January 2007
In
this issue…
SCPI
Planning Committee Maps out Focus Plan for 2007
Professional Education Chair Facilitates Patient Education at the Hope Lodge
Introducing
our Public Awareness Committee Chair…
Be a Part of LIVESTRONG DAY 2007!
SCPI
Planning Committee Maps out Focus Plan for 2007
On
December 18th, 2006 the SCPI Planning
Committee discussed objectives for the new year. The Planning Committee
consists of our Advocacy, Professional Education and Public Awareness
Chairs, Coordinator and TCC
Director of SC
Programs. The group discussed the objectives for the new year. The main
projects of focus will be:
-
Development of a Speakers Bureau to educate healthcare professionals about pain management though out the state
-
Web-based continuing education opportunity in collaboration with the South Carolina Society of Health System Pharmacists,
-
Public awareness survey to understand the public’s perceptions and needs around pain issues
-
September Pain Awareness Month activities which includes assisting in the planning and implementation of the Annual Pain Congress, securing a Pain Proclamation and a possible regulatory summit
If you are interested in any of these activities and would like to volunteer for any other the workgroups, please contact Shannon Johnson.
Professional
Education Chair Facilitates Patient Education at the
On January 16, Tamara Bowman, RN, Nurse Case Manager with the Palliative Care Team at Medical University of South Carolina and SCPI Professional Education Chair led an informative pain talk at The Hope Lodge Downtown Charleston. The American Cancer Society Hope Lodge provides a “home away from home” for cancer patients who are undergoing chemotherapy. Tamara’s presentation “Cancer Pain Management: Knowing the Right Questions, Advocating for Yourself and Understanding the Truths vs. the Myths” was the first in the series of pain education that she plans to continue at the lodge. The audience for her first presentation consisted of patients, volunteers, and staff, but also a caregiver who attended in place of his patient because that patient was in too much pain to attend herself. Tamara plans to continue these SCPI sponsored talks quarterly at the lodge. Other patients or caregivers needing to learn more about how to advocate for their pain treatment are also welcome. Tamara has 15 years of oncology nursing experience and 10 years of hospice experience. Her passion for caring for patients, educating them and advocating for them shows! For more information about the Hope Lodge visit the American Cancer Society Web site.
Introducing our Public Awareness Committee Chair
Be
a Part of
LIVESTRONG
DAY 2007!
Wednesday,
May 16, 2007, is the day. LIVESTRONG
Day! LIVESTRONG
Day is the Lance
Armstrong Foundation’s annual grassroots advocacy effort to unify
people affected by cancer. In its fourth year, the goal of LIVESTRONG
Day is to raise awareness about cancer survivorship issues on a national
level and in local communities across the country. LIVESTRONG
Day is about doing something to make a difference in the fight against
cancer. SCPI will be involved with LIVESTRONG DAY which will be
held in Columbia. The LIVESTRONG Planning Committee for South
Carolina is working on the details about the event. We will keep you
informed about those as we have them. Volunteer opportunities are
available.
Country
Profiles on Opioid Availability Now Available
The
Pain & Policy Studies Group (PPSG) announced enhancements to the
international section of its website that may be useful for individuals
and organizations interested in improving availability and access to
essential opioid medications.
The
PPSG Web site
now offers Country
Profiles that provide standardized information about opioid
availability and key policy-related indicators for every country in the
world. Each Country Profile contains graphs that portray the trend in
reported national consumption of principal opioids as an indicator of
opioid availability. Key policy-related indicators are provided, including
whether the country is a Party to the international conventions which
require governments to estimate their medical requirements for opioids and
to report consumption statistics to the International Narcotics Control
Board. Information on how to contact the national Competent Authority,
which is responsible for administering these important government
functions that supports opioid availability is provided, as well as access
to the WHO Guidelines, “Achieving Balance in National Opioids Control
Policy: Guidelines for Assessment (2000)” now available in 22
languages. Links to national resource documents regarding opioid
availability for pain relief and palliative care will be added as the PPSG
learns about them.
Additional enhancements are being developed and will be announced here. Suggestions for national resource documents are welcome. The Country Profile for the United States can be accessed here.
