Pain Management Nursing最新文献

{"title":"Development of a Risk Assessment Index System of Non-Specific Neck-Shoulder Pain in Physicians and Nurses: A Delphi and Analytic Hierarchy Process Study in China","authors":"Yunxia Li Ph.D. ,&nbsp;Qi Li M.S. ,&nbsp;Lihui Zhang M.S. ,&nbsp;Yamin Li Ph.D. ,&nbsp;Sue Yuan Ph.D.","doi":"10.1016/j.pmn.2025.08.008","DOIUrl":"10.1016/j.pmn.2025.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Physicians and nurses experience a high prevalence of non-specific neck-shoulder pain (NNSP) and are exposed to multiple risk factors. However, no targeted tools comprehensively assess these risk factors.</div></div><div><h3>Objective</h3><div>This study aimed to develop assessment indicators for evaluating risk factors contributing to NNSP among physicians and nurses.</div></div><div><h3>Design</h3><div>A systematic literature review and Delphi method, guided by a theoretical framework, were employed to develop the index system.</div></div><div><h3>Methods</h3><div>This study utilized a theoretical framework based on ergonomics and the biopsychosocial pain model to collect multi-source data for developing a risk assessment index system. Initially, candidate indicators were identified through literature reviews, theoretical analysis, expert interviews, and consultations. Three rounds of the e-Delphi technique were conducted to identify indices potentially affecting neck-shoulder pain. Finally, the analytic hierarchy process (AHP) method was employed to calculate the relative weight of each indicator.</div></div><div><h3>Results</h3><div>After two rounds of expert consultation, the risk assessment index system reached a consensus, comprising six first-level indicators: workload factors, individual factors, work facilities and equipment factors, workspace and environment factors, organization management factors, and psychological factors. These were further divided into 14 second-level indicators and 82 third-level indicators. Among these, workload factors had the highest weight (0.2484), while psychological factors had the lowest (0.1019).</div></div><div><h3>Conclusion</h3><div>The risk assessment index system achieved expert consensus, confirming its scientific validity and practical applicability. It provides a structured approach to identifying risk factors and high-risk individuals for neck-shoulder pain among physicians and nurses.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Pages e198-e206"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080531","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 Experience and Expectations in Oncological Outpatient and Their Caregivers: Phenomenological Study","authors":"Alícia Minaya-Freire PhD, MSc, RN ,&nbsp;Gemma Pou-Pujol RN ,&nbsp;Sílvia Carbonell-Palau PhDc, MSc, RN ,&nbsp;Laura Montero-Aliguer MSN, RN ,&nbsp;Érica Izquierdo-Sánchez MSN, RN ,&nbsp;Ester Fontseré-Candell MSN, RN ,&nbsp;Amal Andich RN ,&nbsp;Anna Ramon-Aribau PhD","doi":"10.1016/j.pmn.2025.08.011","DOIUrl":"10.1016/j.pmn.2025.08.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify the pain experiences of cancer patients and the expectations of patients and caregivers in relation to pain management.</div></div><div><h3>Design</h3><div>Phenomenological qualitative study.</div></div><div><h3>Methods</h3><div>We used convenience sampling to recruit patients who had experienced pain level ≥4 according to the Numeric Rating Scale and their caregivers. The interview script was developed from the Nursing Outcomes Classification. We conducted a narrative analysis of the content.</div></div><div><h3>Results</h3><div>Eleven participants (eight patients and three caregivers) were included. The results were grouped into three main themes: 1) the experience of pain: the description and consequences of pain on participants’ lives, and the meaning it has for patients and caregivers; 2) pain management: pharmacological and non-pharmacological pain management, the support of friends and family, and the lack of references and empowerment in pain management), and 3) expectations: communication with professionals, care by nurses, and pain relief and support.</div></div><div><h3>Conclusions</h3><div>The participants’ oncological pain was intense, persistent and complex. Outpatient management of pain was difficult and was conditioned by the knowledge of patients and caregivers, but also by the professional’s degree of experience. Nurses should be trained in the evaluation and management of oncological pain, so that they can educate patients and caregivers.