Objectives: Lavender essential oil is widely used for pain relief, but its effectiveness in postoperative pain relief remains unclear. This systematic review investigated the effects of inhaled lavender aromatherapy on postoperative pain relief and analgesic consumption in adults.
Methods: We searched Cochrane Library, PubMed, Embase, Web of Science, CINAHL, Medline (Ovid), and Scopus databases up to October 01, 2023. Pain score was the primary outcome, and analgesics consumption was the secondary outcome. Study quality was assessed using the Cochrane risk of bias tool, and evidence strength was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation approach.
Results: Fifteen studies met the inclusion criteria, 14 published in 2015 or later. Most studies were conducted in Iran (9 studies, 60%) and the USA (5 studies, 33%). Participants primarily underwent cardiac (5 studies, 33%) or abdominal surgery (6 studies, 40%). Pain levels were mainly assessed at 5, 30, and 60 minutes after intervention. Regarding the consumption of postoperative analgesics, three studies reported reduced postoperative analgesic use with lavender aromatherapy, while the other three studies found no notable effect.
Conclusions: Inhaled lavender aromatherapy significantly reduced postoperative pain in adults. However, evidence is insufficient to confirm its effect on reducing analgesic consumption. Further high-quality randomized clinical trials are needed to draw definitive conclusions.
{"title":"Inhalation Aromatherapy With Lavender for Postoperative Pain Management: A Systematic Review of Randomized Controlled Trials.","authors":"Yufang Ren, Yuyun Xiang, Zhi Li, Chaoyi Qin, Miao Chen","doi":"10.1016/j.pmn.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.pmn.2025.03.005","url":null,"abstract":"<p><strong>Objectives: </strong>Lavender essential oil is widely used for pain relief, but its effectiveness in postoperative pain relief remains unclear. This systematic review investigated the effects of inhaled lavender aromatherapy on postoperative pain relief and analgesic consumption in adults.</p><p><strong>Methods: </strong>We searched Cochrane Library, PubMed, Embase, Web of Science, CINAHL, Medline (Ovid), and Scopus databases up to October 01, 2023. Pain score was the primary outcome, and analgesics consumption was the secondary outcome. Study quality was assessed using the Cochrane risk of bias tool, and evidence strength was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation approach.</p><p><strong>Results: </strong>Fifteen studies met the inclusion criteria, 14 published in 2015 or later. Most studies were conducted in Iran (9 studies, 60%) and the USA (5 studies, 33%). Participants primarily underwent cardiac (5 studies, 33%) or abdominal surgery (6 studies, 40%). Pain levels were mainly assessed at 5, 30, and 60 minutes after intervention. Regarding the consumption of postoperative analgesics, three studies reported reduced postoperative analgesic use with lavender aromatherapy, while the other three studies found no notable effect.</p><p><strong>Conclusions: </strong>Inhaled lavender aromatherapy significantly reduced postoperative pain in adults. However, evidence is insufficient to confirm its effect on reducing analgesic consumption. Further high-quality randomized clinical trials are needed to draw definitive conclusions.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-02DOI: 10.1016/j.pmn.2025.03.003
Muntaha Ali, Halle Jonassaint, Aleah Bedrosian, Yingwei Yao, Molly W Mandernach, David Fedele, Robert J Lucero, Inge Corless, Brenda W Dyal, Mary H Belkin, Gabriela N Bastidas Mora, Diana J Wilkie, Miriam O Ezenwa
Background: The pain of sickle cell disease (SCD) is often stressful and increases the need for opioids. Relaxation and/or distraction interventions may reduce stress, pain, and opioid use in outpatients with SCD. There is limited information regarding challenges and strategies for successful recruitment, retention, and data collection for a relaxation and/or distraction study in this population.
Aim: The authors examined recruitment, retention, and data collection challenges for the participants in a study of an internet-based guided relaxation intervention to devise strategies to address them.
