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November 2006 |
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In
this issue… SCPI
Exhibit at ONS Conference |
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SCPI
Exhibit Included at ONS Conference The Lowcountry Chapter of the Oncology Nursing Society held its annual conference on November 18 in Mt Pleasant and included the SCPI’s exhibit. The conference titled “Diagnosis Cancer: From Screening to Survival” featured several knowledgeable speakers on topics that included informed consent for cancer treatment, pharmacological interventions, management of the late effects of cancer, palliative care, hospice and the changing needs of survivorship. American Cancer Society Mission Delivery Manager, Regina Creech, MS, CHES, and SCPI member, presented “The Cancer Check Up: Screening and Early Detection.” The conference provided 7.5 CMEs for those in attendance. The ONS is open to registered nurses and other healthcare professionals involved in oncology care. For other ONS events in the Lowcountry, contact Andrea Meaburn, the ONS Chapter President. To find out about other ONS Chapters in the state, visit the Oncology Nursing Society Web site. |
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SPAN
Calls for State Pain Representatives The
American Pain Foundation’s State Pain Action Network (SPAN), a growing
group of leaders from across the country, came to Baltimore in mid-October
for training in media and advocacy. Those gathered consisted primarily of
a group of people who live with pain. They learned how to tell their
story in clear “message bites,” manage interviews for print and TV,
advocate and communicate with those who make policy, and take their ideas
and turn them into action in their state and across the country. SPAN
is a developing grassroots network comprised of people affected by pain,
working in collaboration with healthcare providers and other
organizations, and representing every state in the country. (APF November 2006 Pain Bulletin) SPAN is calling for others to join forces with them in their “Power over Pain” campaign. Healthcare professionals and people who live with pain are needed. They will be trained to speak out across the country about the right to good pain care for all. If you are interested in helping to build an advocacy network in South Carolina and becoming a SPAN leader for our state, contact Mary Bennett (410) 897-2135. |
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Alliance
of State Pain Initiatives Responds to DEA Proposal On September 9th, the Drug Enforcement Agency presented a proposed rule regarding the issuance of multiple prescriptions. According to Matt Bromley, Policy and Communications Director for the ASPI, “The Alliance of State Pain Initiatives supports the intent of the rule to allow the practice of issuing multiple prescriptions, but feels that there are certain provisions in the proposed rule which should be eliminated or modified to assure greater balance.” On November 6th the ASPI sent its response to the DEA. |
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Pain:
The Fifth Vital Sign Origins: ▪
On November 11, 1995 James Campbell,
MD, then president of the American Pain Society, spoke about the
importance of pain assessment and stated: “Vital signs are taken seriously. If
pain were assessed with the same zeal as other vital signs are, it would
have a much better chance of being treated properly. We need to train
doctors and nurses to treat pain as a vital sign. Quality care means that
pain is measured and treated.” Reprinted
from Purdue Pharma “In the Face of Pain” ▪
The American Pain Society coined the
phrase “Pain: The Fifth Vital Sign” to elevate awareness of pain
treatment among health care professionals. ▪
Various organizational and regulatory
bodies, including the Joint Commission on the Accreditation of Healthcare
Organizations (JCAHO) have declared that pain should be treated as vital
sign. Reprinted
from “Is Pain A Vital Sign?” Five
things we can do to improve pain assessment and treatment: ▪
Consider pain the fifth vital sign and
assess patients for pain every time you check for pulse, blood pressure,
core temperature and respiration. ▪
Urge colleagues to take their
patients’ complaints of pain seriously. Remind them not to put patients
in a position of asking for a favor when they want pain relief. ▪
Inform patients that they deserve to
have their pain evaluated and treated. ▪ Work to implement the APS Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain in your own practice setting. (JAMA, 274, 1874–1880) ▪ Wear your Fifth Vital Sign button and make opportunities to explain the importance of pain evaluation and treatment to other healthcare professionals and the public. Contact the APS for Fifth Vital Sign buttons and countercards. Reprinted from http://www.ampainsoc.org |
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Pain
Assessment Tools Several
pain assessment tools are listed below. Some are best for adults while
others are better suited for children. Pain is subjective, therefore,
self-report is generally considered the best method for assessing pain and
should be used whenever possible in clinical settings (Pasero, C. 2006). A
short description and age appropriateness is included. For additional
information and to download the pain assessment tools, click on the links.
