American Society For Pain Management Nursing Research Articles

Disparities, Inequities, and Injustices in Populations With Pain: An ASPMN Position Statement

Disparities, inequities, and injustices in populations with pain are historically pervasive and lead to deleterious patient outcomes and perpetuate systemic barriers to achieving equitable pain management. The American Society for Pain Management Nursing (ASPMN) upholds the principle that all persons with pain have equal rights to evidence-based, high quality pain assessment, management, and treatment. Intervening at multilevels (i.e., individual, interpersonal, community, societal) is necessary to ascertain that just and equitable pain care is provided to all populations.

Position Statement: Range Orders in the Management of Pain

American Society for Pain Management Nursing (ASPMN) supports safe medication practices and the appropriate use of pro re nata (PRN) range orders for analgesics in the management of pain within the scope of nursing practice. Although range orders may apply to many medications prescribed as PRN, the focus of this ASPMN position statement is on PRN analgesic medication. PRN range orders are commonly used to provide flexibility in dosing to meet the analgesic requirements of an individual patient. There are many patient-specific factors that require professional clinical assessment when administering medications to patients. Unfortunately, several myths persist regarding The Joint Commission's (TJC) standard around the implementation of range orders leading many to assume that range orders are not supported or safe. On the contrary, if utilized in a consistent and appropriate manner, PRN range orders can allow nurses to provide optimal pain management while still providing safe administration (Paquette et al., 2022).

Challenges Recruiting and Retaining New Members of a Professional Nursing Organization

BackgroundThe American Society for Pain Management Nursing (ASPMN) began as a nursing-focused pain organization in 1990 and has experienced fluctuations in membership over time. According to the literature, membership to many professional organizations, including ASPMN, are waning. New member recruitment and retention is crucial for maintaining viability and financial strength of an organization. AimThis study explores ASPMN new member attitudes, perceptions, and experiences. The intention was to learn what inspired or influenced nurse participants to join ASPMN, what they expect gain from membership, and how the organization can help fulfill their professional pain management goals. MethodThis IRB-exempted qualitative descriptive study offered participants opportunities to reflect upon and share their member experiences either individually or in small focus groups. Nurses were identified via ASPMN new member lists or referred from ASPMN Chapter leaders. Conversations were recorded and transcribed using virtual technology, validated, then analyzed for recurring themes. ResultsOne key finding was that 0 of 11 participants were fully apprised of member benefits. Key themes were most had motivating factors which prompted their joining ASPMN, and many were seeking organization resources (networking, certification, and new knowledge). Challenging focus group recruitment was likely related to internal and external forces, including post-pandemic fatigue with virtual platforms, time constraints, and a general over-abundance of e-communications. ConclusionsMany professional organizations continue to struggle to recruit and retain members. While there were no material incentives, the focus group or individual interviews promoted collegiality, reinforced knowledge about ASPMN member benefits, and provided a platform to dialog about how the organization can grow while addressing member needs. Findings from this study may benefit ASPMN and other organizations by providing insight into what attracts and maintains new members, creating a platform to learn about members, and ideally, identifying new ways of engagement and initiatives.

Procedural Pain Management: Clinical Practice Recommendations

Undergoing potentially painful procedures is necessary among patients of all ages. Nurses are responsible to optimize safety and minimize harm for patients. The American Society for Pain Management Nursing (ASPMN) holds the position that all patients undergoing painful procedures have the right to safe and effective pain management throughout the phases of care, and that the interprofessional healthcare team ensures such ethical obligation is fulfilled within a framework of the patients or their designees’ goals and preferences. From that position, all nurses, clinicians, and health care organizations are strongly encouraged to offer multimodal pain management that includes integrative interventions when managing procedure related pain.

