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https://www.readbyqxmd.com/read/28212147/monitoring-hospitalized-adult-patients-for-opioid-induced-sedation-and-respiratory-depression
#1
Carla R Jungquist, Kirsten Smith, Kelly L Wiltse Nicely, Rosemary C Polomano
: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks...
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28209260/use-of-the-pasero-opioid-induced-sedation-scale-poss-in-pediatric-patients
#2
Ann Quinlan-Colwell, Gayle Thear, Emily Miller-Baldwin, Andrea Smith
The Pasero Opioid-induced Sedation Scale (POSS) is a valid, reliable tool used to assess sedation when administering opioid medications to manage pain. The POSS is endorsed by The Joint Commission and the American Society for Pain Management Nursing to help prevent adverse opioid-related respiratory events. Although the POSS is used to assess sedation in pediatric patients at some hospitals, prior to this study, it was not formally evaluated in the pediatric population. This study used a quasi-experimental design with a convenience sample of pediatric patients admitted to a large regional medical center in southeastern North Carolina...
February 10, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28198563/frequency-and-predictors-of-analgesic-prescribing-in-u-s-nursing-home-residents-with-persistent-pain
#3
Kevin M Fain, G Caleb Alexander, David D Dore, Jodi B Segal, Andrew R Zullo, Carlos Castillo-Salgado
OBJECTIVES: To quantify prescription analgesic use of elderly nursing home (NH) residents with persistent noncancer pain and to identify individual and facility traits associated with no treatment. DESIGN: Cross-sectional study. SETTING: Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. PARTICIPANTS: Individuals aged 65 and older with persistent noncancer pain were identified from a cross-section of all long-stay U...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28177940/emergency-department-pain-management-in-children-with-appendicitis-in-a-bi-ethnic-population
#4
Ron Jacob, Baruch Krauss, Gal Twito, Ronit Leiba, Itai Shavit
OBJECTIVES: Our goal was to examine factors associated with the administration of ED analgesia (any analgesia, opioid analgesia) in patients with acute appendicitis in a tertiary children's hospital in Israel, and to examine ethnic differences. METHODS: A retrospective cohort study of children evaluated in the ED, who had ICD-9 diagnosis of acute appendicitis. Regression analysis was used to test the effect of multiple variables on the provision of analgesia. Medications were administered according to a nurse-driven pain protocol...
February 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28169899/national-attention-on-opioid-use-and-abuse-national-association-of-clinical-nurse-specialists-in-the-forefront
#5
Melinda Mercer Ray, Jodi Herron Behr
No abstract text is available yet for this article.
March 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28159503/an-interprofessional-education-workshop-to-develop-health-professional-student-opioid-misuse-knowledge-attitudes-and-skills
#6
Kristina Monteiro, Luba Dumenco, Sally Collins, Jeffrey Bratberg, Celia MacDonnell, Anita Jacobson, Richard Dollase, Paul George
OBJECTIVE: To implement and evaluate an interprofessional workshop focused on increasing student knowledge, skills, and attitudes toward opioid misuse. SETTING: The Warren Alpert Medical School of Brown University in Providence, Rhode Island, April 2016. PRACTICE DESCRIPTION: Health professional students from medicine, nursing, pharmacy, social work, and physical therapy participated in an interprofessional education workshop focused on opioid use disorder...
January 31, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28156579/snapshot-of-an-outpatient-supportive-care-center-at-a-comprehensive-cancer-center
#7
Maxine Grace De la Cruz, Angelique Wong, Debra Castro, Eduardo Bruera
: 145 Background: Integration of Palliative Care (PC) in oncology has been found to improve symptom distress, quality of life and survival in patients with advanced cancer. Early integration is most appropriate in the outpatient (OP) setting. However, most PC services in the U.S. do not have an OP component. Our study aims to provide a snapshot of the type of patients that are referred to this novel setting for the delivery of early PC. METHODS: We reviewed a day in the SCC to illustrate the structure and process involved in the delivery of outpatient PC...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152179/central-nervous-system-medication-burden-and-serious-falls-in-older-nursing-home-residents
#8
Joseph T Hanlon, Xinhua Zhao, Jennifer G Naples, Sherrie L Aspinall, Subashan Perera, David A Nace, Nicholas G Castle, Susan L Greenspan, Carolyn T Thorpe
OBJECTIVES: To examine the association between CNS medication burden and serious falls in those with a recent fall history. DESIGN: Nested-case control study; cases matched to four controls by age, gender, and date. SETTING: US nursing homes. PARTICIPANTS: 5,556 residents age ≥65 with a recent fall history admitted to a nursing home between 1/1-9/30/2010 and followed until discharge, death, or December 31, 2010. MEASUREMENTS: Outcome was serious falls as per Medicare Part A and B ICD/CPT codes...
