{"title":"Revolutionizing Healthcare Dynamics: An Innovative Masterclass on Conflict Management, Psychological Safety and Stellar Communication for Nurses and Nurse Practitioners","authors":"Michelle Lavelle-Henry APRN, ACHPN CNP, PMGT-BC, ACHPN , Scott Faust Ed.D, MS, APRN, CNP, ACNP-BC, ACNP-C, ACHPN, CEN, CNMAP, PHN","doi":"10.1016/j.pmn.2025.01.089","DOIUrl":"10.1016/j.pmn.2025.01.089","url":null,"abstract":"<div><div>Purpose, problem statement: Conflict management is integral to effective pain management nursing practice, yet nurses often lack comprehensive training in this area. This abstract outlines the development and implementation of a conflict management training program tailored specifically for nurses specializing in pain management. The program aims to address the lack of formalized conflict resolution training within this specialized field, ultimately enhancing patient care outcomes and promoting a supportive work environment.</div><div>Method of Evaluation/Validation of Evidence: The development of the conflict management training program draws upon evidence-based practices in conflict resolution, adult learning principles, and input from pain management nursing experts. The program design incorporates interactive workshops, case studies, role-playing exercises, and peer-to-peer discussions to facilitate active learning and skill acquisition. Evaluation methods include pre- and post-training assessments, participant feedback surveys, and observational data to measure the program's effectiveness in enhancing conflict management competencies among nurses.</div><div>Summary/Synthesis of Evidence: The evidence supporting the need for conflict management training in pain management nursing stems from various sources, including studies highlighting the prevalence of workplace conflicts and their detrimental effects on patient care and staff morale. Additionally, literature emphasizes the importance of effective communication and collaboration in pain management settings, underscoring the necessity for conflict resolution skills among nursing professionals.</div><div>Results/Relevance to Pain Management: Preliminary results indicate a significant improvement in nurses' confidence and proficiency in managing conflicts related to pain management scenarios post-training. Participants report enhanced communication skills, increased knowledge of conflict resolution strategies, and greater collaboration within interdisciplinary teams. These findings underscore the relevance of targeted conflict management training in improving patient care quality and fostering a positive work environment within pain management settings.</div><div>Future Implications for Nursing Profession: The implementation of conflict management training programs tailored to the unique needs of pain management nurses holds promising implications for the nursing profession. By equipping nurses with essential con</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e237-e238"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715216","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}
{"title":"Evidence to guide nursing support of post-amputation pain","authors":"Tonya Rich PhD, OTR/L","doi":"10.1016/j.pmn.2025.01.071","DOIUrl":"10.1016/j.pmn.2025.01.071","url":null,"abstract":"<div><div>There is a growing population of individuals experiencing amputation due to dysvascular causes. Post-amputation pain (i.e., residual limb pain and phantom limb pain) and sensation (i.e., phantom limb sensation) is common after an amputation. These pain conditions can become persistent and hard-to-treat. All healthcare team members play a critical role in supporting this population including the nursing profession.</div><div>The purpose of this presentation to share current state of research on post-amputation pain and sensation assessment and intervention being conducted at the Minneapolis VA Health Care System.</div><div>Research methods discussed will include qualitative (i.e., interviews and focus groups) and quantitative methods and data. These methods have been used within several studies to learn more about the assessment and treatment of post-amputation pain. From these studies, we have continued to pursue practical, novel assessment and interventions for post-amputation pain. The research methods build upon pain neuroscience education which is a framework for pain treatment that can be used by all members of the health care team, including nursing.</div><div>Results will discuss key findings from our research in clinicians and our local Veteran sample with implications for the use of language, normalizing discussion of these post-amputation conditions, and awareness of novel rehabilitation interventions including those that use augmented reality.</div><div>The implications of this presentation will support the collaborative nature of nursing within comprehensive rehabilitation programs and build foundational knowledge.</div><div>Future research includes continuing to develop novel assessment and intervention approaches for post-amputation with a focus on feasibility and acceptability. Our research is focused on translational outcomes and how we might be able to change the care and long term trajectories of this population. This work will position us well for future multicenter clinical trials.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e231-e232"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715219","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}