ASPMN Position Paper Update: RNs Caring for Patients Receiving Analgesia by Catheter – Ascertaining Standard of Practice

PURPOSE: This cross-sectional study by survey was designed to ascertain if there is a standard of care for registered nurses (RNs) caring for analgesia by catheter technique. This was important to do since a review of literature and statements from state Boards of Nursing did not identify a standard of care of patients receiving medication by catheters. The American Society for Pain Management Nursing (ASPMN) position paper on this subject was authored in 2007 and revision is needed. This study was found to be Exempt by the Colorado Multiple Institutional Review Board (COMIRB) Methods: The Task Force reviewing and updating the ASPMN “Registered Nurse Management and Monitoring of Analgesia by Catheter Techniques: Position Paper” developed an COMIRB approved convenience sample survey that was disseminated via the ASPMN ListServe and E-Newsletter.

Prescribing and Administering Opioid Doses Based Solely on Pain Intensity: Update of a Position Statement by the American Society for Pain Management NursingⓇ

Prescribing and administering opioid doses based solely on pain intensity is inappropriate and potentially unsafe for many reasons, including that pain intensity ratings are completely subjective, cannot be measured objectively, are dynamic as the experience of pain is dynamic, and may be describing a construct other than intensity (i.e. suffering). Many factors, in addition to pain intensity, influence opioid requirements and subsequent dosing. The American Society for Pain Management Nursing (ASPMN) holds the position that the practice of prescribing and administering doses of opioid analgesics based solely on a patient’s pain intensity should be prohibited because it disregards the relevance of other essential elements of assessment and may contribute to negative patient outcomes.

Position Statement: Acute Perioperative Pain Management Among Patients Undergoing Orthopedic Surgery by the American Society for Pain Management Nursing and The National Association of Orthopaedic Nurses

Patients undergoing elective orthopaedic surgery may experience pain that is acute, chronic or a combination of the two, with less than half of all surgical patients reporting adequate pain relief. The National Association of Orthopaedic Nurses (NAON) and the American Society for Pain Management Nursing (ASPMN) have partnered to provide evidence-informed guidance to empower nurses to employ effective pain management. Understanding and applying ethical, evidence-informed, patient-focused, interprofessional interventions will improve outcomes for patients, clinicians, and healthcare organizations. Together, we encourage nurses to embrace the guiding principles presented in this Position Statement to provide optimal pain management for the orthopaedic patient.

Prescribing and Administering Opioid Doses Based Solely on Pain Intensity: Update of A Position Statement by the American Society for Pain Management Nursing

The foundation of safe and effective pain management is an individualized, comprehensive pain assessment that includes, but is not limited to, the intensity of pain if the patient is able to report it. An unforeseen consequence of the widespread use of pain intensity rating scales is the practice of prescribing specific doses of opioid analgesics based solely on specific pain intensity ratings. Many factors in addition to pain intensity influence opioid requirements. To date there is no research demonstrating that a specific opioid dose will relieve pain of a specific intensity in all patients or even in the same patient at different times. The official position of the American Society for Pain Management Nursing (ASPMN) maintains that the practice of prescribing doses of opioid analgesics based solely on pain intensity should be prohibited because it disregards the relevance of other essential elements of assessment and may contribute to untoward patient outcomes.

The Journey of the American Society for Pain Management Nursing Into Advocacy and Governmental Affairs

In the spring of 2008, as issues with the American Society for Pain Management Nursing (ASPMN) organization and members were rising at the federal level in the realm of governmental affairs, the ASPMN leaders decided to pay closer attention to what was occurring with those issues. The decision was made to start with a small first step to monitor legislation and share with ASPMN's members anything that might be of interest or of which they needed to be aware. The initial step forward was to identify what issues were being discussed and by whom.