February 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28151790/management-of-opioid-and-sedative-weaning-in-pediatric-congenital-heart-disease-patients-assessing-the-state-of-practice
#9
Caitlin O'Connell, Sonja Ziniel, Lauren Hartwell, Jean Connor
BACKGROUND: Opioid and sedative medications are commonly used to treat pediatric patients with congenital heart disease; however, their use is not without adverse effects. Symptoms of withdrawal can occur if the medications are discontinued abruptly or weaned too quickly. OBJECTIVE: The aim of this study was to understand and describe the current management of opioid and sedative weaning in pediatric congenital heart disease patients in freestanding children's hospitals across the United States...
March 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28142397/effects-on-pain-of-a-stepwise-multidisciplinary-intervention-sta-op-that-targets-pain-and-behavior-in-advanced-dementia-a-cluster-randomized-controlled-trial
#10
Marjoleine Jc Pieper, Jenny T van der Steen, Anneke L Francke, Erik Ja Scherder, Jos Wr Twisk, Wilco P Achterberg
BACKGROUND: Pain in nursing home residents with advanced dementia remains a major challenge; it is difficult to detect and may be expressed as challenging behavior. STA OP! aims to identify physical and other needs as causes of behavioral changes and uses a stepwise approach for psychosocial and pharmacological management which was effective in improving challenging behavior. AIM: To assess whether implementation of the stepwise multidisciplinary intervention also reduces pain and improves pain management...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28137920/impact-of-parental-presence-at-infants-bedside-on-neonatal-abstinence-syndrome
#11
Mary Beth Howard, Davida M Schiff, Nicole Penwill, Wendy Si, Anjali Rai, Tahlia Wolfgang, James M Moses, Elisha M Wachman
BACKGROUND: Despite increased incidence of neonatal abstinence syndrome (NAS) over the past decade, minimal data exist on benefits of parental presence at the bedside on NAS outcomes. OBJECTIVE: To examine the association between rates of parental presence and NAS outcomes. METHODS: This was a retrospective, single-center cohort study of infants treated pharmacologically for NAS using a rooming-in model of care. Parental presence was documented every 4 hours with nursing cares...
February 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28135387/the-opioid-epidemic-what-does-it-mean-for-nurses
#12
Laura G Leahy
The United States is facing a major crisis with the current opioid epidemic. Tens of thousands of individuals are dying each year due to abuse and misuse of heroin and prescription opiate drugs. Nurses play an integral role in these aspects of health care and offer solutions by providing education; preventive measures; treatments, including medication-assisted treatments (MATs); and ongoing recovery options for individuals with opioid use disorders. Nurses provide education, issue prescriptions and dispense medications, and provide overall physical and mental health care to patients struggling with this "disease of the brain," and with the signing of the Comprehensive Addiction and Recovery Act, advanced practice RNs will soon be able to include MATs related to buprenorphine as part of their treatment plan...
January 1, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/28125964/effect-of-admission-fascia-iliaca-compartment-blocks-on-post-operative-abbreviated-mental-test-scores-in-elderly-fractured-neck-of-femur-patients-a-retrospective-cohort-study
#13
Peter M Odor, Irina Chis Ster, Iain Wilkinson, Frederic Sage
BACKGROUND: Post-operative cognitive impairment is common in elderly patients following surgery for hip fracture, with undertreated pain being an important etiological factor. Non-opioid based analgesic techniques, such as nerve blocks, may help reduce the risk of cognitive complications. The aim of this study was to investigate whether receiving a fascia iliaca compartment block (FICB) as part of a pre-operative analgesic regime increased the odds of high post-operative abbreviated mental test scores (AMTS) when compared with conventional analgesia without a nerve block...
January 5, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28123650/post-operative-capnostream-monitoring-in-patients-with-obstructive-sleep-apnoea-symptoms-case-series
#14
Vasanth Rao Kadam, Mazyar Danesh
Obstructive sleep apnoea (OSA) patients on opioid analgesic have an increased incidence of postoperative respiratory complications; prevention of these may be possible with appropriate post-operative monitoring. We recruited 4 OSA patients who had general anaesthesia for orthopaedic and septoplasty surgery. They required Patient Controlled Analgesia (PCA) or oral opioids in the post-operative period, hence continuous Saturation of Oxygen (Spo2), End Tidal Carbon dioxide (EtCo2) monitoring on Capnostream monitor with Integrated Pulmonary Index (IPI) was organized in high dependency unit...
