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Patients have the right to adequate and safe pain relief in hospitals, but many continue to experience unrelieved pain. Range orders for the delivery of IV opioids give nurses the flexibility needed to treat patients' pain in a timely manner while allowing for differences in patient response to pain and to analgesia. To ensure safety and effectiveness, and to meet the requirements of accreditation agencies, hospitals should develop prescribing guidelines for IV opioid range orders and clear protocols for their implementation. Range orders should, for example, take into consideration the patient's age, pain intensity, and comorbidities; avoid frequency ranges; and prescribe a maximum dose that is at least two times but no more than four times the minimum dose in the range. [ABSTRACT FROM AUTHOR]

The term 'drug seeking' is frequently used but poorly defined. By soliciting nurses' comments and suggestions, a survey was developed to identify behaviors that may cause nurses to refer to a patient as drug seeking, to identify what nurses think the term 'drug seeking' means, to explore how nurses regard the use of the term 'drug seeking' in health care, and to identify differences between general nurses, emergency nurses, and pain management nurses with regard to these items. Behaviors that would cause the majority of all three nurse groups to refer to a patient as drug seeking were as follows: going to different emergency departments to get opioids, telling inconsistent stories about pain or medical history, or asking for a refill because the prescription was lost or stolen. When the term 'drug seeking' is used, all three groups of nurses agreed that it was very likely to mean the patient was addicted to opioids, the patient was abusing pain medicine, or the patient was manipulative. One-half or more for each nurse group said they used the term 'drug seeking' in talking about patients, but less than 10% said they used it in charting. After completing the survey, approximately one half or more of nurses in each group were less inclined to use the term. The use of stigmatizing terms in clinical practice is addressed with suggestions for alternative approaches to patient behavior related to requesting opioids for pain relief. Copyright © 2005 by Elsevier Science (USA). [ABSTRACT FROM AUTHOR]

The use of ketamine, a disease IV anesthetic with dissociative, analgesic, and sedative properties at low doses is now gaining in popularity as a treatment of some painful conditions. [ABSTRACT FROM AUTHOR]

In 1997, the University of Wisconsin began working collaboratively with the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) to integrate pain assessment and treatment into the JCAHO standards and accreditation processes. Pain care committees are an effective mechanism for implementing these changes. The authors discuss the critical role nurse managers can play in the development and success of these committees' activities. [ABSTRACT FROM AUTHOR]

Learn to titrate epidural analgesia to relieve postoperative pain without tipping the scales toward oversedation and other adverse reactions. [ABSTRACT FROM AUTHOR]