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Pages e190-e197"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075790","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":"Quality of Recovery in Veterans Following Postoperative Ketamine Infusion Implementation","authors":"Erika Grattidge DNP, CRNA ,&nbsp;Derrick Glymph PhD, DNAP, CRNA, CHSE, COL., USAR, FAANA, FAAN ,&nbsp;Virginia C. Simmons DNP, CRNA, CHSE-A, ANEF, FAANA, FAAN ,&nbsp;Jennifer Cornejo BSN, RN, M.Ed. ,&nbsp;Karthik Raghunathan MD, MPH ,&nbsp;Shibu Edward MSN, APRN, AGNP-C, PMGT-BC ,&nbsp;Srini Pyati MD, DA (UK), MRCA (UK), FCARCS (Ire)","doi":"10.1016/j.pmn.2025.10.011","DOIUrl":"10.1016/j.pmn.2025.10.011","url":null,"abstract":"<div><div>Chronic pain is highly prevalent among Veterans and contributes to poor surgical recovery. This pilot quality improvement project evaluated a structured postoperative ketamine infusion program at a Veterans Affairs medical center. Veterans with chronic pain undergoing complex surgery received low-dose ketamine infusions (0.2 mg/kg/hr) for 24-72 hours postoperatively. The Quality of Recovery-15 (QoR-15), a validated patient-reported measure, was collected on postoperative days 2, 7, and 30. A minimal clinically important difference (MCID) of six points was used to define meaningful improvement. Among 21 participants, 80% achieved clinically meaningful recovery, with mean scores rising from 84 (poor recovery) on day 2-124 (good recovery) by day 30. No ketamine-related adverse events were reported. The program was successfully implemented across multiple postoperative and inpatient settings with structured nursing education and standardized monitoring procedures. This project is novel in demonstrating the feasibility of a standardized ketamine infusion protocol delivered outside intensive care within a Veterans Affairs hospital. Findings suggest that ketamine infusions were associated with safe, sustained improvements in postoperative recovery among Veterans with chronic pain. Results underscore the importance of nursing-led implementation strategies and highlight ketamine’s potential role as a scalable, multimodal pain management intervention for high-risk surgical populations.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Pages 196-200"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557410","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":"A Bibliometric Analysis of Pain Management Nursing","authors":"Dana Gerberi M.L.I.S., A.H.I.P. ,&nbsp;Jinbing Bai Ph.D., M.S.N., R.N., F.A.A.N. ,&nbsp;Mitchell Knisely Ph.D., R.N., A.C.N.S.-B.C., P.M.G.T.-B.C., F.A.A.N ,&nbsp;Marian Wilson Ph.D., M.P.H., R.N., P.M.G.T.-B.C.","doi":"10.1016/j.pmn.2026.01.012","DOIUrl":"10.1016/j.pmn.2026.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Pain Management Nursing (PMN), the official journal of the American Society for PMN, marked its 25th anniversary in 2025. This milestone provides an opportune time to reflect on the journal’s development and impact on nursing-related pain management research.</div></div><div><h3>Objectives</h3><div>To provide an overview of PMN’s publication trends, primary themes, global reach, and collaborative author networks.</div></div><div><h3>Methods</h3><div>This review used a bibliometric analysis approach to gather and analyze various metrics related to PMN’s published work to provide an overview of the journal’s growth, primary themes, global reach, and collaboration networks.</div></div><div><h3>Results</h3><div>PMN’s scholarly activity has steadily grown over a quarter century with contributions from over 4,800 authors across more than 70 countries. Accelerated output over the past 10 years suggests increased research productivity within the discipline. Analysis of keywords over time showed a shift from foundational topics to more rigorous research methodologies. There has been a strong research emphasis on pain management practices in relation to patient age and gender, as well as assessment approaches. Opportunities exist to investigate links between patient education and clinical competence with procedural outcomes, health disparities, and diversity-related factors on the experience of pain.</div></div><div><h3>Conclusions</h3><div>Since its inception, PMN has reflected the evolution of PMN research, emphasizing multimodal and holistic treatment approaches. PMN continues to advance evidence-based practice and address critical policy issues with an increasing focus on interprofessional collaboration and technology-enhanced patient education and nursing professional development.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Pages 105-114"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228103","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":"Clinical Insights into Migraine – Patterns, Differentials & When to Worry","authors":"Michelle Lavelle-Henry MSN, APRN, CNP, ACHPN, PGMT-BC","doi":"10.1016/j.pmn.2026.01.036","DOIUrl":"10.1016/j.pmn.2026.01.036","url":null,"abstract":"<div><div>Migraine headaches present a significant clinical challenge for advanced practice nurses, particularly in distinguishing them from other primary headache disorders and determining when further evaluation, such as appropriate indications for neuroimaging. With a high prevalence across the lifespan—from pediatrics to adults—migraines are often underdiagnosed or undertreated, contributing to ongoing patient distress and reduced quality of life. This power session provides a comprehensive overview of migraine epidemiology, differential diagnoses among primary headaches, and identification of