Methods: Qualitative data from an ongoing 6-month randomized controlled trial of a relaxation intervention was used. Participants (N = 122) had a mean age of 33.4 ± 10.6 years (range = 18-65), were mostly African American (93%) and female (68%), and were enrolled between March 2021 and May 2024 in collaboration with SCD clinics and communities. Participants completed baseline measures and were randomized to control or experimental groups. Research specialists documented all participant-reported challenges.
Results: Of 122 participants who completed the study, 65 (53%) reported 126 occurrences of challenges: 15 (12%) reported internet issues, 27 (21%) reported technical difficulties with the web-based program or Galaxy tablet, 4 (3%) reported problems using medication devices, 21 (17%) reported trouble adhering to specific data entry time windows, 39 (31%) had missing data points due to hospitalization, and 20 (16%) reported overwhelming pain at home. Several targeted strategies were used to overcome these challenges.
Conclusion: Findings provide insights into the challenges encountered in study recruitment, retention, and data collection when assessing adult outpatients with SCD. Addressing these challenges through targeted strategies, including practical team training, active engagement with participants, and efforts to add recruitment sites, can enhance recruitment, retention, and data collection in this population.
{"title":"Challenges and Strategies: Nationwide Data Collection for an Internet-based Guided Relaxation Intervention in Sickle Cell Disease.","authors":"Muntaha Ali, Halle Jonassaint, Aleah Bedrosian, Yingwei Yao, Molly W Mandernach, David Fedele, Robert J Lucero, Inge Corless, Brenda W Dyal, Mary H Belkin, Gabriela N Bastidas Mora, Diana J Wilkie, Miriam O Ezenwa","doi":"10.1016/j.pmn.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.pmn.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>The pain of sickle cell disease (SCD) is often stressful and increases the need for opioids. Relaxation and/or distraction interventions may reduce stress, pain, and opioid use in outpatients with SCD. There is limited information regarding challenges and strategies for successful recruitment, retention, and data collection for a relaxation and/or distraction study in this population.</p><p><strong>Aim: </strong>The authors examined recruitment, retention, and data collection challenges for the participants in a study of an internet-based guided relaxation intervention to devise strategies to address them.</p><p><strong>Methods: </strong>Qualitative data from an ongoing 6-month randomized controlled trial of a relaxation intervention was used. Participants (N = 122) had a mean age of 33.4 ± 10.6 years (range = 18-65), were mostly African American (93%) and female (68%), and were enrolled between March 2021 and May 2024 in collaboration with SCD clinics and communities. Participants completed baseline measures and were randomized to control or experimental groups. Research specialists documented all participant-reported challenges.</p><p><strong>Results: </strong>Of 122 participants who completed the study, 65 (53%) reported 126 occurrences of challenges: 15 (12%) reported internet issues, 27 (21%) reported technical difficulties with the web-based program or Galaxy tablet, 4 (3%) reported problems using medication devices, 21 (17%) reported trouble adhering to specific data entry time windows, 39 (31%) had missing data points due to hospitalization, and 20 (16%) reported overwhelming pain at home. Several targeted strategies were used to overcome these challenges.</p><p><strong>Conclusion: </strong>Findings provide insights into the challenges encountered in study recruitment, retention, and data collection when assessing adult outpatients with SCD. Addressing these challenges through targeted strategies, including practical team training, active engagement with participants, and efforts to add recruitment sites, can enhance recruitment, retention, and data collection in this population.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.pmn.2025.03.002
David Zuazua-Rico, Alba Maestro-González, Maria-Pilar Mosteiro-Diaz
Introduction: Pain is a complex, personal experience that is difficult to assess, especially in critical care patients who are unable to communicate. Traditional tools for measuring pain in these patients rely on behavioral observation, such as the Critical Care Pain Observation Tool (CPOT), but these tools have limitations in individuals under deep sedation. Based on non-invasive physiological parameters, Nociception Level (NOL) system emerges as a technological alternative for measuring nociception in clinical settings. This study aimed to compare the effectiveness of the NOL monitor with a behavioral scale (CPOT) in response to nociceptive stimuli in deeply sedated ICU patients.
