Browsing by Author "Berben, SA"

Now showing items 1-2 of 2

A nurse-initiated pain protocol in the ED improves pain treatment in patients with acute musculoskeletal pain
Pierik, JGJ ; Berben, SA ; IJzerman, MJ ; Gaakeer, MI ; van Eenennaam, FL ; van Vugt, AB ; Doggen, CJM
2016, Article / Letter to editor (International Emergency Nursing, vol. 27, (2016), pp. 3-10)While acute musculoskeletal pain is a frequent complaint, its management is often neglected. An implementation of a nurse-initiated pain protocol based on the algorithm of a Dutch pain management guideline in the emergency department might improve this. A pre-post intervention study was performed as part of the prospective PROTACT follow-up study. During the pre-( 15 months, n = 504) and post-period ( 6 months, n = 156) patients' self-reported pain intensity and pain treatment were registered. Analgesic provision in patients with moderate to severe pain ( NRS = 4) improved from 46.8% to 68.0%. Over 10% of the patients refused analgesics, resulting into an actual analgesic administration increase from 36.3% to 46.1%. Median time to analgesic decreased from 10 to 7 min ( P < 0.05), whereas time to opioids decreased from 37 to 15 min ( P < 0.01). Mean pain relief significantly increased to 1.56 NRS-points, in patients who received analgesic treatment even up to 2.02 points. The protocol appeared to lead to an increase in analgesic administration, shorter time to analgesics and a higher clinically relevant pain relief. Despite improvements, suffering moderate to severe pain at ED discharge was still common. Protocol adherence needs to be studied in order to optimize pain management. (C) 2016 Elsevier Ltd. All rights reserved.
Pain Management in the Emergency Chain: The Use and Effectiveness of Pain Management in Patients with Acute Musculoskeletal Pain
Pierik, JGJ ; IJzerman, MJ ; Gaakeer, MI ; Berben, SA ; van Eenennaam, FL ; van Vugt, AB ; Doggen, CJM
2015, Article / Letter to editor (Pain Medicine, vol. 16, iss. 5, (2015), pp. 970-984)ObjectiveWhile acute musculoskeletal pain is a frequent complaint in emergency care, its management is often neglected, placing patients at risk for insufficient pain relief. Our aim is to investigate how often pain management is provided in the prehospital phase and emergency department (ED) and how this affects pain relief. A secondary goal is to identify prognostic factors for clinically relevant pain relief. DesignThis prospective study (PROTACT) includes 697 patients admitted to ED with musculoskeletal extremity injury. Data regarding pain, injury, and pain management were collected using questionnaires and registries. ResultsAlthough 39.9% of the patients used analgesics in the prehospital phase, most patients arrived at the ED with severe pain. Despite the high pain prevalence in the ED, only 35.7% of the patients received analgesics and 12.5% received adequate analgesic pain management. More than two-third of the patients still had moderate to severe pain at discharge. Clinically relevant pain relief was achieved in only 19.7% of the patients. Pain relief in the ED was higher in patients who received analgesics compared with those who did not. Besides analgesics, the type of injury and pain intensity on admission were associated with pain relief. ConclusionsThere is still room for improvement of musculoskeletal pain management in the chain of emergency care. A high percentage of patients were discharged with unacceptable pain levels. The use of multimodal pain management or the implementation of a pain management protocol might be useful methods to optimize pain relief. Additional research in these areas is needed.

Now showing items 1-2 of 2

Browsing by Author "Berben, SA"

Browse

All of HAN Publications