red flag symptoms that may indicate potentially life-threatening conditions.Up-to-date treatment strategies, including both pharmacologic and non-pharmacologic therapies. A review of standard treatments such as NSAIDs and triptans alongside emerging options like calcitonin gene-related peptide antagonists, including injection therapies, with a focus on their role in individualized migraine management plans. An overview of non-pharmacologic modalities and lifestyle interventions to support holistic person-centered care are outlined.The pivotal role of pain management nurses in recognizing, treating, and managing migraines across all age groups and healthcare settings is hallmark. By integrating evidence-based practices and identifying worrisome symptoms early, nurses can significantly reduce pain and improve quality of life for patients suffering from migraines. This session reinforces the importance of interdisciplinary, lifespan-oriented approaches in advancing migraine care within all levels of nursing practice.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Page e231"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147570678","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":"Breaking the Stone Cycle: Opioid-Sparing Strategies for Renal Colic Relief","authors":"Scott Faust Ed.D, MS, APRN, CNP","doi":"10.1016/j.pmn.2026.01.039","DOIUrl":"10.1016/j.pmn.2026.01.039","url":null,"abstract":"<div><h3>Purpose/Problem Statement</h3><div>Renal colic is among the most painful and frequently encountered urologic emergencies. Traditionally, opioids have been a cornerstone of symptom relief. However, this practice contributes to opioid overuse and increases risk of adverse effects, dependency, and unnecessary hospital admissions. There is a need for evidence-based, opioid-sparing strategies to manage kidney stone pain while preserving patient safety and satisfaction.</div></div><div><h3>Summary/Synthesis of Evidence</h3><div>A growing body of literature supports the use of NSAIDs, acetaminophen, IV lidocaine, and antispasmodics as effective first-line treatments for renal colic. Ketorolac has shown superior efficacy to morphine for renal colic with fewer side effects. IV lidocaine demonstrates rapid relief in opioid-tolerant patients or those with contraindications to NSAIDs. Multimodal regimens that prioritize non-opioid medications improve pain control and reduce reliance on opioids, especially in repeat stone formers or those at risk of substance use disorders.</div></div><div><h3>Method of Evaluation/Validation of Evidence</h3><div>Evaluation will focus on randomized controlled trials, guideline recommendations (e.g., American Urological Association), and real-world implementation of multimodal protocols in emergency and acute care settings. Comparative effectiveness data will be used to evaluate pain relief, time to discharge, and patient satisfaction.</div></div><div><h3>Results/Relevance to Pain Management</h3><div>Opioid-sparing strategies have been associated with equivalent or superior pain control, fewer side effects, shorter length of stay, and reduced recurrence of opioid use. Adoption of standardized, evidence-informed renal colic protocols contributes to more sustainable, patient-centered care.</div></div><div><h3>Future Implications for Nursing Profession</h3><div>Nurses and APRNs are key to implementing and advocating for multimodal, opioid-sparing approaches. Future research should focus on protocol adherence, patient education, and outcomes related to equity and access.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Page e232"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147570655","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":"Clinical Outcomes Based Healthcare Costs: Comparison of Buprenorphine Formulations for Analgesia and Full-Agonist Extended-Release Opioids","authors":"Jody Green PhD, FAACT,&nbsp;Kaitlin Hartlage MPH,&nbsp;Taryn Dailey-Govoni MPH,&nbsp;Suzanne Vosburg PhD","doi":"10.1016/j.pmn.2026.01.062","DOIUrl":"10.1016/j.pmn.2026.01.062","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Healthcare costs associated with untreated opioid use disorder including opioid overdose and abuse/misuse are estimated at $35 billion/year. Buprenorphine is a partial opioid agonist with buccal film (BBF) and transdermal patch (BTP) formulations approved for severe and persistent pain. Buprenorphine has potentially fewer negative side effects and adverse events than other opioids used for chronic pain treatment, such as full agonist extended-release (FA-ER) opioids. The National Poison Data System (NPDS) is a data repository for America’s Poison Centers and is often used to compare risk profiles of different medications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;This real-world observational study translated clinical outcomes recorded in the NPDS associated with BBF, BTP and FA-ER opioid exposures into estimated healthcare costs. FA-ER opioids included ER solid oral dosage forms of hydrocodone, oxycodone, hydromorphone, oxymorphone, and tapentadol.