Excellence in Care: Pain Management HPRX 3012 Mary Beth Kean, DNP RN-BC CNS CRRN Helen Ross Petty Elizabeth Huss RN, BSN

Transcription

1 Excellence in Care: Pain Management HPRX 3012 Mary Beth Kean, DNP RN-BC CNS CRRN Helen Ross Petty Elizabeth Huss RN, BSN INDEPENDENT STUDY Health Professions Institute for Continuing Education Austin Community College District Health Professions Institute, Continuing Education 5930 Middle Fiskville Road, Austin, TX 78752

2 INDEPENDENT STUDY: HPRX 3012: Managing Pain Description and Purpose: Mary Beth Kean DNP, RN an expert on pain control from Seaton Medical Center, and Helen Petty of the Arthritis Foundation appear with Elizabeth Huss RN, BSN, coordinator with the Health Professions Institute of Austin Community College (ACC), to discuss the issue of pain management, the impact of pain on the healing process and the issues important to both practitioner and patient in managing both acute and chronic pain using pharmacologic and non-pharmacologic strategies. The purpose of this activity is to enrich the RNs contributions to quality healthcare and his/her pursuit of professional career goals by providing in-depth information about assisting patients to deal with both acute and chronic pain. After completing this activity the nurse will be prepared to engage the patient in managing pain using pharmacologic and non-pharmacologic methods. This offering is a learner-paced educational activity developed to meet the individual needs of nurses, social workers, and emergency medical services personnel requiring continuing education for re-licensure. Goals and Objectives: Upon completion of this activity, the student will be able to: 1. Recall definitions of pain, dependence, tolerance, pseudo-addiction, addiction and aberrant drug related behavior. 2. Describe the types and pathophysiology of pain. 3. Describe the impact of untreated pain and the concept of existential/total pain. 4. Discuss pharmacologic treatment of pain. 5. Discuss non pharmacologic management of pain. 6. Integrate objectives 1-5 into a case study. 7. Explain the difference between acute and chronic pain. Requirements for Successful Completion: The packet you have received contains a pre-test, DVD, post-test and a program evaluation. To successfully complete this activity and earn continuing education the participant must: 1. Complete the pre-test 2. View the DVD 3. Complete the post-test (score an 80 or more) 4. And, complete the evaluation NOTE: Following the viewing of the DVD and completing the accompanying documents, questions may be addressed by contacting Elizabeth or eahuss@austincc.edu

3 Submit all of the documents (pre/post-test, evaluation) along with your completed Registration Form (check or credit card), and payment to: Austin Community College Health Professions Institute Attn: Online Nursing Videos 5930 Middle Fiskville Rd. Austin, TX Fax: Within two business weeks from receipt of your material at ACC, your certificate of completion will be available to be mailed, ed, faxed to the address you provide or picked up at the Highland Business Center. Upon successful completion participants will be awarded a certificate of successful completion worth 2.00 contact hours. Austin Community College is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. Contact hours for programs applicable to social work are approved for CEU s by the Texas State Board of Social Worker Examiners. This program is worth 2.00 contact hours or 0.20 continuing education units (CEU s). Continuing education for Emergency Medical Personnel is approved by the Texas Department of State Health Services. This program is worth 2.0 TDH (P) contact hours. Conflicts of Interest: A conflict of interest occurs when an individual has an opportunity to affect or impact educational content with which he or she may have a commercial interest or a potentially biasing relationship of a financial, professional or personal nature. All planners and faculty/content specialist(s) must disclose the presence or absence of a conflict of interest relative to this activity. All potential conflicts are resolved prior to the planning, implementation, or evaluation of the continuing nursing education activity. All activity planning committee members and faculty/content specialists have submitted Conflict of Interest Disclosure forms. The planning committee members and faculty/content specialists of this CNE activity have disclosed no relevant professional, personal or financial relationships related to the planning or implementation of this CNE activity. Sponsorship or Commercial Support: This CNE activity received no sponsorships or commercial support.

