Madison Peters RN, BScN, MN , Dr. Justin Kutzko C.C.F.P., M.B.B.S. , Kalli Stilos (RN, BScN, MScN, CHPCA (C))
{"title":"由住院姑息治疗团队管理的患者持续使用非卧床给药设备。","authors":"Madison Peters RN, BScN, MN , Dr. Justin Kutzko C.C.F.P., M.B.B.S. , Kalli Stilos (RN, BScN, MScN, CHPCA (C))","doi":"10.1016/j.pmn.2024.02.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The use of Patient Controlled Analgesia (PCA) via a Continuous Ambulatory Delivery Device (CADD) is a common and effective means of pain and symptom management for hospitalized patients with a malignancy. Studies exploring the indications for starting such a device for hospitalized inpatients referred to inpatient palliative care teams are limited.</p></div><div><h3>Aim</h3><p>This retrospective chart review aims to explore indications, timing of initiation, and barriers to the use of a CADD.</p></div><div><h3>Methods</h3><p>Over a six month period, during daily inpatient palliative care consult team rounds, patients who required a CADD were enrolled in this study. Sixty-one adult patients were identified who required a pump for symptom control. The team’s database sheets were used to capture patient demographics.</p></div><div><h3>Results</h3><p>The main reasons for initiating a Continuous Ambulatory Delivery Device in the above setting included: lack of efficacy of oral opioids and to increase patient autonomy of their pain management. Approximately 20% of patients required transfer to another unit that could accommodate the CADD. The median length of stay for these patients was 13 days, with a median length of half a day for a pump to be started.</p></div><div><h3>Conclusions</h3><p>This initial study provides the Palliative Care Consult Team with information on the indications for the use of a CADD. The lack of universal access to a CADD in various areas of our hospital due to differences in departmental protocols may compromise good symptom management and patient safety. These results strengthen the argument that the existing hospital policy requires revamping to improve CADD access.</p><p>A CADD has been shown to provide hospitalized patients, with a malignancy, with timely access to effective symptom management, and in turn, reducing their length of stay in hospital. These findings will help inform this organization's CADD policy and support the need to broaden access to this device.</p></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1524904224000237/pdfft?md5=01ca7c0c42442b5e5b59fcdb731319c2&pid=1-s2.0-S1524904224000237-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Continuous Ambulatory Delivery Device Use for Patients Managed by an Inpatient Palliative Care Team\",\"authors\":\"Madison Peters RN, BScN, MN , Dr. Justin Kutzko C.C.F.P., M.B.B.S. , Kalli Stilos (RN, BScN, MScN, CHPCA (C))\",\"doi\":\"10.1016/j.pmn.2024.02.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The use of Patient Controlled Analgesia (PCA) via a Continuous Ambulatory Delivery Device (CADD) is a common and effective means of pain and symptom management for hospitalized patients with a malignancy. Studies exploring the indications for starting such a device for hospitalized inpatients referred to inpatient palliative care teams are limited.</p></div><div><h3>Aim</h3><p>This retrospective chart review aims to explore indications, timing of initiation, and barriers to the use of a CADD.</p></div><div><h3>Methods</h3><p>Over a six month period, during daily inpatient palliative care consult team rounds, patients who required a CADD were enrolled in this study. Sixty-one adult patients were identified who required a pump for symptom control. The team’s database sheets were used to capture patient demographics.</p></div><div><h3>Results</h3><p>The main reasons for initiating a Continuous Ambulatory Delivery Device in the above setting included: lack of efficacy of oral opioids and to increase patient autonomy of their pain management. Approximately 20% of patients required transfer to another unit that could accommodate the CADD. The median length of stay for these patients was 13 days, with a median length of half a day for a pump to be started.</p></div><div><h3>Conclusions</h3><p>This initial study provides the Palliative Care Consult Team with information on the indications for the use of a CADD. The lack of universal access to a CADD in various areas of our hospital due to differences in departmental protocols may compromise good symptom management and patient safety. These results strengthen the argument that the existing hospital policy requires revamping to improve CADD access.</p><p>A CADD has been shown to provide hospitalized patients, with a malignancy, with timely access to effective symptom management, and in turn, reducing their length of stay in hospital. 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Continuous Ambulatory Delivery Device Use for Patients Managed by an Inpatient Palliative Care Team
Background
The use of Patient Controlled Analgesia (PCA) via a Continuous Ambulatory Delivery Device (CADD) is a common and effective means of pain and symptom management for hospitalized patients with a malignancy. Studies exploring the indications for starting such a device for hospitalized inpatients referred to inpatient palliative care teams are limited.
Aim
This retrospective chart review aims to explore indications, timing of initiation, and barriers to the use of a CADD.
Methods
Over a six month period, during daily inpatient palliative care consult team rounds, patients who required a CADD were enrolled in this study. Sixty-one adult patients were identified who required a pump for symptom control. The team’s database sheets were used to capture patient demographics.
Results
The main reasons for initiating a Continuous Ambulatory Delivery Device in the above setting included: lack of efficacy of oral opioids and to increase patient autonomy of their pain management. Approximately 20% of patients required transfer to another unit that could accommodate the CADD. The median length of stay for these patients was 13 days, with a median length of half a day for a pump to be started.
Conclusions
This initial study provides the Palliative Care Consult Team with information on the indications for the use of a CADD. The lack of universal access to a CADD in various areas of our hospital due to differences in departmental protocols may compromise good symptom management and patient safety. These results strengthen the argument that the existing hospital policy requires revamping to improve CADD access.
A CADD has been shown to provide hospitalized patients, with a malignancy, with timely access to effective symptom management, and in turn, reducing their length of stay in hospital. These findings will help inform this organization's CADD policy and support the need to broaden access to this device.
期刊介绍:
This peer-reviewed journal offers a unique focus on the realm of pain management as it applies to nursing. Original and review articles from experts in the field offer key insights in the areas of clinical practice, advocacy, education, administration, and research. Additional features include practice guidelines and pharmacology updates.