Methods: This quasi-experimental study included 15 patients in a general ICU between January 2023 and May 2024. Behavioral (CPOT) and physiological (NOL) responses to nociceptive stimuli (pressure on nail beds and endotracheal suctioning) were compared. Measurements were taken before, and at five time points after the stimuli (0, 15, 30, 60, and 90 seconds). Patients with conditions that could alter nociception measurements, such as arrhythmias or neuromuscular blockades, were excluded.
Results: Significant differences were observed between CPOT and NOL scores for both nociceptive stimuli. The NOL system captured sustained nociceptive responses more effectively than the CPOT scale, particularly after endotracheal suctioning, where the CPOT stopped detecting pain after 60 seconds, while NOL continued to show elevated values.
Conclusion: The NOL monitor is a promising tool for assessing pain in deeply sedated ICU patients.
{"title":"Comparison of Nociception Monitoring in Sedated ICU Patients: Behavioral Scale vs. Nociception Level (NOL) Monitor.","authors":"David Zuazua-Rico, Alba Maestro-González, Maria-Pilar Mosteiro-Diaz","doi":"10.1016/j.pmn.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.pmn.2025.03.002","url":null,"abstract":"<p><strong>Introduction: </strong>Pain is a complex, personal experience that is difficult to assess, especially in critical care patients who are unable to communicate. Traditional tools for measuring pain in these patients rely on behavioral observation, such as the Critical Care Pain Observation Tool (CPOT), but these tools have limitations in individuals under deep sedation. Based on non-invasive physiological parameters, Nociception Level (NOL) system emerges as a technological alternative for measuring nociception in clinical settings. This study aimed to compare the effectiveness of the NOL monitor with a behavioral scale (CPOT) in response to nociceptive stimuli in deeply sedated ICU patients.</p><p><strong>Methods: </strong>This quasi-experimental study included 15 patients in a general ICU between January 2023 and May 2024. Behavioral (CPOT) and physiological (NOL) responses to nociceptive stimuli (pressure on nail beds and endotracheal suctioning) were compared. Measurements were taken before, and at five time points after the stimuli (0, 15, 30, 60, and 90 seconds). Patients with conditions that could alter nociception measurements, such as arrhythmias or neuromuscular blockades, were excluded.</p><p><strong>Results: </strong>Significant differences were observed between CPOT and NOL scores for both nociceptive stimuli. The NOL system captured sustained nociceptive responses more effectively than the CPOT scale, particularly after endotracheal suctioning, where the CPOT stopped detecting pain after 60 seconds, while NOL continued to show elevated values.</p><p><strong>Conclusion: </strong>The NOL monitor is a promising tool for assessing pain in deeply sedated ICU patients.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-28DOI: 10.1016/j.pmn.2025.01.038
Brandi Obrien RN-BC, CPNP-AC, AGPNP-BC, MSN, PHN, CHPN, OCN , Jason L. Reed DO , Kathy Baule DNP, RN, APN-ACNS-BC, CCRN, CNRN, RNFA , Kevin Peterson Lt. Col USAF, MC
Purpose and Problem Statement
The clinical utility of ketamine extends across various patient demographics, including pediatric, geriatric, and adult populations. This review aims to address the purpose and problem statement surrounding ketamine's diverse applications in trauma care, intensive care units (ICUs), medical-surgical settings and the outpatient environment. The PICO question guiding this review is: In patients of all age groups, how does the administration of ketamine compare to traditional pain management methods in terms of efficacy, safety, and patient outcomes?
Summary/Synthesis of Evidence
A thorough literature review was conducted, synthesizing evidence from clinical trials, observational studies, and meta-analyses. The evidence highlights ketamine's efficacy in pain management through various administration methods, including intravenous (IV) and oral administration, both independently and in conjunction with opioids. Ketamine's role in the emergency department (ED) for trauma patients, its dosing on medical-surgical floors, and specific considerations for pediatric and geriatric use were also examined.
Method of Evaluation/Validation of Evidence
The evaluation involved critical appraisal of studies using established frameworks for clinical research. Key metrics included pain relief effectiveness, side effect profiles, patient safety, and overall outcomes. Comparative analysis with traditional pain management techniques was also conducted to validate ketamine's clinical benefits.