{"title":"Utilization of a Multidisciplinary Comfort Team to Decrease Pain and Anxiety in the Pediatric Medical Setting","authors":"Lindsey Cramer BA, CCLS, Meredith Loring McCulloch MA, ATR-BC, PC, REAT, Shannon Pignatiello MSN, APRN, CPNP, CPN, CCRN","doi":"10.1016/j.pmn.2025.01.066","DOIUrl":"10.1016/j.pmn.2025.01.066","url":null,"abstract":"<div><div>Medical procedures, testing, and monitoring are often anxiety-provoking and psychologically traumatizing to pediatric patients and their families. Outdated practices such as physical holds and inadequate pain control and prevention are unfortunately still occurring in the pediatric setting. These, and other limiting practices, can be mitigated with the use of a pediatric comfort team. At this 400-bed children's hospital within a large, Midwestern health system, a multidisciplinary team was developed about 10 years ago and continues to grow. The team's goal is to ensure that every pediatric patient within the Enterprise receives evidence-based and developmentally appropriate comfort measures at every encounter. Our process includes researching relevant techniques, working diligently to implement initiatives into practice, and providing education to medical staff, patients, and families. The comfort team is comprised of certified child life specialists, creative arts therapists, nursing, and provider staff who meet monthly to review current evidence in pharmaceutical and non-pharmaceutical interventions to improve coping. Pharmaceutical options include the use of topical numbing ointment, needleless lidocaine injection, oral sucrose, minimal sedation, pain medication, and others. Non-pharmaceutical options include use of vapocoolant spray, equipment grounded in the gate control theory including vibration and other sensory items, distraction, and comfort positioning. The team also provides focused education during onboarding orientation of pediatric resident physicians and newly hired nurses. Other initiatives include monthly newsletters highlighting specific comfort measures distributed to all pediatric care providers, just in time education in the care areas, an annual comfort fair which features comfort options available at the health system, new product rollouts, and participation in safety fairs. Fostering collaboration between the comfort team and pediatric leaders in these ways will ensure that the goal of improving coping for every pediatric patient within the Enterprise is achieved now and in the future.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e229-e230"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715494","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}
{"title":"The Landscape of Urine Drug Testing: Past, Present and Future.","authors":"Steven Passik PhD","doi":"10.1016/j.pmn.2025.01.047","DOIUrl":"10.1016/j.pmn.2025.01.047","url":null,"abstract":"<div><h3>Purpose</h3><div>To enhance patient adherence/safety, tactical use of urine drug testing for substances beyond opioids can be crucial though its role has not been well articulated</div></div><div><h3>Summary</h3><div>Understanding psychiatric comorbidity and adherence with prescribed psychiatric medications, use of non-opioid analgesics, use of legal substances with abuse potential such as cannabis, ketamine and alcohol can lead to benefits in terms of patient safety and outcomes</div></div><div><h3>Method of Evaluation</h3><div>Literature review</div></div><div><h3>Results</h3><div>Monitoring of adherence and use of a range of substances and treatments beyond solely opioids is supportive of improved outcomes</div></div><div><h3>Future Implications for Nursing Profession</h3><div>Pain management nurses should become proficient in the tactical use of urine drug testing to ensure patient adherence and safety</div><div>Problem Statement/Background: The role of urine drug testing of people with chronic pain in the post opioid/overdose epidemic era is evolving. Opioid prescribing has decreased by 46% nationally, and the role of definitive drug testing is less closely tied to the monitoring of prescribed controlled substances.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e223"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715098","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}
{"title":"Ketamine in the Outpatient population","authors":"Brandi Obrien RN-BC, CPNP-AC, AGPNP-BC, MSN, PHN, CHPN, OCN","doi":"10.1016/j.pmn.2025.01.039","DOIUrl":"10.1016/j.pmn.2025.01.039","url":null,"abstract":"<div><div>Session Abstract: Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist which has traditionally been utilized as a general, dissociative anesthetic, indicated for short diagnostic and surgical procedures. The NMDA receptor is in a calcium channel closely involved in the development of central (dorsal horn) desensitization. This channel has a role in opioid resistant pain, neuropathic pain, allodynia and hyperalgesia. During this power session, we will examine its role in pain management in the hospice setting for one adult case and one pediatric case. We will examine Ketamine's role in persistent pain, its efficacy, implication for clinical practice, side effects and nurse protocol monitoring. We will discuss future implications or outpatient use of oral Ketamine in patients with persistent pain.</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":"143715119","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}