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Exposures reported to NPDS resulting in hospital admissions or emergency department (ED) visits due to intentional abuse/misuse of BBF, BTP, FA-ER opioids from January 2020-December 2023 were calculated. Exposure rates were then adjusted for population (US Census) and drug utilization (IQVIA) (per 100,000 US population per 100 million dosage units dispensed). Healthcare Cost and Utilization Project (HCUP; 2020) average costs for opioid-related hospital admissions ($20,706) and opioid-related ED visits ($3,795) were multiplied by exposure rates to generate cost estimates. HCUP data are for research purposes only. Rates were generated with SAS Proc Genmod. Non-overlapping confidence intervals (95%) determined statistically significant differences.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Extrapolated opioid-related hospital admission costs were lower for BBF ($7,681; Rate of exposure=0.37) than BTP ($34,080; Rate of exposure=1.65) and FA-ER ($27,488; Rate of exposure=1.33). Extrapolated opioid-related ED costs were lower for BBF ($2,048; Rate of exposure=0.54) than BTP ($7,496; Rate of exposure=1.98) and FA-ER ($7,078; Rate of exposure=1.87).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion/Implications for Nursing&lt;/h3&gt;&lt;div&gt;When considering population- and drug utilization-adjusted rates of intentional abuse/misuse exposure, opioid-related hospitalization and ED visits were less likely to occur after exposure to BBF than BTP or FA-ER opioid medications, resulting in significantly lower extrapolated healthcare costs. Healthcare costs may vary due to the severity of the exposure; however, this level of variability cannot be fully accounted for with the present model. Interpretation should focus on the relative differences between the comparators and not the absolute rates or costs. Taken as a whole, the NPDS and HCUP are real-world data that lead to insights regarding healthcare costs. These data reveal potential healthcare cost-savings associated with BBF relative t","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Page e240"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147570807","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 is a Brain Thing ...and Nurses Can Help Rewire It","authors":"Marie O’Brien DNP, ANP-C, PMGT-BC, CCRN","doi":"10.1016/j.pmn.2026.01.046","DOIUrl":"10.1016/j.pmn.2026.01.046","url":null,"abstract":"<div><div>Emerging science confirms what holistic nurses have known for decades: pain is more than tissue damage — it’s a whole-person experience shaped by the brain, body, and immune system. Psychoneuroimmunology, the study of how thoughts, emotions, and stress impact physical health, offers powerful insight into why mind-body nursing interventions matter in pain care. This interactive session will explore how pain neuroscience, health coaching principles, and holistic modalities can empower patients to access their own inner resources for comfort and resilience. Grounded in recent research, we’ll examine practical, evidence-informed tools nurses can use at the bedside and in coaching conversations — including guided imagery, breathwork, aromatherapy, clinical hypnosis, and simple nervous system regulation strategies. Together, we’ll explore how nurses can help patients “rewire” their experience of pain — not by dismissing it, but by expanding the pathways of relief, safety, and healing within the body-mind-immune connection.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Pages e234-e235"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147570878","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":"Relationships Among Continuing Opioid Therapy (COT) Regulations and Pain Management Outcomes","authors":"Roshni Patel DNP (student), MSN, RN, FNP-BC, PMGT-BC","doi":"10.1016/j.pmn.2026.01.072","DOIUrl":"10.1016/j.pmn.2026.01.072","url":null,"abstract":"<div><h3>Introduction, Background, Significance</h3><div>Safe use of COT in managing chronic pain challenges healthcare professionals and patients alike, and recent regulatory changes add complicated workflows for all involved. Safe prescribing workflows include informed consent, execution of a signed pain management agreement, monitoring the prescription monitoring program (PMP), and appropriate monitoring of urine drug screens. Insufficient evidence exists showing how the regulatory strategies, specifically the signed COT agreement, contribute to safety and optimizing pain management outcomes.</div></div><div><h3>Purpose</h3><div>The purpose of this study is to examine relationships among COT regulatory practices and pain management outcomes.</div></div><div><h3>Methods</h3><div>A retrospective record review of patients seen in an orthopedic/pain management ambulatory setting included patients aged 18 and older seen between 1/1/2022 through 5/31 2024 who met criteria as receiving continuous opioid therapy for at least three months. Human subjects were protected through the institutional review board oversight. Data was extrapolated from the medical record into redcap and organized for analysis.