Results/Relevance to Pain Management
Results indicate that ketamine is highly effective in managing acute and persistent pain, providing rapid relief with a favorable safety profile. Its use in both inpatient and outpatient care settings demonstrate significant benefits in pain control and sedation, especially where traditional opioids may pose risks.
Future Implications for Nursing Profession
The findings suggest important implications for the nursing profession, advocating for the integration of ketamine protocols into pain management strategies. Future research should focus on optimizing dosing regimens, understanding long-term outcomes, and developing guidelines for safe administration across different patient populations.
{"title":"Ketamine in Modern Medical Practice: Applications Across Age Groups and Clinical Settings","authors":"Brandi Obrien RN-BC, CPNP-AC, AGPNP-BC, MSN, PHN, CHPN, OCN , Jason L. Reed DO , Kathy Baule DNP, RN, APN-ACNS-BC, CCRN, CNRN, RNFA , Kevin Peterson Lt. Col USAF, MC","doi":"10.1016/j.pmn.2025.01.038","DOIUrl":"10.1016/j.pmn.2025.01.038","url":null,"abstract":"<div><h3>Purpose and Problem Statement</h3><div>The clinical utility of ketamine extends across various patient demographics, including pediatric, geriatric, and adult populations. This review aims to address the purpose and problem statement surrounding ketamine's diverse applications in trauma care, intensive care units (ICUs), medical-surgical settings and the outpatient environment. The PICO question guiding this review is: In patients of all age groups, how does the administration of ketamine compare to traditional pain management methods in terms of efficacy, safety, and patient outcomes?</div></div><div><h3>Summary/Synthesis of Evidence</h3><div>A thorough literature review was conducted, synthesizing evidence from clinical trials, observational studies, and meta-analyses. The evidence highlights ketamine's efficacy in pain management through various administration methods, including intravenous (IV) and oral administration, both independently and in conjunction with opioids. Ketamine's role in the emergency department (ED) for trauma patients, its dosing on medical-surgical floors, and specific considerations for pediatric and geriatric use were also examined.</div></div><div><h3>Method of Evaluation/Validation of Evidence</h3><div>The evaluation involved critical appraisal of studies using established frameworks for clinical research. Key metrics included pain relief effectiveness, side effect profiles, patient safety, and overall outcomes. Comparative analysis with traditional pain management techniques was also conducted to validate ketamine's clinical benefits.</div></div><div><h3>Results/Relevance to Pain Management</h3><div>Results indicate that ketamine is highly effective in managing acute and persistent pain, providing rapid relief with a favorable safety profile. Its use in both inpatient and outpatient care settings demonstrate significant benefits in pain control and sedation, especially where traditional opioids may pose risks.</div></div><div><h3>Future Implications for Nursing Profession</h3><div>The findings suggest important implications for the nursing profession, advocating for the integration of ketamine protocols into pain management strategies. Future research should focus on optimizing dosing regimens, understanding long-term outcomes, and developing guidelines for safe administration across different patient populations.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e222"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-28DOI: 10.1016/j.pmn.2025.01.035
Lynn Webster MD
Introduction
Chronic pain management has seen a surge in digital technologies promising improved outcomes, efficiency, and revenue. However, the diverse functionalities and focus areas of these platforms make choosing the right one a critical healthcare decision. This study compares 10 popular platforms to delineate their unique capabilities.
Materials and Methods
The author searched online for “Telehealth OR mHealth OR mHealth OR app AND remote therapeutic monitoring AND chronic care management OR pain OR chronic pain.” Platforms that were not provider-facing and reimbursement-friendly were excluded. Ten platforms (PainScript, Keet Health, Prevounce Health, PatchRx, HealthArc, TimeDoc, Paindrainer, HealthViewX, Limber, and PainScored) were evaluated by primary focus, key features, user interface, integration capabilities, healthcare models supported, and unique offerings. Information was collated from official product websites and relevant literature.
Results
Functional comparisons included targeted populations, daily monitoring categories and types of monitoring for each platform. Technical capabilities were also compared and included use and type of smartphone required, presences of secure messaging, gamification, EHR integration and patient time commitment for meeting the platform expectations. Comparisons will be presented in table format.
