Advancing Nursing Practice in Pain Management

Advancing Nursing Practice in
Pain Management......Page 5
Contents......Page 7
Contributors’ biographies......Page 13
Foreword 1......Page 17
Foreword 2......Page 19
Preface......Page 21
Acknowledgement......Page 23
Advanced practice......Page 25
The context of pain management: definitions and prevalence......Page 29
Advancing practice in pain management......Page 30
Bringing together advanced practice and pain management......Page 31
Conclusions......Page 32
Introduction......Page 35
Pain control......Page 36
Changes in pain perception......Page 37
Analgesic drugs and the elderly......Page 38
Benefits of FNB......Page 39
Rationale for a nurse-led service......Page 40
Protocol development and training......Page 41
Patient group directions......Page 42
Problems encountered with the training......Page 43
Challenges in implementing a new service......Page 44
Evaluation of the 1-year pilot study......Page 45
Justifying the advanced nursing contribution......Page 47
Conclusions......Page 49
Acknowledgements......Page 50
Introduction......Page 53
Developing the service......Page 57
Challenges in implementing a new service or area of practice development......Page 61
Evaluation of using ketamine for pain relief......Page 62
Justifying the advanced nursing contribution......Page 64
Conclusions......Page 66
Definitions and causes of neuropathic pain......Page 69
Prevalence of neuropathic pain......Page 70
A proposal and rationale for a nurse-led clinic for sufferers of neuropathic pain......Page 71
Identifying stakeholders......Page 74
Developing a business plan......Page 75
Assessment tools......Page 76
The challenges and reality......Page 78
Evaluation of the service......Page 81
Conclusions......Page 82
Appendix 1: Original business plan......Page 83
Appendix 2: Text of an open letter to all local general practitioners informing them of the proposal to commence a nurse-led clinic for painful diabetic neuropathy......Page 87
Appendix 3: Example of a typical letter to a general practitioner, at the time pregabalin was not available for prescription......Page 88
Introduction......Page 95
Intravenous opioid PCA......Page 96
Epidural analgesia......Page 97
New role......Page 98
Developing the service......Page 99
Oral and PCA analgesia......Page 101
Challenges in implementing the changes in practice......Page 108
Ongoing evaluation and audit......Page 111
Justifying the advanced nursing contribution......Page 112
Conclusions......Page 113
Introduction......Page 117
Rationale for setting up an acupuncture clinic for pain management......Page 118
Staff development: education and maintaining competencies......Page 126
Clinical governance......Page 129
Editors’ note......Page 133
Alliances and strategic alliances......Page 137
Skill acquisition......Page 138
Developing entrepreneurial services in pain management......Page 139
The challenge of forming alliances to enable implementation......Page 143
The challenge of maintaining standards......Page 145
Advanced nursing practice and strategic alliances......Page 147
Conclusions......Page 148
Acknowledgements......Page 149
Introduction......Page 151
Background – an overview of the provision of pain services......Page 152
Developing the service......Page 153
Challenges......Page 156
Evaluation......Page 158
Conclusions......Page 163
Appendix 1: Pain clinic audit......Page 164
Introduction......Page 167
Developing the service......Page 169
Challenges in implementing the service......Page 174
Maintaining standards and evaluating the service......Page 177
Justifying the advanced nursing contribution......Page 182
Psychosocial yellow flags – the beliefs and behaviours which may predict poor outcome and which pain management programmes address......Page 183
Acknowledgements......Page 184
Introduction......Page 187
Chronic pain......Page 189
Rationale for service development......Page 191
Evaluation use of audit and CPD......Page 196
Justifying the advanced nursing contribution to develop nurse prescribing in pain management......Page 200
Conclusions......Page 201
Introduction......Page 205
Developing a formal educational qualification in pain......Page 208
Challenges in establishing and managing an interprofessional course......Page 211
Evaluation and the use of audit......Page 213
Justifying the advanced nursing contribution......Page 215
Conclusions......Page 216
Introduction......Page 219
Advancing practice in pain management......Page 226
Conclusions......Page 228
Index......Page 231