Course Code: REL-PAC-ELNEC-CCMPAINM
Hours: 2
Type: Online Course
Content Expiration Date: 12/31/2026
Learning Objectives:
Identify three barriers to adequate pain relief for patients with serious illness in the critical care setting.
Describe two components of a thorough pain assessment.
Describe two pharmacological and two nonpharmacological therapies used to relieve pain.
Discuss the critical care nurse’s role in pain assessment and management for patients with serious illness in the critical care setting.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Introduction to Pain Management
Pain and Pain Treatment
Pain Is…
Causes of Pain in Critical Care
Cancer and Pain
Non-Malignant Disease and Pain
Effects of Unresolved Pain
Barriers to Pain Relief
Overcoming Barriers
Clinical Practice Guidelines
Pain vs. Suffering
Undertreatment of Pain
Undertreatment in Older Adults
Others at Risk
Review
Summary
Section 3: Pain Assessment
Pain Etiology
Pain Intensity
Pain Assessment and Management Vignette
Discussion Questions
Communication
Pain Experience
Foci of Pain Assessment
Physical Examination
Functional Assessment
Laboratory and Diagnostic Evaluation
Inability to Self-Report
Reassess
Communicating Assessment Findings
Review
Summary
Section 4: Pain Management
Pain Management in Critical Care
Acetaminophen
NSAIDs
NSAID Adverse Effects
Commonly Used Opioids
Buprenorphine
Other Opioids
Opioid Use in Critical Care
Opioids and Renal Failure
Opioids and Respiratory Depression
Opioids and Constipation
Other Adverse Effects
Substance Use Disorder, Tolerance, and Dependence
Antidepressants
Other Adjuvant Therapy
Other Agents Used Frequently in Critical Care Settings
Routes of Administration
Review
Summary
Section 5: Principles of Pain Management
Opioid Dose Titration
Opioid Rotation and Equianalgesia
Equianalgesia
Communicating Pain Assessment Findings
Substance Use Disorder
Other Issues with Pain Management
Interventional Therapies
Non-Pharmacologic Strategies
Review
Summary
Section 6: Conclusion
Course Summary
Course Contributors
Resources
References
Subject Matter Expert: 2023 ELNEC Critical Care Series
The content for this course was written by The ELNEC Project Team.
The ELNEC Project, which began in 2000, is a collaboration between City of Hope, Duarte, CA and the American Association of Colleges of Nursing (AACN), Washington, DC. For more information about ELNEC, go to www.aacnnursing.org/ELNEC
The content for this course was revised by:
Constance Dahlin, MSN, ANP-BC, ACHPN®, FPCN, FAAN has focused her career within hospice and palliative care. She has experience in administration of programs, program development, curricula development, education of the interprofessional team, and clinical practice in the home, clinic, long term care setting, rehabilitation setting and the acute care setting.. Currently, she is faculty here at University of Maryland Baltimore PhD, Master of Science and Graduate Certificate in Palliative Care, a consultant to the Center to Advance Palliative Care (CAPC) in community-based care and education, co-director of the Palliative APP Externship, with a clinical practice as a palliative nurse practitioner at Salem Hospital and. She serves as national faculty for the End-of-Life Nursing Education Consortium (ELNEC), the American Hospital Association Circle of Life Committee, the Massachusetts Serious Illness Coalition Nursing Taskforce, and the Massachusetts Comprehensive Cancer Steering Committee.
Ms. Dahlin authored several editions of the Palliative Nursing: Scope and Standards and Competencies for the Palliative and Hospice RN, and APRN. She wrote the Hospice and Palliative APRN Professional Practice Guide and A Primer of Reimbursement, Billing, and Coding: Essential Information for the Hospice and Palliative APRN. She is coeditor of the Oxford University Press Advanced Practice Palliative Nursing 1st and 2nd editions. She referenced the 2004 first education of the National Consensus Project’s Clinical Practice Guidelines for Palliative Care and edited the 2009 second and third 2013 editions.
Ms. Dahlin served on the Measurement Applications Partnership PAC/LTC Workgroup, the Measurement Applications Partnership Clinician Workgroup within the National Quality Forum and co-chaired the Massachusetts Comprehensive Cancer Control and Prevention Network Palliative Care Workgroup. Ms. Dahlin is a Fellow of Hospice and Palliative Nursing, a Fellow of the American Academy of Nursing, a 2005 Certified ACHPN APRN of the year, a 2016 recipient of a Sojourns Cambia Health Foundation Sojourns Leadership Scholar Award, a 2018 American Academy of Hospice and Palliative Medicine Visionary in Hospice and Palliative Medicine, the 2020 HPNA Distinguished Practice Award and the 2021 University of Maryland Baltimore Master of Science and Graduate Certificates in Palliative Care Teacher of the Year. She completed her MSN in oncology nursing and her post-masters in adult primary care at the MGH Institute of Health Professions. She has authored peer reviewed articles, chapters and curricula and presented nationally and internationally.
Judith Paice, PhD, RN is the Director of the Cancer Pain Program in the Division of Hematology-Oncology and a Research Professor of Medicine, Northwestern University, Feinberg School of Medicine. She is also a member of the Robert H. Lurie Comprehensive Cancer Center. Dr. Paice is presently a member of the NIH HEAL Initiative Multidisciplinary Working Group and has served as President of the American Pain Society and Secretary of the International Association for the Study of Pain. Currently a panel member of the NCCN Adult Cancer Pain Clinical Practice Guideline, much of Dr Paice’s clinical work has been in the relief of pain associated with cancer. She has traveled widely within six continents to educate health care professionals regarding cancer pain relief and palliative care. Dr. Paice serves on the editorial board of the Journal of Pain, Journal of Pain and Symptom Management and Journal of Clinical Oncology and is the author of more than 170 scientific manuscripts. She was one of the original consultants in the End-of-Life Nursing Education Consortium (ELNEC) and has continued serving as a faculty member in this program. In 2018, Dr. Paice was named one of the 30 Visionaries in the field by the Academy of Hospice and Palliative Care.
Target Audience:
The target audience for this course is: Nursing Personnel; in the following settings: Hospice.
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To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.