Conclusions
This is the first known qualitative study comparing digital platforms for clinical pain management. Reviewed platforms offered varied functionalities tailored to specific needs. PainScript and Paindrainer specifically targeted chronic pain and substance use disorder, facilitating direct patient-provider interaction and real-time monitoring. HealthViewX and Limber offered broader services in telehealth and physical therapy with strong emphases on integration and comprehensive care coordination. Keet Health and TimeDoc sought to enhance patient engagement and outpatient care continuity. Prevounce Health and PainScored prioritized preventive care and chronic disease management to streamline care processes and improve patient compliance. Lastly, PatchRx introduced innovative medication adherence technology, illustrating the potential of digital solutions to address common drug misuse challenges. Choice of a digital health platform should be guided by the specific patient population needs and operational workflow.
{"title":"Tailoring Technology for Pain Management: A Qualitative Comparison of Digital Health Platforms","authors":"Lynn Webster MD","doi":"10.1016/j.pmn.2025.01.035","DOIUrl":"10.1016/j.pmn.2025.01.035","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic pain management has seen a surge in digital technologies promising improved outcomes, efficiency, and revenue. However, the diverse functionalities and focus areas of these platforms make choosing the right one a critical healthcare decision. This study compares 10 popular platforms to delineate their unique capabilities.</div></div><div><h3>Materials and Methods</h3><div>The author searched online for “Telehealth OR mHealth OR mHealth OR app AND remote therapeutic monitoring AND chronic care management OR pain OR chronic pain.” Platforms that were not provider-facing and reimbursement-friendly were excluded. Ten platforms (PainScript, Keet Health, Prevounce Health, PatchRx, HealthArc, TimeDoc, Paindrainer, HealthViewX, Limber, and PainScored) were evaluated by primary focus, key features, user interface, integration capabilities, healthcare models supported, and unique offerings. Information was collated from official product websites and relevant literature.</div></div><div><h3>Results</h3><div>Functional comparisons included targeted populations, daily monitoring categories and types of monitoring for each platform. Technical capabilities were also compared and included use and type of smartphone required, presences of secure messaging, gamification, EHR integration and patient time commitment for meeting the platform expectations. Comparisons will be presented in table format.</div></div><div><h3>Conclusions</h3><div>This is the first known qualitative study comparing digital platforms for clinical pain management. Reviewed platforms offered varied functionalities tailored to specific needs. PainScript and Paindrainer specifically targeted chronic pain and substance use disorder, facilitating direct patient-provider interaction and real-time monitoring. HealthViewX and Limber offered broader services in telehealth and physical therapy with strong emphases on integration and comprehensive care coordination. Keet Health and TimeDoc sought to enhance patient engagement and outpatient care continuity. Prevounce Health and PainScored prioritized preventive care and chronic disease management to streamline care processes and improve patient compliance. Lastly, PatchRx introduced innovative medication adherence technology, illustrating the potential of digital solutions to address common drug misuse challenges. Choice of a digital health platform should be guided by the specific patient population needs and operational workflow.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e221"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-28DOI: 10.1016/j.pmn.2025.01.078
Kaylyn Williams MSN, RN, AHN-BC, NEA-BC, Mariah Pierre BSN, MEDSURG-BC, HNB-BC
Purpose, problem statement, PICO: The objective of this pilot was to use a quasi-experimental, quality improvement design to assess both the feasibility and impact of an acupuncture service within an inpatient setting.
Summary/Synthesis of Evidence: 1 level 1 article, 2 level 2 articles. 2 level 3 articles, 3 level 5 articles showing good and consistent evidence warranting a pilot.
Method of Evaluation/Validation of Evidence: All eligible inpatients admitted to pilot units over a 6-month period were offered acupuncture services regardless of diagnosis. Pilot interventions included implementation of an initial acupuncture service and follow-up services as able. Pre- and post-acupuncture symptom assessment was recorded using a modified Edmonton Symptom Assessment System scale.