July 2016: Sleep Science
https://www.readbyqxmd.com/read/28112967/will-societies-of-anesthesiologists-partake-in-the-take-off-of-non-anesthesiologist-administration-of-propofol
#15
Jean-Marc Dumonceau
Propofol sedation is increasingly used for standard and advanced endoscopies due to its advantages over traditional sedation based on benzodiazepines and/or opioids. These include a better sedation, greater patient cooperation, and higher patient satisfaction for most endoscopic procedures; it also decreases time to sedation and decreases recovery and discharge times. As anesthesiologists have typically provided propofol-based sedation, the increase in its use is limited by anesthesiologists' availability and cost...
February 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28108642/the-potential-role-for-smartphones-among-older-adults-with-chronic-noncancer-pain-a-qualitative-study
#16
Joshua E Richardson, Jennifer I Lee, Anita Nirenberg, M Carrington Reid
: OBJECTIVE : To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. DESIGN:  Qualitative study. SETTING:  One academically affiliated primary care practice serving older adults with CNCP in New York City. SUBJECTS : Thirteen older adults (age 65-85 years) with CNCP on chronic opioid therapy, that is, continuous use of opioids for at least six months...
January 20, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28100528/higher-risk-of-opioid-induced-respiratory-depression-in-children-with-neurodevelopmental-disability-a-retrospective-cohort-study-of-12%C3%A2-904-patients
#17
M A Jay, B M Thomas, R Nandi, R F Howard
BACKGROUND: Children with neurodevelopmental disabilities may be at risk of opioid-induced respiratory depression. We aimed to quantify the risks and effectiveness of morphine nurse-controlled analgesia (morphine-NCA) for postoperative pain in children with neurodevelopmental disabilities. METHODS: We carried out a retrospective cohort study of 12 904 children who received postoperative i.v. morphine-NCA. Subjects were divided into a neurodevelopmental disability group and a control group...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077162/a-fixed-inhaled-nitrous-oxide-oxygen-mixture-as-an-analgesic-for-adult-cancer-patients-with-breakthrough-pain-study-protocol-for-a-randomized-controlled-trial
#18
Qiang Liu, Yu Wang, Xiang-Jiang Luo, Ning-Ju Wang, Ping Chen, Xin Jin, Guo-Xia Mu, Xiao-Min Chai, Yue-Juan Zhang, Yu-Xiang Li, Jian-Qiang Yu
BACKGROUND: The management of breakthrough pain in cancer patients is always a challenge for medical professions. Occurring in 80% of cancer patients with advanced disease, breakthrough pain significantly decreases both patient's and caregiver's quality of life. The aim of this study is to assess the analgesic efficacy of a fixed inhaled nitrous oxide/oxygen mixture for adult cancer patients with breakthrough pain. METHODS/DESIGN: This is a randomized, placebo-controlled, double-blind study; it will be conducted in the General Hospital of Ningxia Medical University...
January 11, 2017: Trials
https://www.readbyqxmd.com/read/28063863/correlation-between-observational-scales-of-sedation-and-comfort-and-bispectral-index-scores-bis
#19
Michael Barbato, Greg Barclay, Jan Potter, Wilf Yeo, Joseph Chung
CONTEXT: When palliative care patients enter the phase of unconsciousness preceding death it is standard practice to initiate or continue a subcutaneous infusion of an opioid plus or minus a sedative. The doses are determined somewhat empirically and adjustments are based on clinical assessment and observational measures of sedation and comfort. Following reports that these observational measures could be misleading, this study assesses their validity by comparing them with an objective measure of sedation, the Bispectral Index score (BIS)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28045611/establishment-of-personalized-pain-goals-in-oncology-patients-to-improve-care-and-decrease-costs
#20
Dylan Zylla, Amber Larson, Gladys Chuy, Lisa Illig, Adina Peck, Sarah Van Peursem, James W Fulbright, Pamala A Pawloski, Sara Richter, Jeanne Mettner
PURPOSE: Cancer-related pain is common, negatively affects quality of life and survival, and often requires treatment with opioid analgesics. Patient-reported data that describe the incidence and severity of pain, medication use, and patient satisfaction with care are lacking. METHODS: We analyzed 18 months of outpatient oncology clinic encounters from the electronic medical record to obtain data on pain levels and opioid and nonopioid treatments. In June 2014, we instituted a pain intervention by creating a pain management information handout for patients, educating clinicians on opioid cost-effectiveness, and implementing a nursing protocol to document personalized pain goals (PPGs)...
January 3, 2017: Journal of Oncology Practice
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