Portal de Periódicos da CAPES

Nursing Leadership in Innovation

2022; Elsevier BV; Volume: 23; Issue: 2 Linguagem: Inglês

10.1016/j.pmn.2022.02.009

1532-8635

Elaine Miller,

Spine and Intervertebral Disc Pathology

The term “innovation” in healthcare refers to a novel idea, product, service, or care pathway with distinct benefits (Kelly and Young, 2017Kelly C.J. Young A.J. Promoting innovation in healthcare.Future healthcare journal. 2017; 4: 121-125https://doi.org/10.7861/futurehosp.4-2-121Google Scholar) and used everywhere. For instance, healthcare organizations advertise for “Directors of Innovation”, “Innovation & Insights Leaders”, “Director of Nurse Innovation and Entrepreneurship”, “Innovation & Strategy VPs”, and other titles with “innovation” in the descriptions. There are even new enterprises and models of care delivery such as Oak Street Health, Oscar Health, Spring Health, and Babylon Health that focus on better and more efficient ways to deliver care. Blending into this “innovation milieu” are technology companies like Flatiron Health, Verge Genomics, QuiO, and Hinge Health that are using artificial intelligence (AI), analytics, and other measures to better manage population health, particularly for people with chronic conditions including pain. In pain management, innovation has occupied a significant part of our history and healthcare providers have frequently created new and inventive ways to manage or alleviate pain. We will likely see greater use of electrical nerve stimulation, radiofrequency ablation, cryotherapy, psychotherapy, and other inventive approaches to pain management that do not require the use of medications (Deer et al., 2021Deer T.R. Gilmore C.A. Desai M.J. Li S.C. DePalma M.J. Hopkins T.J. Burgher A.H. Spinner D.A. Cohen S.P. McGee M.J. Boggs J.W. Percutaneous peripheral nerve stimulation of the medial branch nerves for the treatment of chronic axial back pain in patients after radiofrequency ablation.Pain medicine. 2021; 22: 548-560https://doi.org/10.1093/pm/pnaa432Google Scholar, Manning et al., 2019Manning A. Ortega R. Moir L. Edwards T. Aziz T. Bojanic S. Green A. Fitzgerald J. Burst or conventional peripheral nerve field stimulation for treatment of neuropathic facial pain.Neuromodulation. 2019; 22: 645-652https://doi.org/10.1111/ner.12922Google Scholar, Sturgeon, 2014Sturgeon J.A. Psychological therapies for the management of chronic pain.Psychology research and behavior management. 2014; 7: 115-124https://doi.org/10.2147/PRBM.S44762Google Scholar.). However, the difficulty of effective pain management that is holistic and patient-centered persists. Nurses, especially those specializing in pain management, know firsthand the challenges we face in helping people deal with pain, especially chronic pain. Nurses understand how pain affects the healing process and know its negative consequences for both patients and family caregivers. Nevertheless, nurses are constantly coming up with inventive ways to reduce pain and are most often the ones regularly assessing, managing and evaluating pain, especially in acute and chronic care environments. Moreover, nurses have played a pivotal role in developing many of the common pain scales in use today such as the McCaffrey Initial Pain Assessment Tool (McCaffery and Pasero, 1999McCaffery M. Pasero C. Pain: Clinical Manual.2nd ed. Mosby, St. Louis, MO1999Google Scholar), FACES (Wong and Baker, 1988Wong DL Baker CM Pain in children: comparison of assessment scales.Pediatric Nursing. 1988; 14: 9-17Google Scholar), the Multidimensional Objective Pain Assessment Tool (McGuire et al., 2011McGuire D.B. Reifsnyder J. Soeken K. Kaiser K.S. Yeager K.A. Assessing pain in nonresponsive hospice patients: development and preliminary testing of the multidimensional objective pain assessment tool (MOPAT).Journal of palliative medicine. 2011; 14: 287-292https://doi.org/10.1089/jpm.2010.0302Google Scholar), and the Checklist of Nonverbal Pain Indicators (CNPI) (Feldt, 2000Feldt K. The checklist of nonverbal pain indicators (CNPI).Pain Management Nursing. 2000; 1: 13-21Google Scholar). In addition, given that over 30% of adults and 12% of children use complementary modalities for pain management (National Center for Complementary and Integrative Health 2021National Center for Complementary and Integrative HealthComplementary, Alternative, or Integrative Health: What's in a Name?.2021https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-nameGoogle Scholar), nurses are continually looking for creative alternatives to pain medication such as relaxation therapy, music, acupuncture, mindfulness, aromatherapy, and reflexology (see the February 2019 Pain Management Nursing Special Issue: Complementary and Integrative Treatment Approaches of Pain Management Nursing). Furthermore, Pain Management Nursing has published numerous groundbreaking and highly cited clinical practice guidelines, position statements and articles that have globally advanced pain management. Examples include “Pain Assessment in the Patient Unable to Self-Report: Position Statement with Clinical Practice Guideline” (Herr et al., 2011Herr K. Coyne P.J. McCaffery M. Manworren R. Merkel S. Pain assessment in the patient unable to self-report: position statement with clinical practice recommendations.Pain management nursing. 