Results/Relevance to Pain Management: Among 136 matched observations with complete pre- and post-acupuncture notes, there was significant improvement in average pain, anxiety, nausea, and well-being scores (p<0.001 for each). The largest impact was a reduction in average pain score of -1.6 (95%CI -1.89, -1.31).
Future Implications for Nursing Profession: Acupuncture is a low risk, non-pharmacological, integrative care intervention. It has proven to be effective with symptom management among hospitalized patients on the oncology medical-surgical units. This pilot demonstrated both feasibility and improvement of symptoms and overall well-being. No adverse events were reported during this pilot.
{"title":"Inpatient Acupuncture for Symptom Management: A Pilot Feasibility Project","authors":"Kaylyn Williams MSN, RN, AHN-BC, NEA-BC, Mariah Pierre BSN, MEDSURG-BC, HNB-BC","doi":"10.1016/j.pmn.2025.01.078","DOIUrl":"10.1016/j.pmn.2025.01.078","url":null,"abstract":"<div><div>Purpose, problem statement, PICO: The objective of this pilot was to use a quasi-experimental, quality improvement design to assess both the feasibility and impact of an acupuncture service within an inpatient setting.</div><div>Summary/Synthesis of Evidence: 1 level 1 article, 2 level 2 articles. 2 level 3 articles, 3 level 5 articles showing good and consistent evidence warranting a pilot.</div><div>Method of Evaluation/Validation of Evidence: All eligible inpatients admitted to pilot units over a 6-month period were offered acupuncture services regardless of diagnosis. Pilot interventions included implementation of an initial acupuncture service and follow-up services as able. Pre- and post-acupuncture symptom assessment was recorded using a modified Edmonton Symptom Assessment System scale.</div><div>Results/Relevance to Pain Management: Among 136 matched observations with complete pre- and post-acupuncture notes, there was significant improvement in average pain, anxiety, nausea, and well-being scores (p<0.001 for each). The largest impact was a reduction in average pain score of -1.6 (95%CI -1.89, -1.31).</div><div>Future Implications for Nursing Profession: Acupuncture is a low risk, non-pharmacological, integrative care intervention. It has proven to be effective with symptom management among hospitalized patients on the oncology medical-surgical units. This pilot demonstrated both feasibility and improvement of symptoms and overall well-being. No adverse events were reported during this pilot.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e234"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-28DOI: 10.1016/j.pmn.2025.01.077
Janet Jay, Nicole Hemmenway CEO
There is a fractured relationship between providers and patients living with chronic pain. Chronic pain is under-researched, and patients living with this pain are under-served. Many of them feel marginalized and unheard. The session aims to highlight the importance of actively listening to patients' experiences of pain and integrating their perspectives into future nursing practice. By doing so, we can improve pain management outcomes. Attendees will learn from the narratives of real-life individuals, emphasizing the significance of incorporating patient insights into care decisions. Attendees will be encouraged to critically evaluate the applicability of listening to and incorporating the patient experience into their practice settings. The session will demonstrate how patient-centered approaches can lead to tangible improvements in pain management practices and highlight the broader implications for the nursing profession.
{"title":"Amplifying the Patient Voice: Enhancing Pain Management through Active Listening in Nursing Practice","authors":"Janet Jay, Nicole Hemmenway CEO","doi":"10.1016/j.pmn.2025.01.077","DOIUrl":"10.1016/j.pmn.2025.01.077","url":null,"abstract":"<div><div>There is a fractured relationship between providers and patients living with chronic pain. Chronic pain is under-researched, and patients living with this pain are under-served. Many of them feel marginalized and unheard. The session aims to highlight the importance of actively listening to patients' experiences of pain and integrating their perspectives into future nursing practice. By doing so, we can improve pain management outcomes. Attendees will learn from the narratives of real-life individuals, emphasizing the significance of incorporating patient insights into care decisions. Attendees will be encouraged to critically evaluate the applicability of listening to and incorporating the patient experience into their practice settings. The session will demonstrate how patient-centered approaches can lead to tangible improvements in pain management practices and highlight the broader implications for the nursing profession.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e233-e234"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This systematic review aims to evaluate the effectiveness of cold application techniques for postoperative pain management in arthroscopic surgeries. The problem it addresses is the need for more consistency in the effectiveness of these techniques, as reported by various studies.