</div></div><div><h3>Results</h3><div>Eighty-five (n=85) patients met criteria (average age of 69.3 years (range 29-92), 58.8% (50) female, 91.8% Caucasian, and 97.6% non-Hispanic). Duration of opioid therapy ranged 6 months to 8 years and no COT safety events were noted. Analysis showed no differences in the pain agreement status based on age, gender, race, ethnicity, or predominate comorbid conditions (anxiety, depression, obesity, diabetes). No significant differences in the use of the PMP were noted based on pain management agreement status. Patients with a pain management agreement were more likely to have urine drug screen testing and were less likely to have NSAID or acetaminophen medications prescribed or recommended. The use of antidepressants, muscle relaxers, neuropathic agents, physical therapy, surgical intervention, and pain intervention/injection was comparable irrespective of the presence of a pain management agreement. Pain relief adequacy and reported functionality were similar across both groups.</div></div><div><h3>Discussion</h3><div>In this sample, the presence of a pain management contract contributed to more frequent urine drug screen testing. Findings do not support that the presence of the pain management agreement prevented COT safety events nor contributed to overall pain management outcomes.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Page e243"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147570883","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":"From Fragmentation to Flow: A Nurse-Led Regional Anesthesia and Acute Pain Management Team Driving Improved Patient Outcomes","authors":"Erica Pitchford MSN, RN, PMGT-BC, ONC,&nbsp;Frances Webb MSN, RN,&nbsp;Sarah Bradley ADN, RN,&nbsp;Alicia King BSN, RN, CCRN","doi":"10.1016/j.pmn.2026.01.060","DOIUrl":"10.1016/j.pmn.2026.01.060","url":null,"abstract":"<div><h3>Purpose</h3><div>In 2020, a nurse-led team at Sutter Medical Center, Sacramento-supported by Administration and partnering with specialized anesthesiologists-spearheaded the creation of the Acute Pain Service (APS). The program aimed to standardize regional anesthesia delivery and improve efficiency. Before APS, regional blocks were inconsistently done intraoperatively, and multimodal pain management was underused, resulting in variable outcomes in pain control, provider satisfaction, and length of stay (LOS).</div></div><div><h3>Summary</h3><div>Opioid-sparing analgesic methods in spine surgeries continue to demonstrate effective pain management and improve patient recovery. Regional blocks reduce adverse events and enhance recovery in total hip and knee arthroplasty. A nurse-led team can effectively support multimodal pain management and patient education. The role of acute perioperative pain management in orthopedic patients, highlights multimodal pain strategies, such as regional anesthesia. Multimodal pain management as a standard of care in acute and chronic pain settings, as it reduces opioid dependency, improving patient outcomes.</div></div><div><h3>Method of Evaluation</h3><div>An interdisciplinary team conducted a SWOT analysis to guide the development of APS. Hospital policies were revised to define the Specialty Registered Nurse Coordinator (SRNC) role. PDSA cycles refined workflows and drove rapid cycle changes. The result was a nurse-led APS that standardizes regional anesthesia, promotes multimodal pain control, and improves patient care. SRNCs lead daily operations- coordinating schedules, assisting with procedures, monitoring patients pre and post procedure, and ensuring consistent follow-up. They collaborate with anesthesiologists on unresolved pain cases and maintain two key databases: provider preferences for regional anesthesia and daily Morphine Milligram Equivalents (MME), pain scores, and follow up data for patients discharged with a peripheral nerve catheter (PNC). A discharge call template was created to support consistent assessment, communication, and documentation. SRNCs and anesthesiologists round daily - performing assessments, educating patients and bedside RNs, and providing discharge instructions. The team supported Skilled Nursing Facilities receiving PNC patients by helping develop policies and providing education for consistent care. These efforts increased surgeon buy-in, expanding the use of regional anesthesia and improving outcomes.</div></div><div><h3>Results</h3><div>Average LOS for Total Joint replacement patients decreased by 53%. Average MME use across the surgical spectrum on postoperative day 1 decreased by 51.1%. Patient volume increased by 24% since program creation.</div></div><div><h3>Future Implications</h3><div>This model highlights the potential for expanded nursing leadership in acute pain services and offers a scalable framework for other institutions.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"27 2","pages":"Page e239"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147570805","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}