Pain
Notes
-
By investigating the case of a Pakistani boy who felt no pain when he walked on hot coals, researchers have discovered a gene “central to the perception of pain.” The British research team identified a defect in some of the boy’s kin, who also do not feel pain. “The gene is obviously an attractive new target for drug developers seeking to eliminate pain.” One pain expert cautioned, however, that the goal is not the elimination of pain, but rather its control. (The New York Times, 12/13, The Carolinas Center Weekly Updates 12/06)
-
Milwaukee’s Medical College of Wisconsin is the recipient of a two-year $513,000 grant to develop palliative care education programs at six medical schools. The programs will involve required and elective palliative care courses for upper level medical students and the establishment of faculty development programs in palliative care. Representatives from the chosen schools will also attend Harvard’s Program in Palliative Care Education and Practice (PCEP). PCEP, the article says “is considered the premier palliative care faculty development program in the United States.” (WisBusiness.com, 12/12, The Carolinas Center Weekly Updates 12/06)
-
In a follow-up to its May and June articles on palliative radiation for cancer patients, Hospice Letter has published some of the responses from its online survey about whether hospices should provide the service. Those supporting it felt that it should be offered, but only if it truly relieved pain and symptoms, and that its use would attract patients earlier. One detractor felt that the effects of the radiation were sometimes worse than the cancer itself. Another felt that patients were too often offered the service simply “because it can be given,” and that radiation was truly palliative in very few cases. (Hospice Letter, 12/2006, The Carolinas Center Weekly Updates, 12/06)
-
SnowWorld, a virtual reality game designed by the director of the University of Washington’s Virtual Reality Analgesia Research Center, lessens the pain that pediatric burn patients feel as their wounds are treated. Children especially need non-medicinal pain control during treatment, because the medicines used for adult patients are too risky for them. Not only does SnowWorld distract them—they “really, really want to get those penguins”—but it takes away the anticipatory aspect of pain since the kid can’t see when his burned skin is going to be stretched or treated. SnowWorld is being given free of charge to burn centers across the US. (Yahoo! News, 12/28, The Carolinas Center Weekly Updates 1/5/07)
SAVE
THE DATE!
February
Event
The
Cleveland Clinic
Center
for Continuing Education
Department
of Pain Management
9th
Annual Pain Management Symposium
February
10–14
Orlando,
FL
On-line CME opportunities!
March
Event
The
Carolinas Center for Hospice and End of Life Care’s
Annual
Clinical Conference
The
Hilton Oceanfront Resort in Hilton Head Island, SC
March
18–21
mdoherty@carolinasendoflifecare.org
September Event
The
Carolinas Center for Hospice and End of Life Care Pain Congress & South
Carolina and North Carolina Pain Initiatives Meetings
September
27–28
Charlotte, NC
If
you know of any pain related courses or events in South Carolina that your
organization would like highlighted, please forward the information to Shannon
Johnson.
SPOTLIGHT:
On-line Course
ONS
Site-Specific Cancer Series: Lung Cancer Online Course
provides the cutting-edge information you need to truly understand the many
complexities of lung cancer diagnosis, treatment, and symptom management.
The next course starts March 1. Students will receive 14.2 Contact hours
upon the successful completion of the program.
Birth
Defects and NSAIDS?
As January is Birth Defect Awareness Month, we included a link to an article regarding a possible link between birth defects and NSAIDs if taken in the first trimester of pregnancy.
Neonatal
Pain
Though it was once believed that neonates did not feel pain or felt pain less acutely than adults do, clinicians now can refer to evidence based research that shows that neonates do feel pain. They “possess the necessary anatomical structures and functional ability to process pain (Pasero, C., 2002).” Below is a link to a publication by the American Pain Society regarding fetal and neonatal pain that also states implications for clinical practice and research.
Fetal “Pain”—A Look at the Evidence by Stuart W.G. Derbyshire, PhD
Another
publication regards neonatal infant pain assessment. This one is from the
Journal of Obstetric, Gynecologic and Neonatal Nursing. The Fifth Vital
Sign: Implementation of a Neonatal Infant Pain Scale, written by Ana-Maria
Gallo MSN, CNS, RNC, describes
a hospital’s implementation of the Neonatal Infant Pain Scale, including
the education provided to nurses and utilization of the tool in the
assessment of well newborns. You can view the abstract here.
Neonatal Infant Pain Scale
Neonatal/Infant
Pain Scale (NIPS)
(Recommended for children less than 1 year old)
A score greater than 3 indicates pain.
|
Pain
Assessment |
Score
|
|
|
Facial
Expression |
|
|
|
0
– Relaxed muscles |
Restful
face, neutral expression |
|
|
1
– Grimace |
Tight
facial muscles; furrowed brow, chin, jaw, (negative facial
expression – nose, mouth and brow) |
|
|
Cry
|
|
|
|
0
– No Cry |
Quiet,
not crying |
|
|
1
– Whimper |
Mild
moaning, intermittent |
|
|
2
– Vigorous Cry |
Loud
scream; rising, shrill, continuous (Note: Silent cry may be scored
if baby is intubated as evidenced by obvious mouth and facial
movement. |
|
|
Breathing
Patterns |
|
|
|
0
– Relaxed |
Usual
pattern for this infant |
|
|
1
– Change in Breathing |
Indrawing,
irregular, faster than usual; gagging; breath holding |
|
|
Arms |
|
|
|
0
– Relaxed/Restrained |
No
muscular rigidity; occasional random movements of arms |
|
|
1
– Flexed/Extended |
Tense,
straight legs; rigid and/or rapid extension, flexion |
|
|
Legs |
|
|
|
0
– Relaxed/Restrained |
No
muscular rigidity; occasional random leg movement |
|
|
1
– Flexed/Extended |
Tense,
straight legs; rigid and/or rapid extension, flexion |
|
|
State
of Arousal |
|
|
|
0
– Sleeping/Awake |
Quiet,
peaceful sleeping or alert random leg movement |
|
|
1
– Fussy |
Alert,
restless, and thrashing |
|
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