Population (P): Adult Patients undergoing arthroscopic surgeries
Articles were scanned using Turkish and English keywords among the 2,366 obtained. From various databases, 2,352 were excluded due to study year, language, non-randomized controlled trials, studies not conducted in intensive care units, and repetitions. Fourteen studies met the inclusion criteria. The review includes seven randomized controlled trials and seven quasi-experimental designs focusing on cold application techniques for managing postoperative pain. The synthesis showed that cold applications, mainly cryotherapy, and cryotherapy with compression, significantly reduced postoperative pain and swelling.
Method of Evaluation
Studies were assessed for quality based on relevance to the research question and robustness of findings. The focus was on cold application types, pain and swelling measurement, patient satisfaction, and functional recovery outcomes. The systematic analysis revealed patterns and discrepancies among studies.
Results
Most studies showed that cold application techniques significantly help reduce postoperative pain and swelling. The expected benefits included enhanced patient satisfaction and improved functional recovery. Kraeutler et al. found compressive cryotherapy superior to standard ice application for patient comfort and pain reduction. The findings suggest cold applications will likely enhance patient outcomes post-arthroscopic surgeries.
Future Implications for the Nursing Profession
Nurses should implement and maximize cold application practices during postoperative care. Standardizing such practices can optimize benefits. Future research should explore long-term results for different patient populations and various arthroscopic surgeries. Developing evidence-based practice guidelines for these modalities can significantly enhance nursing practice to improve postoperative patient comfort, satisfaction, and functional recovery.
{"title":"The Effect of Cold Application in Postoperative Pain Management of Arthroscopic Surgeries: A Systematic Review","authors":"Gamze Bozkul PhD, RN , Hande Nur Arslan PhD Candidate, RN , Mehmet Avcul PhD Student, RN , Sevilay Şenol Çelik PhD, RN","doi":"10.1016/j.pmn.2025.01.037","DOIUrl":"10.1016/j.pmn.2025.01.037","url":null,"abstract":"<div><h3>Purpose, problem statement, PICO</h3><div>This systematic review aims to evaluate the effectiveness of cold application techniques for postoperative pain management in arthroscopic surgeries. The problem it addresses is the need for more consistency in the effectiveness of these techniques, as reported by various studies.</div><div>Population (P): Adult Patients undergoing arthroscopic surgeries</div><div>Intervention (I): Cold applications (cryotherapy, cold compression therapy, etc.)</div><div>Comparison (C): Routine postoperative care</div><div>Outcome (O): Pain intensity reduction</div></div><div><h3>Synthesis of Evidence</h3><div>Articles were scanned using Turkish and English keywords among the 2,366 obtained. From various databases, 2,352 were excluded due to study year, language, non-randomized controlled trials, studies not conducted in intensive care units, and repetitions. Fourteen studies met the inclusion criteria. The review includes seven randomized controlled trials and seven quasi-experimental designs focusing on cold application techniques for managing postoperative pain. The synthesis showed that cold applications, mainly cryotherapy, and cryotherapy with compression, significantly reduced postoperative pain and swelling.</div></div><div><h3>Method of Evaluation</h3><div>Studies were assessed for quality based on relevance to the research question and robustness of findings. The focus was on cold application types, pain and swelling measurement, patient satisfaction, and functional recovery outcomes. The systematic analysis revealed patterns and discrepancies among studies.</div></div><div><h3>Results</h3><div>Most studies showed that cold application techniques significantly help reduce postoperative pain and swelling. The expected benefits included enhanced patient satisfaction and improved functional recovery. Kraeutler et al. found compressive cryotherapy superior to standard ice application for patient comfort and pain reduction. The findings suggest cold applications will likely enhance patient outcomes post-arthroscopic surgeries.</div></div><div><h3>Future Implications for the Nursing Profession</h3><div>Nurses should implement and maximize cold application practices during postoperative care. Standardizing such practices can optimize benefits. Future research should explore long-term results for different patient populations and various arthroscopic surgeries. Developing evidence-based practice guidelines for these modalities can significantly enhance nursing practice to improve postoperative patient comfort, satisfaction, and functional recovery.