Evaluation of an Acute Pain Service

Kitowski, Terri; Mcneil, Helena

doi:10.1053/jpan.2002.30244

Cited by 8 publications

(2 citation statements)

References 9 publications

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“…It is essential to periodically assess the acute pain service to identify its strengths and weaknesses as well as strategies for future development and improvement . Key performance indicators should be identified and may include adherence to important components in pain management such as pain assessment, its documentation, complications, and response times.…”

Section: The Ideal Acute Pain Servicementioning

confidence: 99%

Developing a pediatric pain service

Kost‐Byerly

Chalkiadis

2012

Pediatric Anesthesia

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Pediatric pain services were first established in larger pediatric centers over two decades ago. Children's acute pain was poorly managed at the time owing to misconceptions, safety concerns, and variability in practice. While many larger pediatric centers now have acute pain services, there remains a need for better pain management in facilities and geographic locations with fewer resources. Institutional acknowledgement and desire to change, appropriate staffing, and funding are major obstacles. Better recognition and assessment as well safer and more efficacious treatment of pain are the principal objectives when establishing a pain service. It is important to determine whether the proposed service intends to treat acute, chronic, procedural, and/or cancer and palliative pain as each requires different skills and resources. An ideal and comprehensive pediatric pain service should be equipped to diagnose and treat acute, persistent (chronic), procedural, and cancer/palliative pain. It is not feasible or necessary for every hospital to manage all. Establishing the scope of practice (based on case mix and caseload) in any given hospital will determine which resources are desired. Country-specific standards, local staffing, and fiscal constraints will influence which resources are available.

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Section: The Ideal Acute Pain Servicementioning

confidence: 99%

Developing a pediatric pain service

Kost‐Byerly

Chalkiadis

2012

Pediatric Anesthesia

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“…Nurses often don't receive adequate training to interpret pediatric analgesic medication orders and pain intensity scales, and often lack the authority or training to administer PRN medication orders well (19)(20)(21)(22)(23) Few Mexican hospitals have pain services or pain clinics that manage or provide consultation on pediatric pain management.…”

Section: The Selection Of Analgesic Varied Pediatric and General Surmentioning

confidence: 99%

Errors in Managing Postsurgical Pediatric Pain in Mexico

Matus¹,

Zúñiga²

2011

Journal of Pain & Palliative Care Pharmacotherapy

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Postoperative pain is a subjective symptom that has been extensively studied in adults, but only minimally in children. In children, use of low analgesic doses and failure to document the pain and its management are common concerns. In newborns and infants pain is difficult to interpret. This was a double-blind, prospective, multicenter observational study conducted in four public Mexican hospitals to identify analgesic use. One hundred subjects were enrolled at each institution and monitored for 24 to 48 hours following surgery. Data were collected on 152 girls and 248 boys ranging in age from newborns to 14 years. Nearly 300 (290) underwent major procedures; 110 had short stay surgery. The most common analgesics used were paracetamol and dipyrone at low doses. Less frequently ibuprofen or another anti-inflammatory was used. Many children received no analgesic, including 30 newborns, and others received only one or two analgesic doses. Fifteen burn patients received ketorolac. The occurrence and characteristics of the pain were poorly documented in all four hospitals. Postoperative pain causes suffering and can prolong hospital stays. Graphic pain intensity scales exist to evaluate pain, but use of them was not documented in medial records. Nurses and doctors in training did not have the skills needed to evaluate pain. The study revealed errors in pain management and fear among staff in using high doses of common analgesics. The study results document patterns of care in most Mexican hospitals today and indicate a need for pain management training for Mexican doctors and nurses.

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