Assessing the Impact of the Position Paper “Prescribing and Administering Opioid Doses Based Solely on Pain Intensity”

BackgroundA task force of members of the American Society for Pain Management Nursing (ASPMN) authored a position paper “Prescribing and Administering Opioid Doses Based Solely on Pain Intensity.” Some of the authors of this ASPMN position paper presented a concurrent session at the September 2016 ASPMN National Conference discussing the content of the position paper. As a follow-up, the authors designed a research study to identify the impact of the position statement in facilitating change in institutional practice of dosing analgesics based solely on pain intensity. AimsOur aim was to ascertain the effect of the American Society for Pain Management Nursing ASPMN position paper “Prescribing and Administering Opioid Doses Based Solely on Pain Intensity” (2016) on changes in institutional practices. DesignThe study used an online anonymous questionnaire that included open-ended questions. SettingsAn anonymous electronic questionnaire was used to assess the impact across the United States. Participants/SubjectsParticipants were members of the American Society for Pain Management Nursing. MethodsAn eight-question anonymous questionnaire created through Survey Monkey was sent to members of the American Society for Pain Management Nursing via an e-mail listserv and the monthly e-newsletter. ResultsOf the 142 members who consented to participate in the study, 120 members answered one or more questions. Those who responded to the question about changes in practice, only 13 (11.1%) reported that the position paper had influenced a change in practice at their institution. The majority, 89 (75%), reported that practice had not changed in their institution. ConclusionsAmong those clinicians who participated in this study, the position paper “Prescribing and Administering Opioid Doses Based Solely on Pain Intensity” reportedly had minimal impact on changing institutional practices.

‘‘As-Needed’’ Range Orders for Opioid Analgesics in the Management of Pain: A Consensus Statement of the American Society for Pain Management Nursing and the American Pain Society

Effective pain management requires careful titration of analgesics and evaluation of individual patient's responses to treatment using valid and reliable pain and pain relief assessment tools, and evidence-based patient monitoring for adverse treatment effects. A registered nurse, competent in pain assessment and analgesic administration, can safely interpret and implement properly written ''as-needed'' or ''PRN'' range orders for analgesic medications. The American Society for Pain Management Nursing (ASPMN) and the American Pain Society (APS) support safe medication practices and the appropriate use of PRN range orders for opioid analgesics in the management of pain.

American Society for Pain Management Nursing Position Statement: Prescribing and Administering Opioid Doses Based Solely on Pain Intensity

The foundation of safe and effective pain management is an individualized, comprehensive pain assessment, which includes, but is not limited to, determining the intensity of pain if the patient is able to report it. An unforeseen consequence of the widespread use of pain intensity rating scales is the practice of prescribing specific doses of opioid analgesics based solely on specific pain intensity. Many factors in addition to pain intensity influence opioid requirements, and there is no research showing that a specific opioid dose will relieve pain of a specific intensity in all patients. The American Society for Pain Management Nursing (ASPMN) holds the position that the practice of prescribing doses of opioid analgesics based solely on a patient's pain intensity should be prohibited because it disregards the relevance of other essential elements of assessment and may contribute to untoward patient outcomes.

The Use of “As-Needed” Range Orders for Opioid Analgesics in the Management of Pain:: A Consensus Statement of the American Society of Pain Management Nurses and the American Pain Society

View Large Image Figure Viewer Download Hi-res image Effective pain management requires careful individual titration of analgesics that is based on a valid and reliable assessment of pain and pain relief. A registered nurse, who is competent in pain assessment and analgesic administration, can safely interpret and implement properly written “as-needed” or “PRN” range orders for analgesic medications. The American Society for Pain Management Nursing (ASPMN) and the American Pain Society (APS) support safe medication practices and the appropriate use of PRN range orders for opioid analgesics in the management of pain.

American Society for Pain Management Nursing Position Statement with Clinical Practice Guidelines: Authorized Agent Controlled Analgesia

The American Society for Pain Management Nursing (ASPMN) has updated its 2007 position statement on the use of authorized agent controlled analgesia (AACA) for patients who are unable to independently utilize patient-controlled analgesia (PCA). ASPMN continues to support the use of AACA to provide timely and effective pain management while promoting equitable care for vulnerable patient populations who are unable to utilize PCA. ASPMN does not support the use of “PCA by Proxy” in which unauthorized individuals activate PCA for a patient. The background of the development of the position statement, definitions related to AACA, and application of ethical principles to the use of AACA are presented in the document. This position statement includes an updated review of the evidence related to AACA and a call for further research. Clinical practice recommendations for authorized agents, nurses, prescribers, and organizations are provided with an emphasis on the importance of appropriate authorized agent selection, education, diligent patient assessment and medication management.