{"title":"Pain and Other Comorbid Symptoms Profiles in Cancer Patients on Immunotherapy","authors":"Gee Su Yang PhD, RN","doi":"10.1016/j.pmn.2025.01.021","DOIUrl":"10.1016/j.pmn.2025.01.021","url":null,"abstract":"<div><div>A growing challenge in extended survivorship is pain and other comorbid symptoms. These symptoms can be aggravated by the use of new cancer treatment, including immunotherapy, which manipulates the immune system to fight cancer cells. While toxic events associated with immunotherapy have been well accepted by clinicians, psychoneurological (PN) symptoms are typically underestimated in clinical settings even though symptoms can affect treatment outcomes and quality of life. There has been no specific focus on PN symptoms in patients with cancer receiving immunotherapy and relevant biomarkers.</div><div>The purpose of this pilot study is to elucidate the PN symptom profiles and gut microbiome characterization in cancer patients receiving immunotherapy.</div><div>In a cross-sectional, observational study design, we collected questionnaire data on PN symptoms, as well as saliva and fecal samples for a subset of inflammatory cytokine quantification and gut microbiome analysis. Sample characteristics were described using mean and frequency. We used Pearson's correlation and the Mann-Whitney U test.</div><div>17 immunotherapy-treated patients and 19 age-matched health controls, with a mean age of 68.72±9.68 years (male=17, female=19), were enrolled. Patients have received immunotherapy for an average of 9.47 months, and 70.6% had melanoma/skin cancer. Pembrolizumab was administered to 58.8%, and Nivolumab to 17.6%. Patients on immunotherapy reported greater fatigue than healthy controls (BFI now: 3.35±2.55 vs. 1.84±2.43, p=.034; BFI usual: 3.88±2.67 vs. 1.79±2.20, p=.015). However, the mean scores for pain (BPI average: 1.47±2.21 vs. 1.89±2.38, p=.594), depression (HADS: 3.65±3.18 vs. 2.26±3.53, p=.062), perceived cognitive abilities (FACT-Cog: 20.76±8.17 vs. 22.42±6.75, p=.873), sleep disturbance (GSDS: 37.29±14.96 vs. 42.16±27.64, p=.787), and stress (10.53±6.90 vs. 10.89±6.78, p=1.000) showed no significant differences between both groups. There was no significant correlation of pain presence with C-reactive protein (p=.437), IL-1β (p=.617), and IL-6 (p=.815).</div><div>This preliminary data suggests that patients on immunotherapy report pain levels similar to those of healthy controls. However, patients may experience greater fatigue during immunotherapy treatment. A larger study can facilitate the development of a more comprehensive care plan for monitoring and supporting patients after immunotherapy and identify the brain-gut-microbiota mechanism underlying these symptoms in immunotherapy.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e216"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715201","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}
Lena Ngo RN, MSN, CNS , Marilyn Bazinski DNP, AGCNS, RN, PMGT-BC
{"title":"Synergy of Pain Resource Nurses and Technology to Improve Pain Reassessment Scores","authors":"Lena Ngo RN, MSN, CNS , Marilyn Bazinski DNP, AGCNS, RN, PMGT-BC","doi":"10.1016/j.pmn.2025.01.069","DOIUrl":"10.1016/j.pmn.2025.01.069","url":null,"abstract":"<div><h3>Purpose</h3><div>UCSFs monthly Pain Resource Nurse (PRN) meetings aim to improve nurse knowledge about evidence-based pain practices, including required pain and sedation reassessments after opioid administration. This presentation will highlight how engaging PRNs with dashboard data can improve nursing reassessments after ‘as needed’ opioid administration in hospitalized patients.</div></div><div><h3>Summary</h3><div>Timely reassessments across all populations and settings help healthcare teams determine treatment efficacy or adverse effects related to analgesia. Enforcing established reassessment timeframes and EHR reminders help promote a culture of safety and quality patient care. Having designated PRNs positively influences nursing practice.</div></div><div><h3>Method of Evaluation</h3><div>Administering ‘as needed’ opioids is a key nursing task, yet reassessments are frequently missing from electronic health records (EHRs). Regulatory standards mandate hospitals screen, assess, and reassess pain in all patients, and create reports to monitor performance. In June of 2021, the Pain Management Clinical Nurse Specialist (CNS) launched a pain dashboard to measure pain reassessments after ‘as needed’ IV and oral opioids per policy-driven timeframes. It offers interactive and longitudinal data visualizations of unit and nurse-specific pain reassessments. A summary page displays total number of IV and oral opioids administered and completed reassessments for each route. Variable methods help visualize and analyze completed or missing documentation.</div></div><div><h3>Results/Relevance</h3><div>Initially, 52% of administrations had completed both pain and sedation reassessments. Gradually, PRNs and nursing leaders adopted quality improvement initiatives to increase unit and nurse scores. With the dashboard, overall scores are now sustained over 70%, with select units at nearly 90%. Reassessments have prevented adverse patient outcomes, fostered improved performance evaluations, and will serve as an exemplar for an upcoming advanced surgical certification.</div></div><div><h3>Future Implications</h3><div>Staff nurses are restricted from direct access to the Dashboard due to its sensitive patient and nurse data but encouraged to partner with their leaders to develop unit-based strategies for staff engagement. The pain dashboard has been instrumental for the enterprise to recognize gaps and to improve pain and sedation reassessment scores while aligning practice with policy and regulatory requirements.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e230-e231"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715217","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}
