range orders enable necessary adjustments in doses based on individual response to treatment. However, PRN range opioid orders have recently come under scrutiny as a source of confusion and as a medication management safety issue.

Prospective analysis of a novel long-acting oral opioid analgesic regimen for pain control after total hip and knee arthroplasty.

Parenteral opioid use after total knee (TKA) and hip (THA) arthroplasty often results in substantial functional interference and side effects. This prospective study compared use of traditional intravenous patient-controlled analgesia (IV PCA) with a novel oral regimen after TKA and THA. Sixty-two patients received IV PCA and 62 received scheduled long-acting and, as needed, short-acting oral opioids postoperatively.

The WPI's review of Wisconsin's managed care climate for pain management: opportunities for improvement.

Background: Reimbursement obstacles, such as inadequate insurance coverage, have been identified as barriers to adequate pain management. The purpose of this study was to determine Wisconsin insurers' and managed care organizations' (MCOs) policies and practices regarding pain treatment and MCO medical directors' perceptions of barriers to providing effective pain management for their enrollees.

Methods: A descriptive qualitative design was used with semi-structured interviews of 6 administrative executives of commercial health management organizations' products from the major insurers in Wisconsin.

The evaluation of mechanical devices for lateral transfers on perceived exertion and patient comfort.

Purpose: The purpose of this study was to compare the perceived physical stress felt by subjects (nursing and other hospital personnel), time spent, number of personnel required, and patient comfort using various methods to transfer patients laterally in the supine position.

Design: Descriptive comparative design.

Sample: One hundred ninety-two transfer ratings (132 using manual methods and 60 using a mechanical device) were compared.

Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty.

Purpose: The purpose of this study was to compare pain and anxiety in orthopaedic patients scheduled for elective total hip or knee arthroplasty who have received a kit of nonpharmacologic strategies for pain and anxiety in addition to their regularly prescribed analgesics to those who receive the usual pharmacologic management alone.

Design: Descriptive comparative and correlational design using surveys and chart audits.

Sample: Sixty-five patients randomized to receive usual care or usual care plus a kit of nonpharmacologic strategies.

Incidence and characteristics of naloxone use in postoperative pain management: a critical examination of naloxone use as a potential quality measure.

The administration of naloxone may be an important monitor of the quality and safety of postoperative pain management. However, studies that support the use of naloxone as a quality measure are absent. The purposes of this study are to determine the incidence and factors associated with naloxone administration in the postoperative setting and to critically examine naloxone as a potential quality measure.

Continuous local anesthetic infusion for pain management after outpatient inguinal herniorrhaphy.

Background: The purpose of the present study is to compare postoperative pain and functional outcomes in patients undergoing inguinal herniorrhaphy who receive a continuous wound infusion of bupivacaine to those who receive an infusion of saline.

Methods: A prospective, randomized, blinded, placebo-controlled trial was conducted in adults undergoing outpatient inguinal herniorrhaphy. Patients received saline or bupivacaine through a disposable infusion pump for 60 hours postoperatively.

The American Society of Pain Management Nurses role-delineation study. National Association of Orthopaedic Nurses respondents.

Purpose: A role-delineation study was conducted by the American Society of Pain Management Nurses to examine the activities performed by nurses involved in pain management.

Design: A survey was sent to nurses involved in pain management. The role-delineation survey consisted of 92 activity statements and was based on the Nursing Intervention Classifications.

A 10-year review of quality improvement monitoring in pain management: recommendations for standardized outcome measures.

Quality measurement in health care is complex and in a constant state of evolution. Different approaches are necessary depending on the purpose of the measurement (e.g.

Implementing clinical research: perils, pitfalls, and planning.

Performing clinical nursing research is critical to enhancing patient care. Even the most carefully planned study, however, is subject to the "real world" of clinical practice and unforeseen obstacles. Attention to detail throughout all phases of the study, flexibility, and problem-solving are key to successful completion of your study.

The American Society of Pain Management Nurses practice analysis: role delineation study.

A role delineation study was carried out by the American Society of Pain Management Nurses (ASPMN) to determine the activities performed by nurses involved in pain management. Demographic characteristics of pain management nurses and differences in practice based on educational preparation and specialty affiliation were identified. The role delineation survey was developed based on Nursing Intervention Classifications.