American Society for Pain Management Nursing Position Statement

The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high-quality pain assessment and management. Failure to identify and treat the concurrent conditions of pain and substance use disorders will compromise the ability to treat either condition effectively. Barriers to caring for these patients include stigmatization, misconceptions, and limited access to providers skilled in these two categories of disorders. Topics addressed in this position statement include the scope of substance use and related disorders, conceptual models of addiction, ethical considerations, addiction risk stratification, and clinical recommendations.

American Society for Pain Management Nursing Position Statement: Pain Management in Patients with Substance Use Disorders

The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high-quality pain assessment and management. Failure to identify and treat the concurrent conditions of pain and substance use disorders will compromise the ability to treat either condition effectively. Barriers to caring for these patients include stigmatization, misconceptions, and limited access to providers skilled in these two categories of disorders. Topics addressed in this position statement include the scope of substance use and related disorders, conceptual models of addiction, ethical considerations, addiction risk stratification, and clinical recommendations.

Opioid-Induced Sedation and Respiratory Depression: Evidence-Based Monitoring Guidelines

RESPIRATORY DEPRESSION IS the most feared of the opioid adverse effects. Nurses in hospitals and all settings nationwide are challenged every day to prevent this life-threatening adverse effect. In 2011, the American Society for Pain Management Nursing (ASPMN) released evidence-based guidelines on monitoring for opioid-induced sedation and respiratory depression in patients receiving opioids for painmanagement in the acute care setting. The guidelines provide answers to frequently asked questions and may be useful in the development of hospital policies and procedures related to this important aspect of patient care. This article describes the development of the guidelines and provides its key recommendationswith implications for nursing practice and the care of patients with pain.

American Society for Pain Management Nursing (ASPMN) Position Statement: Male Infant Circumcision Pain Management

The ASPMN strongly recommends that infants who are being circumcised must receive optimal pain management. ‘‘If a decision for circumcision is made, procedural analgesia should be provided’’ (AAP, 1999, p. 691). Therefore, it is the position of the ASPMN that optimal pain management must be provided throughout the circumcision process. Furthermore, parents must be prepared for the procedure and educated about infant pain assessment. They must also be informed of pharmacologic and integrative pain management therapies that are appropriate before, during, and after the procedure.

Procedural Pain Management: A Position Statement with Clinical Practice Recommendations

The American Society for Pain Management Nursing (ASPMN) has developed a position statement and clinical practice recommendations related to procedural preparation and comfort management. Procedures potentially produce pain and anxiety, both of which should be assessed and addressed before the procedure begins. This position statement refers to “comfort management” as incorporating the management of pain, anxiety, and any other discomforts that may occur with procedures. It is the position of ASPMN that nurses and other health care professionals advocate and intervene based on the needs of the patient, setting, and situation, to provide optimal comfort management before, during, and after procedures. Furthermore, ASPMN does not condone procedures being performed without the implementation of planned comfort assessment and management. In addition to outlining this position with supporting evidence, this paper reviews the ethical considerations regarding procedural comfort management and provides recommendations for nonpharmacologic and pharmacologic management during all phases of the procedure. An appendix provides a summary of this position statement and clinical practice recommendations.

Use of Placebos in Pain Management

The American Society for Pain Management Nursing (ASPMN) holds the position that a placebo should not be used by any method to assess and/or manage an individual’s pain regardless of their age or diagnosis. The only justifiable use of placebos is for participants enrolled in a blinded clinical trial. These clinical trials must be Institutional Review Board (or equivalent) approved with participants clearly informed that they may receive a placebo before they consent to participate and actually have the sham treatment administered.