2011; 12: 230-250https://doi.org/10.1016/j.pmn.2011.10.002Google Scholar), “Pain Assessment in the Nonverbal Patient: Position Statement with Clinical Practice Recommendations” (Herr et al., 2006Herr K. Coyne P.J. Key T. Manworren R. McCaffery M. Merkel S. Pelosi-Kelly J. Wild L. Pain management nursing. 2006; 7: 44-52https://doi.org/10.1016/j.pmn.2006.02.003Google Scholar), “Procedural Pain Management: A Position Statement with Clinical Practice Guidelines” (Czarnecki et al., 2011Czarnecki M.L. Turner H.N. Collins P.M. Doellman D. Wrona S. Reynolds J. Procedural pain management: a position statement with clinical practice recommendations.Pain Management Nursing. 2011; 12: 95-111https://doi.org/10.1016/j.pmn.2011.02.003Google Scholar), “Pain Assessment in the Patient Unable to Self-Report: Clinical Practice Recommendations in Support of the ASPMN 2019 Position Statement” (Herr et al., 2019), and “Moving Beyond Pain as the Fifth Vital Sign and Patient Satisfaction Score to Improve Patient Care in the 21st Century” (Scher, Meador, Van Cleave and Reid, 2018Scher C. Meador L. Van Cleave J.H. Reid M.C. Moving beyond pain as the fifth vital sign and patient satisfaction scores to improve pain care in the 21st century.Pain Management Nursing. 2018; 19: 125-129Google Scholar). Adding to these efforts, pain management nurses have been creative in offering pain management education for both nurses and other healthcare professionals. For instance, Aronowitz, Compton and Schmidt, 2021Aronowitz S.V. Compton P. Schmidt H.D. Innovative approaches to educating future clinicians about opioids, pain, addiction and health policy.Pain management nursing. 2021; 22: 11-14https://doi.org/10.1016/j.pmn.2020.07.001Google Scholar describe their interdisciplinary pain course, “Opioids: From Receptors to Epidemic”, that expanded clinical understanding of pain and substance use disorders as well as knowledge about public health and policy interventions., In this issue there are multiple examples of how Pain Management Nursing is providing valuable cutting-edge standards and research information to improve best practices and models of care delivery. Turner et al., 2021Turner H.N. Oliver J. Compton P. Matteliano D. Sowicz T.J. Strobbe S. St Marie B. Wilson M. Pain management and risks associated with substance use: Practice recommendations.Pain management nursing. 2021; 23: 91-108Google Scholar present practice recommendations for pain management and risks associated with substance abuse while Panicker, Prasum, Stockmann and Simon, 2022Panicker L. Prasum M. Stockmann C. Simon J. Evaluation of chronic, noncancer pain management initiative in a multidisciplinary pain clinic.Pain Management Nursing. 2022; 23: 122-127Google Scholar reports the outcome of a non-cancer pain management interdisciplinary clinic. Aebischer, Deckmann, Jones and St. John, 2022Aebischer J. Deckmann N. Jones K. St. John A. Chronic pain clinical and prescriptive practices in the cannabis era.Pain Management Nursing. 2022; 23: 109-121Google Scholar describes clinical and prescriptive practices of Cannabis, followed by articles dealing with tapering opioids for high-risk patients (Bérubé et al., 2022Bérubé M. Leduc S. Roy I. Turcotte V. Cote C. Tapering opioid prescription program for high-risk trauma patients: A pilot randomized controlled trial.Pain Management Nursing. 2022; 23: 142-150Google Scholar) and a review of assessment of depression in patients with chronic pain, (Tenti, Raffaeli and Gremigni, 2022Tenti M. Raffaeli W. Gremigni P. A narrative review of the assessment of depression in chronic pain.Pain Management Nursing. 2022; 23: 158-167Google Scholar). Assisting cancer patients with pain self-care management is addressed by Mertilus, Lengacher and Rodriguez, 2022Mertilus D.S. Lengacher C.A. Rodriguez C.S. A review and conceptual analysis of cancer pain self-management.Pain Management Nursing. 2022; 23: 168-173Google Scholar and how pain interference affects post operative care of the CABG patient (Tüfekçi, Akansel and Sivrikaya, 2022Tüfekçi H. Akansel N. Sivrikaya S. Pain interference with daily living activities and dependency level of patients undergoing CABG surgery.Pain Management Nursing. 2022; 23: 180-187Google Scholar). Along with these timely articles are the numerous abstracts from the 2021 ASPMN conference on “hot topics” that affect day-to-day pain management nursing practice. As we move forward, it is apparent that the over 4 million nurses in the US and 20 million nurses worldwide (National Council of State Boards of Nursing 2020National Council of State Boards of NursingNCSBN's environmental scan: A portrait of nursing and healthcare in 2020 and beyond.Journal of Nursing Regulation. 2020; 10: S1-S36Google Scholar) will remain challenged to provide high quality care for those experiencing pain and will continue to create inventive solutions for holistic patient-centered care. Publishing practice standards, performing research and quality improvement projects, conducting rigorous literature reviews, advancing health care policy, and numerous other efforts along with disseminating the findings through publication and presentation will continue to expand best practices. It is evident that pain management nurses have a strong track record of innovation and will continue to make significant contributions.