Joshi, G., & Kehlet, H. (2013). Procedure-specific Pain Management: The Road to Improve Postsurgical Pain Management?. Anesthesiology, 118(4), 780-782. .
This article explained that good pain management is known to produce many benefits for the postoperative patient. However, the article goes on to explain that treating postoperative pain is still a major issue with inadequate postoperative patient pain relief remaining high. The article discussed how the Joint Commission declared pain the “fifth vital sign”. And that the Joint Commission has determined not all pain could be eliminated, but that goal-related therapy may be suitable. The article concluded by explaining that there was a need for evidence-based procedure specific pain management guidelines. I found this to be an interesting concept that the article presented. In summary the authors believed we could better manage pain based on knowing the type and amount of pain usually caused based on the type of surgery.
Zuccaro, S., Vellucci, R., Sarzi-Puttini, P., Cherubino, P., Labianca, R., & Fornasari, D. (2012). Barriers to Pain Management. Clinical Drug Investigation, 32(S1), 11-19.
This article started by showing that although there are many techniques to alleviate pain there are even more barriers to effective pain management. With these many barriers leading to a large number of patients not receiving the best pain control. The abstract went on to give examples of the different types of barriers for patients, physicians, and health care institutions. The author believed that identifying and acknowledging these barriers was the beginning to overcoming them. The abstract concluded that health care providers need to be more aware of their patient’s as well as their own cognitive, emotional, and behavioral barriers in order to achieve optimal pain management.
Sinatra, R. (2010). Causes and Consequences of Inadequate Management of Acute Pain. Pain Medicine, 11(12), 1859-1871.
This article started off by showing that acute pain affects millions of patients every year. This author also agreed that even with the increased focus on pain management patients pain control continues to be subpar. The purpose of the authors’ study was also to determine barriers to effective pain management as well as consequences to ineffective pain control. This was achieved by completing a review of recent literature regarding the subject of pain management. The study determined that physicians and patients attitudes and educational barriers as well as limited available therapies lead to inadequate pain management. The authors concluded that studies on the use of multiple analgesics with different mechanisms of action could improve the efficiency as well as adverse effects over the single agent approach.
Schatman, M. E. (2011). The Role of the Health Insurance Industry in Perpetuating Suboptimal Pain Management. Pain Medicine, 12(3), 415-426.
This article started by sharing that pain practitioners function according to medical ethics while health care insurers operate under business ethics of cost and profit. The authors believe that the health insurance industry continues to fail at servicing those suffering from chronic pain and instead the industry stays focused on serving itself. The essay focused on the different self-serve strategies used by the health insurance industry including efforts to falsify chronic pain and its treatments. In conclusion the author felt that the future outlook for those with chronic pain was not good until a not-for-profit single payer system replaced the current self-serving health care insurance industry.
Loder, E., Witkower, A., McAlary, P., Huhta, M., & Matarrazzo, J. (2003). Rehabilitation hospital staff knowledge and attitudes regarding pain. American Journal Of Physical Medicine & Rehabilitation / Association Of Academic
In summary this article was based on a study that focused on inpatient care staff and their knowledge related to pain. A survey was conducted with hospital staff regarding attitudes and experience related to pain care responsibilities. This study showed the staff rated personal lack of education regarding pain management as the main barrier to effective pain management. It also showed that the majority of staff surveyed felt uncomfortable with many aspects of pain management including the use of opioids in the treatment plan. The study went on to discuss how the findings could be used to improve pain management in the hospital setting going forward including staff education.
Niruban, A., Biswas, S., Willicombe, S., & Myint, P. (2010). An audit on assessment and management of pain at the time of acute hospital admission in older people. International Journal Of Clinical Practice, 64(10), 1453-1457.
This study focused on pain being more prevalent in older people and how well that pain is assessed and managed in the emergency environment. The study was performed at a hospital in West Norfolk, UK on 140 patients with acute pain hospital admissions. The pain management of these patients were evaluated for 24 hours after admission. The study findings concluded that pain management was not optimal for these patients. The study also showed that management of pain would have been better with scheduled monitoring, education, and better assessment.
This review of literature has positively impacted my understanding of pain management in many ways. These articles opened my eyes to how important of a role pain control plays in the overall success of the patient. The studies showed how pain management directly effects overall patient outcome. If pain control is handled optimally then positive patient outcome goes up and vice versa. Before this review I knew pain management was important, but I didn’t realize how important with it directly being related to overall patient outcome.
This literature also helped me to recognize that health insurance practices play a major role in patient care. The health insurance industry sets many guidelines that determine how and when care is given to our patients. One of the articles focused on how the insurance industry is guided by business ethics with profit being the most important focus. While care providers are guided by medical ethics with positive patient care being the priority.
Finally, this review opened my eyes to the many barriers in the way of proper pain management for patients. I now realize that there are patient, provider, and institute barriers effecting optimal pain management as well as many others. And that these barriers include educational, personal attitudes, beliefs, and more. This review helped me realize that identifying and acknowledging these barriers is the first step in overcoming these barriers in order to provide the best pain control and best total care to my patients.
Joshi, G., & Kehlet, H. (2013). Procedure-specific Pain Management: The Road to Improve Postsurgical Pain Management?. Anesthesiology, 118(4), 780-782.
Loder, E., Witkower, A., McAlary, P., Huhta, M., & Matarrazzo, J. (2003). Rehabilitation hospital staff knowledge and attitudes regarding pain. American Journal Of Physical Medicine & Rehabilitation / Association Of Academic Niruban, A., Biswas, S., Willicombe, S., & Myint, P. (2010). An audit on assessment and management of pain at the time of acute hospital admission in older people. International Journal Of Clinical Practice, 64(10), 1453-1457.
Schatman, M. E. (2011). The Role of the Health Insurance Industry in Perpetuating Suboptimal Pain Management. Pain Medicine, 12(3), 415-426. Sinatra, R. (2010). Causes and Consequences of Inadequate Management of Acute Pain. Pain Medicine, 11(12), 1859-1871. Zuccaro, S., Vellucci, R., Sarzi-Puttini, P., Cherubino, P., Labianca, R., & Fornasari, D. (2012). Barriers to Pain Management. Clinical Drug Investigation, 32(S1), 11-19.
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