Login
Communauté Vinci
Extérieur
Si votre nom d'utilisateur ne se termine pas par @vinci.be ou @student.vinci.be, utilisez le formulaire ci-dessous pour accéder à votre compte de lecteur.
Titre : | Decreasing Opioid Utilization in Rehabilitation Patients Using a Clinical Nurse Specialist Pain Consultant Program (2017) |
Auteurs : | Michael S. Urton ; Elaine Rohlik ; Meagan Farrell |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2017/12, 2017) |
Article en page(s) : | p. 2491-2497 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Douleur ; Infirmières spécialistes cliniques ; Pain ; Rééducation et réadaptation |
Mots-clés: | Nurse clinicians |
Résumé : |
Objective To investigate whether access to a clinical nurse specialist (CNS) with expertise in pain management will result in more rapid decline in opioid use across the rehabilitation hospitalization. Design Retrospective chart review of patients discharged during 6 months prior to and 6 months after introduction of the CNS role. Setting Not-for-profit 98-bed community inpatient rehabilitation hospital. Participants Two population-based samples of adult, inpatient rehabilitation patients (N=72) with daily opioid use ≥30mg morphine equivalent dose (MED) per day on admission and length of stay ≥24 days. Interventions Implementation of a CNS pain consult program. Main Outcome Measures Change in average daily opioid use (milligrams of MED per day), measured at admission, week 1, week 2, and week 3. Results Linear mixed modeling was used to estimate individual and group average opioid trajectories, including individual patient intercepts (opioid use at admission) and slopes (change in opioid use over time). There was a significant interaction between group and time (b=5.75, t=2.52, P<.01 indicating faster change in opioid use for the cns group slope compared with no quadratic reflected an initial increase from admission to week followed by a steady decline. conversely there was virtually group. random effects revealed considerable variability trajectories across patients.> Conclusions Addition of a CNS pain consultant program to an inpatient rehabilitation hospital supported a distinct pattern of opioid tapering that promoted more rapid titration of daily opioid use across the rehabilitation hospitalization. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999317304215 |