4 Non-Endorsement of Products: Approved provider status of Austin Community College refers only to the continuing nursing education activity and does not imply a real or implied endorsement by Austin Community College, the American Nurses Credentialing Center (ANCC) or the Texas Nurses Association (TNA) of any commercial product, service, or company referred to or displayed in conjunction with this activity, nor any company subsidizing costs related to this activity. Off-label Product Use: This CNE activity does not include any information about off-label use of any product for a purpose other than that for which it is approved by the U.S. Food and Drug Administration (FDA). Reporting of Perceived Bias: Bias is defined by the American Nurses Credentialing Center s Commission on Accreditation (ANCC COA) as preferential influence that causes a distortion of opinion or of facts. Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their ANCC Accreditation Feedback Line to report any noted bias or conflict of interest in the educational activity. The toll free number is 1(866) Expiration: This continuing nursing education activity will expire on September 1, 2014

5 Pre-test: Pain Management Name A. MATCHING: Match the definitions on the right to the terms on the left. (1) Whatever the person says it is, occurring whenever ( ) PSEUDOADDICTION the person experiencing it says it does (2) Evidenced by the person having withdrawal symptoms ( ) DEPENDENCE when the drug is not available (3) Evidenced by increasingly higher doses needed to obtain ( ) ADDICTION the same degree of relief (4) When healthcare workers make the mistake of ( ) ABBERANT DRUG identifying an addiction where one does not exist RELATED BEHAVIOR (5) A disease of the brain resulting in behavior which ( ) PAIN requires extensive treatment for healing (6) Problematic behaviors which mimic disease states related ( ) TOLERANCE to the use of therapeutic or street drugs B: MULTIPLE CHOICE: Chose the one most correct answer. 7. Which of the following best describes the difference in acute pain and chronic pain: a. acute pain has a stimulus which is relatively easy to identify b. acute pain is greater in intensity that chronic pain c. acute pain responds better to non-pharmacological methods than does chronic pain 8. Chronic pain is defined by the following characteristic(s): a. the pain stimulus is no longer present b. the ascending pathways continue to send pain signals to the brain c. the clinician s job is to find a way to block the pain signals rather than eliminate the source of the pain 9. A recent American Cancer Society Study identified the fact that the following percent of cancer victims had unresolved issues when dealing with their pain: a. close to 50% b. about 20% c. less than 30% d. nearly 80% 10. Cancer pain is multi-dimensional and could be caused by many factors including: a. fear of mutilation or death b. pain impulses originating in the cancerous site c. loss of social status

6 11. The following medications are the first line of defense for persons with mild to moderate pain: a. hydrocodone, aspirin b. tramadol, acetaminophen c. codeine, Demerol d. acetominophen, aspirin 12. The following is true about Non-steroidal anti-inflammatory drugs (NSAIDS) a. ibuprofen belongs to this class b. they will worsen renal failure c. they are more effective than acetaminophen 13. The gold standard ( the most effective we have) for treating both intractable chronic pain and severe acute pain is: a. hydromorphone b. fentanyl c. morphine d. meperidine/demerol 14. The one drug which has been found most ineffective to use for pain control and should be used only if all other options are exhausted is: a. hydromorphone b. fentanyl c. morphine d. meperidine/demerol 15. The following are risk factors which need to be considered when managing pain: a. obstructive sleep apnea b. liver failure c. renal failure 16. The most frequently bothersome side effect of pain medications reported by patients is: a. diarrhea b. constipation c. skin rash d. dizziness 17. The first and most important thing a nurse needs to do in helping a patient manage pain is: a. show confidence b. establish a trusting relationship c. be empathetic 18. Non-pharmacological approaches to pain management include: a. acupuncture b. tens units c. yoga d. hypnosis e. all of the above

7 Written: I. Pre-Test Excellence in Care: Pain Management Program Outline DVD Presentation: II. Definitions A. Pain B. Dependence C. Tolerance D. Pseudoaddiction E. Addiction F. Aberrant Drug Related Behavior III. Pathophysiology of Pain A. Physical B. Emotional IV. Vicious Cycle of Cancer Pain V. Chronic Pain versus Acute Pain VI. The 4 A Approach VII. Risk Considerations VIII. Pharmacologic treatment IX. Non-Pharmacologic treatments X. Case Study Written: IX. Post-Test X. Evaluation

8 EVALUATION---PAIN MANAGEMENT Title of Education Activity: Excellence in Care Location: DVD Video Format Participants check out and complete on own time Purpose of this activity: The purpose of this activity is to enrich the participant s contribution to quality healthcare and the pursuit of professional career goals by providing current and updated information on management of pain. Directions/Instructions: Please complete this evaluation questionnaire. Your anonymous responses will be used to revise this activity and to plan future educational activities. Circle the number that best fits your evaluation of this activity. 1 = Not at all 2 = Somewhat 3 = Almost completely 4 = Completely 1. Recall definitions of pain, dependence, tolerance, pseudo-addiction, addiction and aberrant drug related behavior. 2. Describe the types and pathophysiology of pain Describe the impact of untreated pain Discuss pharmacologic treatment of pain Discuss non pharmacologic management of pain Integrate objectives 1-5 into a case study Please evaluate guest speaker- Mary Beth Kean, DNP, RN a. Knowledge and currency of topic b. Ability to make points clear c. Ability to apply content to practice