The Partners Against Pain “Pain Management Tool Kit” lists additional
assessment tools. Visit the Web
site to request a free CD-Rom pain assessment tool kit that was developed by
Purdue Pharma. Faces Scales - Pain Faces Scale link Advised
for assessing pain intensity in preschool and school-age children. Children
as young as 3. Uses
realistic facial expressions to represent pain intensity. Quick
to use and easy to explain. Ask
the child to choose which face best describes his/her pain. Faces
Pain Scale- Revised (FPS-R) Web
site link for English version and 25 other language versions! Pieces
of Hurt Pain Most
appropriate for ages 3–7. A
concrete ordinal rating scale. Uses
poker chips to help a child quantify pain. English Instructions
1.
Use four
red poker chips. 2.
Align the
chips horizontally in front of the child on the bedside table, a clipboard
or other firm surface. 3. Tell the child, “These are pieces of hurt.” Beginning at the chip nearest the child’s left side and ending at the one nearest the right side, point to the chips and say, “This (the first chip) is a little bit of hurt and this (the fourth chip) is the most hurt you could ever have.”
For a young child or for any child who does not comprehend the
instructions, clarify by saying, “That means this (the first chip) is
just a little hurt; this (the second chip) is a little more hurt; this
(the third chip) is more hurt; and this (the fourth chip) is the most hurt
you could ever have.” 4.
Ask the
child, “How many pieces of hurt do you have right now?” Children
without pain will say they don’t have any. 5.
Clarify
the child’s answer by words such as “Oh, you have a little hurt? Tell
me about the hurt.” (Use the Pain Interview.) 6.
Record
the number of chips selected on the bedside flow sheet. Spanish Instructions* 1.
Follow
the English instructions, substituting the following words. 2.
Tell the
parent, if present: “Estas fichas son una manera de medir dolor. Usamos
cuatro fichas.” 3.
Say to
the child: “Estas son pedazos de dolor: una es un poquito de dolor y
cuatro son el dolor maximo que tu puedes sentir. Cuantos pedazos de dolor
tienes?
Reprinted from the National Library of Medicine Web site.
*Acknowledgment: Spanish instructions for the Poker Chip Tool initially developed by Jordan-Marsh M., Hall, D., Yoder, L., Watson, R., McFarlane-Sosa, G., & Garcia, M. (1990). The Harbor-UCLA Medical Center Humor Project for Children. Los Angeles: Harbor-UCLA Medical Center. Visual Analog - Link to PDF of Visual Analog Scale Ages
6 and up A
line is shown to the patient that has extremes of no pain to worst pain on
each end. Ask
the patient to indicate on the line where the pain is in relation to the
extremes. Numeric
Pain Intensity Scale Ages
8 and up Asks
for a pain rating using numbers 0–10 Patient
must have a solid understanding of numbers Universal
Pain Assessment Tools for Adults Includes
number descriptor, verbal descriptor, Wong-Baker Facial Grimmace Scale,
Activity Tolerance Scale and translations into other languages. Two
versions available: |
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December
Educational Events The Carolinas Center for Hospice and End of Life
Care presents: ▪ Breakfast for Brainiacs® Audio
Conference—Medication Reconciliation, Review and Reconfiguration Thursday, December 11, 8:30–9:30 a.m.
Mary Lynn McPherson,
Pharm.D., BCPS, Professor University
of Maryland, School of Pharmacy ▪ Cancer Series Audio Conference—Bladder and
Renal Cancer: Urine Trouble December 14, 8:30–9:30 a.m. Hunter Woodall, MD, Medical
Director, Hospice of the Upstate, Anderson, SC |
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Pain:
Current Understanding of Assessment, Management and Treatments This
program is supported by an unrestricted educational grant from NPC. For
permission to reprint any of the copyrighted materials herein, contact NPC
at (703) 620-6390 or visit the National
Pharmaceutical Council (NPC) Web site.
Expiration
Date:
June 2007 Sections can be downloaded and included Assessment of Pain, Types of Treatments, Management of Acute Pain and Chronic Noncancer Pain, and Strategies to Improve Pain Management. CME credit is available. |
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