{"title":"Refresh, Reset, Reframe Your Clinical Interactions with NDM","authors":"Karen Maree Pike RN, MSN, OCN, PMGT-BC, Dip. Hom. Swedish Massage Technician, S4OM Preferred Practitioner, ASPMN, DEDH USA, ONS, GLAONS, S4OM","doi":"10.1016/j.pmn.2025.01.073","DOIUrl":"10.1016/j.pmn.2025.01.073","url":null,"abstract":"<div><div>The intention of this power presentation is for participants to gain understanding of the delivery of a 30 to 120 sec hand and foot massage for integration into clinical practice, benefitting recipient and provider, in a post minimum contact era. The goal is for providers in any setting to feel confident, comfortable and able to recognize opportunities for integrating NDM into interactions with pain management patients of any age safely.</div><div>Living out pain experience is challenging in and of itself . Accessing healthcare system can be difficult on a good day, becomes daunting when accompanied by pain. Providers pressed for time with multiple responsibilities, often are not privy to what it took for a patient/client to get to appointments. NDM can change the tone of an encounter, reframing and resetting it towards positive outcomes for recipient and provider.</div><div>NDM, is a non-pharmacological intervention, paraphrasing Andy Roman RN, MT, NBCC, it combines the nursing process thoroughness with massages intuitive somatic intelligence.</div><div>Activating the parasympathetic nervous system, decreasing sympathetic nervous system activity, initiating Relaxation Response, prompting endorphins, oxytocin, serotonin & dopamine release occur with NDM. Cortisol levels are decreased, lymphatic system stimulated, NDM also affects all four tissue types.</div><div>Studies have shown nurses experiencing compassion fatigue benefited from delivering massage.</div><div>Requiring no special equipment NDM can be delivered in any setting at any “side’– chair, wheelchair, bed, stretcher, cot, crib. It can be delivered Over The Sheets (OTS) and Over The Clothes (OTC). It is possible in 30-120 seconds to integrate an NDM into an interaction.</div><div>Utilizing acupressure points, modified Swedish Massage strokes and core massage modifications (positioning, pressure, pace, site, product) NDM can be adapted to accommodate medical conditions (eg. Blood clots, lymphedema etc) and medical devices NDM can be delivered safely to patients of any age. Suitable for the medically frail, compassionately delivered NDM is often the only touch, and only “good” touch recipient has received over an extended period.</div><div>Strengthened Nurse/Patient/Client relationships, reduced stress, improved physiological and psychological comfort, being present/centered in the moment, make learning about and applying NDM in practice relevant to pain management.</div><div>Basic human need drives the need of physical touch (and affection).</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e232"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715221","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}
{"title":"PainSpeak: What to Do When Nothing Works - Navigating Sensitive Conversations with Individuals Who Are Experiencing Persistent Pain","authors":"Scott Faust Ed.D, MS, APRN, CNP, ACNP-BC, ACNP-C, ACHPN, CEN, CNMAP, PHN","doi":"10.1016/j.pmn.2025.01.086","DOIUrl":"10.1016/j.pmn.2025.01.086","url":null,"abstract":"<div><div>Purpose, problem statement: This abstract explores the integration of mediation and restorative circle processes into pain management to improve patient adherence, satisfaction, and outcomes. Challenges persist in effective pain management, necessitating innovative approaches.</div><div>Summary/Synthesis of Evidence: Literature demonstrates the efficacy of mediation and restorative circles in fostering dialogue, understanding, and collaboration in healthcare. These processes enhance patient empowerment and engagement, leading to improved adherence and satisfaction with pain management interventions.</div><div>Method of Evaluation/Validation of Evidence: Evidence synthesis involves systematic reviews, meta-analyses, and empirical studies from reputable databases. Rigorous evaluation tools ensure the validity of selected studies, supplemented by expert consensus and clinical guidelines.</div><div>Results/Relevance to Pain Management: Mediation and restorative circles facilitate collaborative decision-making, address barriers to adherence, and promote patient-centered care. Studies indicate enhanced patient adherence, communication, and satisfaction with pain management interventions through these processes.</div><div>Future Implications for Nursing Profession: Nurses play a crucial role in facilitating mediation and restorative circles, driving patient-centered care in pain management. Future research should investigate implementation strategies and mechanisms influencing outcomes in diverse healthcare settings.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e236-e237"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715307","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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