Continuous local anesthetics.
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Biomedical subjects
Publications and source records attributed to C Pasero.
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In 1997, the University of Wisconsin began working collaboratively with the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) to integrate pain assessment and treatment into the JCAHO standards and accreditation processes. Pain care committees are an effective mechanism for implementing these changes. The authors discuss the critical role nurse managers can play in the development and success of these committees' activities.
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The purpose of this study was to investigate staff nurses' perceptions of barriers to pain management including lack of educational preparation; inadequacy of clinical practice skills; and certain legal/political, financial, and ethical problems. Staff nurses rated the adequacy of their knowledge and skills in each of these areas as well as how important they believed each area was on a four-point Likert scale (1 = very inadequate or very unimportant to 4 = very adequate or very important). Nurses were also asked to list the most important pain management problems in their institutions. A random sample of 24 hospitals stratified on the basis of size was drawn from four states in the United States. Of 125 nurses contacted, 108 (86%) responded to the questionnaire. Nurses rated their educational preparation (mean, 2.6; SD, 0.05) and knowledge of legal/political issues (mean, 2.3; SD, 0.05) midway between inadequate and adequate. Practice was rated as adequate (mean 3.1; SD, 0.36), and financial issues were rated as inadequate (mean, 1.9; SD, 0.06). Knowledge of ethical issues was adequate (mean, 3.1; SD, 0.03). Implications of these ratings based on the literature in pain management are discussed.
Four infections were identified among 4,832 patients receiving epidural analgesia (an attack rate of 0.08%). The infections involved cesarean-section patients and occurred within a 9-month period. Findings suggest that the risk of infection is decreased by maintaining a closed system for the duration of the analgesia course.
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