Perioperative, Operating Room and Surgical Nursing Commons^™

Implementing A Nurse-Led Multimodal Pain Management Toolkit To Enhance Recovery After Outpatient Urologic Surgery, Danielle Cirlos-Valles

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose To evaluate the impact of a nurse-led multimodal postoperative pain management toolkit on recovery outcomes among adults undergoing same-day urologic surgery.

Design Quality improvement project using a pre–post implementation design in an outpatient perioperative setting.

Methods An evidence-based toolkit grounded in Enhanced Recovery After Surgery (ERAS) principles was implemented over eight weeks, incorporating scheduled non-opioid analgesics, nonpharmacologic strategies (thermal therapy, guided breathing, early mobilization), standardized patient education, and 24-hour follow-up calls. Outcomes included Visual Analog Scale (VAS) pain scores at discharge and 24 hours, escalation pathway utilization, and nurse knowledge competency. Descriptive statistics and paired t tests were used. …

In A Bind: Effect Of Abdominal Binding On Postoperative Pain In Abdominal Surgery Patients, Mattison Edinger-Vanatta

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

This evidence-based project seeks to answer the question, in patients who have undergone abdominal surgery, what is the effect of abdominal binders on postoperative pain? A literature review was conducted and ultimately, five peer-reviewed articles, comprised of three randomized controlled trials and two systematic reviews, were selected to answer this question. Each article studied the effect of abdominal binders using a “binder” and a “non-binder” group in patients who had undergone various types of open abdominal surgeries, including gynecological cancer excisions, cesarean deliveries, midline laparotomies, hernia repairs, and more. Each study used the visual analogue scale to assess patient pain …

Intraoperative Ketamine Administration: An Adjunctive Therapy That Reduces Postoperative Pain For Patients Undergoing Spinal Surgery, Brittany Pierce

Doctoral Projects

In 2017, the United States Department of Health and Human Services declared that the country was experiencing an opioid crisis (U.S. Department of Health and Human Services, 2018). As a result of this phenomenon, healthcare providers are examining how they are managing pain and researching new avenues for the treatment of pain. Anesthesia providers are in a unique position to help reduce postoperative pain and ultimately the development of chronic pain. This doctoral project was conducted in order to write an evidence-based policy that directs and educates anesthesia providers in the administration of intraoperative ketamine to reduce postoperative pain in …

The Association Of Prescription Opioid Exposure And Patient Factors With Prolonged Postoperative Opioid Use In Opioid Naive Patients, Jennifer Lanzillotta

Electronic Theses and Dissertations

Background

Research suggests prolonged postoperative opioid use occurs in 4-13% of opioid naïve patients and is related to factors other than surgical pain. However, it is unclear which patient factors and prescribing practices are associated with prolonged use after surgery among opioid naïve patients.

Objectives

To identify factors associated with prolonged postoperative opioid use (refills 90-180 days after surgery) in opioid naïve patients in two domains: specific patient characteristics (demographics, smoking status, comorbidities, etc.) and exposure through postoperative opioid prescriptions (in oral morphine milligram equivalents [OME]).

Methods

An electronic medical record dataset analysis of inpatient and outpatient opioid naïve adult …

Opioid Use In The Cesarean Section Patient With The Preoperative Administration Of Intravenous Acetaminophen, Dana Edwards Bernardo

Doctoral Projects

Cesarean sections are one of the most common surgical procedures and there are no current guidelines for the management of postoperative pain control (Darvish, Ardestani, Shali, & Tajik, 2013). Unresolved pain in this population can lead to long lasting problems, such as chronic pain and depression (Booth, Harris, Eisenach, & Pan, 2015). The goal of multimodal therapy with IV acetaminophen for CS mothers was to ensure a rapid and safe recovery process with reduced adverse complications and shortened hospital length of stay. The independent t-test was used to compare the mean time for length of stay, first request of pain …

Does The Use Of A Regional Nerve Block Decrease The Incidence Of Post Operative Nausea And Vomiting, Decrease Pain Scores, Or Decrease Discharge Time Compared To General Anesthesia Alone?, Donald Lane Whitney

Doctoral Projects

Problem Statement: The use of regional anesthesia in orthopedic surgeries has been shown to decrease the rate of postoperative nausea and vomiting (PONV), postoperative pain, and decrease postoperative discharge time. However, some healthcare facilities continue to provide anesthesia for these procedures without the use of regional anesthesia techniques.

Purpose: The purpose of this capstone project was to determine if the addition of a regional anesthetic technique would be beneficial to the patient and cost efficient to the healthcare facility.

Methods: A retrospective chart review was conducted and data collected on the population of interest. Inclusion criteria were patients undergoing orthopedic …

Intravenous Acetaminophen Reduces Opioid Use For Postoperative Pain In Obese Patients Undergoing Laparoscopic Cholecystectomy, Kimberly S. Burks

Doctoral Projects

Opioid-induced respiratory depression is categorized as a sentinel event, which is an unanticipated occurrence that may result in severe injury or death. Although the incidence of opioid-induced respiratory depression is 0.2 to 2%, this issue persists as a substantial basis of morbidity and mortality. The obese population has multiple physiologic elements that increase their risk for opioid-induced respiratory depression. This retrospective study examined if intravenous (IV) acetaminophen reduces opioid consumption in the postoperative period in obese patients who underwent a laparoscopic cholecystectomy. Adequately controlled postoperative pain provides for greater patient satisfaction, decreased hospital length of stay (LOS), and reduced costs …

Preoperative Predictors Of Postoperative Pain, Robyn A. Paterson

Theses: Doctorates and Masters

The purpose of this study was to investigate five factors, which have been identified in the literature as having influence on the experience of postoperative pain. (1) Patient satisfaction with preoperative information, (2) Anticipated postoperative pain, (3) General self-efficacy, (4) Age, (5) Gender. These variables were examined to determine their relationship, if any with postoperative pain. Any relationship between these variables was also examined. Review of the literature revealed considerable research on pain, and that much of that research has been directed at the treatment of, rather than prediction of postoperative pain. Also, these studies have focused on patients who …

Administration Of Post-Operative Analgesia, Liora J. Valinsky

Theses : Honours

Pain is one of the major problems encountered by patients who have undergone surgery. The relief of pain is an important part of their treatment, and is both a nursing and a medical responsibility. Analgesics, both narcotic and non-narcotic, are usually prescribed by doctors on a pro re nata, or ‘as needed' basis. The responsibility for administration lies with the nurses, and they choose the type and quantity of drug to be given. Research into the area of pain relief has shown that both nurses and doctors need further education in the judicious use of analgesics, particularly narcotics. This study …