Nursing Commons^™

Implementing Pain Management Policies And Procedures At A Rural Pain Clinic, Jamie Swearingen

Doctor of Nursing Practice Projects

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural …

Fascia Iliaca Blocks For The Treatment Of Hip Fractures In The Emergency Department, Megan Hahn

Doctor of Nursing Practice Projects

Due to the aging population, the number of falls are increasing, leading to an increased number of individuals with hip fractures presenting in emergency departments (ED). Opioids are often administered for intraoperative pain related to hip fractures, which may result in a number of adverse effects, especially in the elderly. There is strong evidence suggesting that the use of fascia iliaca blocks (FIBs) in the ED can minimize opioid use, and improve patient outcomes and recovery. FIB is a compartment block that delivers local anesthetic around the lumbar plexus to provide analgesia associated with hip fractures.

The purpose of this …

Implementation Of Provider Education For A Subanesthetic Ketamine Infusion For Acute Analgesia In Opioid Tolerant Postpartum Patients, Leah Baecht

Doctor of Nursing Practice Projects

The current opioid epidemic demands the development of new management policies and staff education to increase awareness of issues and improve care of patients with Opioid Use Disorder (OUD). A recent dramatic increase in OUD during pregnancy has paralleled the epidemic observed in the general population. The combination of OUD and cesarean delivery, place both the mother with OUD and neonate at risk for increased postoperative complications. The purpose of this project was to evaluate and increase staff knowledge regarding OUD in obstetrics. An analysis of staff knowledge was performed via surveys both pre and post dissemination of evidence. The …

Managing Chronic Back Pain In A Rural Primary Care Setting, Cassandra Chambers, Kaitlin E. Behnken

Doctor of Nursing Practice Projects

Chronic back pain management is complex and is often challenging for Primary Care Providers (PCPs). Rural PCPs are managing chronic back pain despite limited training and availability of pain management specialists. Pharmacological interventions are often used to treat chronic back pain despite current evidence suggesting physical therapy and aquatic therapy are first-line treatments. A directory of local therapy facilities offering physical and aquatic therapy and a review of clinical practice guidelines (CPG) were provided to three PCPs in a rural clinic in the Midwest. Use of the directory and the CPG was intended to help decrease reliance on pharmacological options …

Improving Acute Pain Management For Pediatric Patients: Development Of A Ketamine Infusion Protocol, Oksana Koeppen

Doctor of Nursing Practice Projects

Multimodal analgesia is a recommended approach for acute pain management for adults and children (ASA, 2012; Chou et al., 2016). This approach is becoming a prominent modality in pain control strategies in the pediatric population. An intravenous anesthetic, ketamine, may be a useful adjunct for acute pain management in children. Development of a pediatric ketamine infusion protocol and its subsequent introduction to the key stakeholders at the host facility in central Illinois were the focus of this project. Research has demonstrated the effectiveness of low-dose intravenous ketamine in acute pain management when used as an adjunct to other medications (Asadi …

Improving Acute Pain Management: Development Of An Adult Dexmedetomidine Infusion Protocol, Timothy Denney

Doctor of Nursing Practice Projects

Studies have revealed over 80% of surgical patients experience acute postoperative pain: 75% of patients describe pain levels as moderate, severe, or extreme (Chou et al., 2016). Opioids continue to be the mainstay of most postoperative analgesia regimens (Tan, Law, & Gan, 2015). While effective for the treatment of severe pain, opioid use also prolongs length of hospital stay and places patients at greater risk for higher adjusted mean costs due to dose-related side effects. Multimodal analgesia is a concept that continues to gain momentum to improve perioperative analgesia while reducing the incidence of opioid-related adverse events (Buvanendran & Kroin, …