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e221-e222"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospitalized patients have come to rely on the immediate pain relief afforded by intravenous (IV) opioids. Often appropriate upon admission, as needed, prolonged IV opioid orders remain active even after the patient's conditions improves. If prn opioids are ordered and the patient asks for the IV opioid, the RN feels obligated to administer the medication. Recent medical guidelines urged hospitalists to adhere to prescribing strategies that favor the oral route when the patient does not have gastrointestinal dysfunction. Prolonged IV opioid use, when other routes are available, can carry significant risks. These risks include more side effects, medication errors, and potential downstream improper opioid use post hospitalization. In addition, opioids administered intravenously, rapidly reach the reward and euphoria brain centers. This produces reinforcement in patients. Reinforcement is escalated when repeated doses of IV opioids are administered; this may lead to habitual and eventual problematic opioid use post hospitalization. The Acute Pain Service (APS)is an interdisciplinary nursing/pharmacy team at a 901-bed hospital in Sarasota, Florida. Using descriptive statistics, the team examined the medical records of one hundred patients after an electronic alert fired. The alert signaled that the patient had received twelve doses of IV opioid during his hospitalization. We questioned whether APS recommendations would ultimately change prolonged opioid orders. Of the one hundred patients studied, physicians accepted 45% of the APS recommendations. Many physicians were unaware that their patients were continuing to receive IV opioids. Prolonged IV opioid orders were deemed appropriate (55%) in hospice situations, short time IV opioid use situations and in those patients who were discharged shortly after the alert fired. Given the national emphasis on curbing prescription opioid use, this presentation has implications for acute care nurses. Learn how the APS manages the alert using a critical thinking algorithm including approaching both patients and physicians. Concepts discussed will enable nurses to deliver safe analgesic care.
{"title":"Only the IV Dilaudid works for me","authors":"Diane Scheb MSN RN, AP-PMN, PMGT-BC, Kaylyn (Katie) Williams MSN, RN, AHN-BC, NEA-BC","doi":"10.1016/j.pmn.2025.01.076","DOIUrl":"10.1016/j.pmn.2025.01.076","url":null,"abstract":"<div><div>Hospitalized patients have come to rely on the immediate pain relief afforded by intravenous (IV) opioids. Often appropriate upon admission, as needed, prolonged IV opioid orders remain active even after the patient's conditions improves. If prn opioids are ordered and the patient asks for the IV opioid, the RN feels obligated to administer the medication. Recent medical guidelines urged hospitalists to adhere to prescribing strategies that favor the oral route when the patient does not have gastrointestinal dysfunction. Prolonged IV opioid use, when other routes are available, can carry significant risks. These risks include more side effects, medication errors, and potential downstream improper opioid use post hospitalization. In addition, opioids administered intravenously, rapidly reach the reward and euphoria brain centers. This produces reinforcement in patients. Reinforcement is escalated when repeated doses of IV opioids are administered; this may lead to habitual and eventual problematic opioid use post hospitalization. The Acute Pain Service (APS)is an interdisciplinary nursing/pharmacy team at a 901-bed hospital in Sarasota, Florida. Using descriptive statistics, the team examined the medical records of one hundred patients after an electronic alert fired. The alert signaled that the patient had received twelve doses of IV opioid during his hospitalization. We questioned whether APS recommendations would ultimately change prolonged opioid orders. Of the one hundred patients studied, physicians accepted 45% of the APS recommendations. Many physicians were unaware that their patients were continuing to receive IV opioids. Prolonged IV opioid orders were deemed appropriate (55%) in hospice situations, short time IV opioid use situations and in those patients who were discharged shortly after the alert fired. Given the national emphasis on curbing prescription opioid use, this presentation has implications for acute care nurses. Learn how the APS manages the alert using a critical thinking algorithm including approaching both patients and physicians. Concepts discussed will enable nurses to deliver safe analgesic care.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e233"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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