Association between organizational characteristics and adequate pain management at the intensive care unit

Publication date: Available online 16 November 2019Source: Journal of Critical CareAuthor(s): Marie-José Roos-Blom, Dave Dongelmans, Willemke Stilma, Jan Jaap Spijkstra, Evert de Jonge, Nicolette de KeizerAbstractPurposeHalf of the patients experience pain during their ICU stay which is known to influence their outcomes. Nurses and physicians encounter organizational barriers towards pain assessment and treatment. We aimed to evaluate the association between adequate pain management and nurse to patient ratio, bed occupancy rate, and fulltime presence of an intensivist.Materials and methodsWe performed unadjusted and case-mix adjusted mixed-effect logistic regression modeling on data from thirteen Dutch ICUs to investigate the association between ICU organizational characteristics and adequate pain management, i.e. patient-shift observations in which patients' pain was measured and acceptable, or unacceptable and normalized within 1 h.All ICU patients admitted between December 2017 and June 2018 were included, excluding patients who were delirious, comatose or had a Glasgow coma score 
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research

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Authors: Kuettel D, Primdahl J, Weber U, Terslev L, Østergaard M, Petersen R, Pedersen AK, Möller S, Hørslev-Petersen K Abstract OBJECTIVE: To examine prospectively self-reported flare characteristics and their longitudinal association with disease activity and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA). METHODS: Consecutive RA patients with DAS28CRP
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research
AbstractPurpose of ReviewPancreatic duct stones are sequela of chronic pancreatitis. They can cause pancreatic duct obstruction which is the most important cause of pain in chronic pancreatitis. Stone resolution has shown to improve pain. The goal of this review is to highlight recent endoscopic and surgical advancements in treatment of pancreatic duct stones.Recent FindingsStone fragmentation by extracorporeal shock wave lithotripsy has become first line and the mainstay of treatment for majority of patients with pancreatic duct stones. Introduction of digital video pancreatoscopy in the last few years with the capability...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
ConclusionsOur survey indicates that IPM practice and training were not uniform, and that interventional therapies for chronic pain may not be performed in accordance with the best available evidence. Our survey highlights a lack of IPM training opportunities, which may result in substandard training. Concerted efforts involving physician organizations and regulators are needed to standardize IPM training and develop clinical guidelines to optimize evidence-based practice.
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
Publication date: Available online 2 December 2019Source: Medical Journal Armed Forces IndiaAuthor(s): Vijay Singh, Abdul NasserAbstractCongenitally deaf and mute adult patients have speech and language disabilities. Establishing meaningful communication with these patients is a challenge in acute hospital-care settings, particularly when anaesthetic care is to be provided. Several methods can be adopted to facilitate interaction, such as sensitisation of health-care providers and training them in ways to communicate effectively. A thorough preoperative assessment and customised perioperative management satisfying the pati...
Source: Medical Journal Armed Forces India - Category: General Medicine Source Type: research
Objective: To evaluate the efficacy of intraoperative superior hypogastric plexus (SHP) blocks on postoperative pain management in abdominal hysterectomies. Materials and Methods: A total of 78 female American Society of Anesthesiologists grade I or II patients who underwent elective total abdominal hysterectomy for benign reasons were assessed for eligibility. After exclusion of patients who did not fulfill the inclusion criteria, 60 patients were evaluated in 2 groups: patients who had intraoperative SHP block (SHP; n=30), and patients who did not have intraoperative SHP block (No-SHP; n=30). Results: There was n...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
__________ Just a heads-up about a great event later this week in Dublin, Ireland, for those working on virtual and augmented reality and healthcare innovation. When: Thu Dec 5, 2019 8:00 am — Fri Dec 6, 2019 5:00 pm. Where: Davenport Hotel Featured sessions include: Day 1 – Thursday, December 5th, 2019 9:00am‑9:30am Introductions, Welcome and Setting The Stage Robert Fine, Executive Director, International Virtual Reality and Healthcare Association (IVRHA) 9:30am-10:30am Keynote Presentation:  Virtual Reality and Healthcare: The Past, The Present and The Future Dr. Walter Gree...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Cognitive Neuroscience Education & Lifelong Learning Health & Wellness Technology augmented reality Dublin healthcare healthcare innovation virtual-reality Source Type: blogs
Current guidelines recommend assessing and relieving pain in all children and in all instances; yet, in clinical practice, management is frequently suboptimal. We investigated the attitude of Italian family pe...
Source: Italian Journal of Pediatrics - Category: Pediatrics Authors: Tags: Research Source Type: research
Abstract The prolonged disability associated with musculoskeletal (MSK) pain represents an enormous health burden, for individuals as well as society. Promoting pain and disability management for patients with persistent MSK-related conditions can be very challenging for rehabilitation professionals. These often-complex conditions require the adoption of a biopsychosocial perspective in order to assess and address a vast array of potential factors affecting the patient. Fortunately, a self-management (SM) approach has been deemed effective in enhancing patients' control over their symptoms and disabilities. Howeve...
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
AbstractPurpose of ReviewSuicidal behaviours are a challenge for a medical system and public health, partly due to the current lack of evidence-based, effective, rapid tools for suicidal crisis management. Ketamine and its enantiomer esketamine have raised hopes regarding this issue in the recent years. However, their efficacy in suicidal behaviours and mechanisms for it remain a topic of debate.Recent FindingsSubanesthetic ketamine doses rapidly, albeit transiently decrease suicidal ideation, with effects emerging within an hour and persisting up to a week. Current evidence points to various and not necessarily exclusive ...
Source: Current Psychiatry Reports - Category: Psychiatry Source Type: research
AbstractBackgroundCurrent guidelines recommend assessing and relieving pain in all children and in all instances; yet, in clinical practice, management is frequently suboptimal. We investigated the attitude of Italian family pediatricians towards the evaluation and treatment of different types of acute pain in children aged 7 –12 years.MethodsThis is a cross-sectional study based on a 17-question survey accessible online from October 2017 to October 2018. Responders had to describe cases of children suffering from any type of acute pain among headache, sore throat, musculoskeletal/post-traumatic pain, and eara...
Source: Italian Journal of Pediatrics - Category: Pediatrics Source Type: research
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