9 4. Please evaluate guest speaker- Helen Petty a. Knowledge and currency of topic b. Ability to make points clear c. Ability to apply content to practice Please evaluate the moderator- Elizabeth Huss RN, BSN a. Guides the discussion b. Asks pertinent questions c. Fosters clarification of presented information Were the objectives relevant to the overall purpose? (see above) 5. How long (in minutes) did it take you to complete the entire activity (including taking the pre-test, watching the video, taking the post-test, and completing this evaluation tool)? Minutes 6. List two (2) ways you will integrate what you learned in this activity into your practice and/or employment environment. 7. The following were disclosed prior to the beginning of this activity in writing? a. Requirements for successful completion Yes No b. Conflicts of Interest Yes No c. Commercial Support Yes No d. Non-endorsement of Products Yes No e. Off-label Use Yes No

10 8. Did you, as a participant, notice any bias that was not previously disclosed in this presentation? Yes No If Yes, please describe who was biased and how. 9. Comments: If you answered (1) to any of the above, please comment. 10. Please list any suggestions or topics for future programming. To receive continuing education credits please return this completed evaluation, the pre-test and the post-test along with your completed registration form and payment to Austin Community College Health Professions Institute Attn: Online Nursing Videos Highland Business Center 5930 Middle Fiskville Rd. Austin TX If you prefer you may deliver the items to the registration desk on the 4 th floor of the Highland Business Center at the indicated address.

11 Post-Test: Pain Management Name: A. MATCHING: Match the definitions on the right to the terms on the left. (1) Whatever the person says it is, occurring whenever ( ) PSEUDOADDICTION the person experiencing it says it does (2) Evidenced by the person having withdrawal symptoms ( ) DEPENDENCE when the drug is not available (3) Evidenced by increasingly higher doses needed to obtain ( ) ADDICTION the same degree of relief (4) When healthcare workers make the mistake of ( ) ABBERANT DRUG identifying an addiction where one does not exist RELATED BEHAVIOR (5) A disease of the brain resulting in behavior which ( ) PAIN requires extensive treatment for healing (6) Problematic behaviors which mimic disease states related ( ) TOLERANCE to the use of therapeutic or street drugs B: MULTIPLE CHOICE: Chose the one most correct answer. 7. Which of the following best describes the difference in acute pain and chronic pain: a. acute pain has a stimulus which is relatively easy to identify b. acute pain is greater in intensity that chronic pain c. acute pain responds better to non-pharmacological methods than does chronic pain 8. Chronic pain is defined by the following characteristic(s): a. the pain stimulus is no longer present b. the ascending pathways continue to send pain signals to the brain c. the clinician s job is to find a way to block the pain signals rather than eliminate the source of the pain 9. A recent American Cancer Society Study identified the fact that the following percent of cancer victims had unresolved issues when dealing with their pain: a. close to 50% b. about 20% c. less than 30% d. nearly 80% 10. Cancer pain is multi-dimensional and could be caused by many factors including: a. fear of mutilation or death b. pain impulses originating in the cancerous site c. loss of social status

12 11. The following medications are the first line of defense for persons with mild to moderate pain: a. hydrocodone, aspirin b. tramadol, acetaminophen c. codeine, Demerol d. acetominophen, aspirin 12. The following is true about Non-steroidal anti-inflammatory drugs (NSAIDS) a. ibuprofen belongs to this class b. they will worsen renal failure c. they are more effective than acetaminophen 13. The gold standard (the most effective we have) for treating both intractable chronic pain and severe acute pain is: a. hydromorphone b. fentanyl c. morphine d. meperidine/demerol 14. The one drug which has been found most ineffective to use for pain control and should be used only if all other options are exhausted is: a. hydromorphone b. fentanyl c. morphine d. meperidine/demerol 15. The following are risk factors which need to be considered when managing pain: a. obstructive sleep apnea b. liver failure c. renal failure 16. The most frequently bothersome side effect of pain medications reported by patients is: a. diarrhea b. constipation c. skin rash d. dizziness 17. The first and most important thing a nurse needs to do in helping a patient manage pain is: a. show confidence b. establish a trusting relationship c. be empathetic 18. Non-pharmacological approaches to pain management include: a. acupuncture b. tens units c. yoga d. hypnosis e. all of the above