8). A number of alternative treatment modalities have been used in an effort to avoid these adverse side effects, including various mind-body and therapeutical techniques that may prove efficacious in some orthopedic patients, but many healthcare providers remain unaware or untrained in their use (Lukas, 2004). For instance, one orthopedic nurse reports that, "In today's fast-paced surgical environment, perioperative nurses face many challenges to meet the needs of outpatients in helping to alleviate their pain and anxiety. Most nurses have not been taught non-pharmacologic methods for control of pain and anxiety" (Lukas, 2004 p. 8).
Besides this lack of training in providing adjunct treatment modalities for pain management in the orthopedic patient, there is also a pronounced lack of training concerning efficacious treatment modalities for younger orthopedic patients. For instance, Bennett-Branson and Craig (1999) emphasize that, "Despite advances in pharmacological approaches to pain control, most children who undergo surgery continue to experience moderate to severe postoperative pain. Children and their parents are forced to rely on personal resources to cope with this severe stressor" (p. 355). As noted above, individual manifestations of pain exist along a continuum that differs from time to time and place to place, but most adults are better able to communicate their level of post-operative pain to their healthcare team, while children under 5 years may be at a distinct disadvantage in this area. For orthopedic patients 5 years and over, though, McGrath (1996) reports that there are several self report measures of pain for children available, as well as observational measures such as facial action scales which appear to be most sensitive to children's post-operative pain. Despite the availability of these measures, many authorities suggest that children's parents should be actively involved in this formulation of pain management approaches, before, during and following surgical interventions. In this regard, Bennett-Branson and Craig (1999) add that parents are a reliable source of accurate information concerning the pain levels being experienced by their children, but that their children's anxiety level corresponded to the parents', suggesting that a family-oriented approach to pain management in the post-operative orthopedic pediatric patient is most appropriate (Bennett-Branson & Craig, 1999).
Implications for Practice
The research to date indicates that postoperative pain management following orthopedic surgical interventions remains less than completely effective, indicating that many of the readily available pharmacological alternatives that are safe and effective for postoperative pain management continue to be underutilized (Bennett-Branson & Craig, 1999). This lack of effectiveness may be due in part to a need for additional training to improve awareness of the various efficacious treatment modalities that are available for adults and children, but the need appears especially pronounced for pediatric patients. In this regard, Bennett-Branson and Craig (1999) conclude that, "Given the increasing use of day surgery, with children discharged home the day of the operation, parents are assuming greater responsibility for the management of unrelieved postoperative pain, yet they currently receive little to no preparation for that role, and find it anxiety provoking" (p. 357). Therefore, parents of orthopedic pediatric patients should receive adequate training and information concerning the effective management of pain following their return home, both for the benefit of the young patient as well as to help reduce their anxiety levels which children can sense and which can contribute to elevated anxiety in them as well (Bennett-Branson & Craig, 1999).
Healthcare practitioners must improve their awareness of the need for efficacious, evidence-based pain management methods for adults and children alike. Because everyone experiences pain in different ways at different times, it is vitally important for clinicians to shake off their preconceptions about pain and develop an empathetic approach that is responsive to orthopedic patients' pain management needs. Not only is this a quality improvement indicators, it is also congruent with the overall need to improve patient satisfaction and facilitate improved clinical outcomes.
Bennett-Branson, S.M. & Craig, K.D. (1999). Postoperative pain in children: Developmental and family influences on spontaneous coping strategies. Canadian Journal of Behavioural Science, 25(3), 355-357.
Eccleston, C. (2001, July). Role of psychology in pain management. British Journal of Anesthesiology 87(1), 144-52.
Facts about Pain Management. (2012, January 9). The Joint Commission. Retrieved from http://
Hunter, S. (2000). Determination of moral negligence in the context of the undermedication of pain by nurses. Nursing Ethics 7(5), 379-384.
Lukas, L.K. (2004). Orthopedic outpatients' perception of perioperative music listening as therapy. Journal of Theory Construction & Testing,…
Patient Safety Through Medication Reconciliation
The adoption of the Affordable Healthcare Act has assisted an increasing number of Americans to have access to health insurance. Despite the benefits associated with the new law, the quality of health delivery is still low because of the issue such as medication errors. The poster recommends an implementation of medical reconciliation to improve the quality of healthcare delivery in the United States. The method of
The ability to resolve conflicting patients is also an appreciable quality. Research is an integral aspect of every subject that requires quality improvement. Research on Orthopedic nursing is required for overall development in the care and assistance provided to improve health conditions of orthopedic patients. ("Orthopedic Nursing Standards," 2007)
Orthopedic nurses currently require developing their knowledge on relevant issues regarding neuro-muscular and skeletal challenges of a patient and the response
Postoperative Patient Falls
Hospitalized patient falls affect health in huge way as they directly affect safety of patients as well as the concern for the quality of healthcare public health facilities around the world provide to patients. While limited data and information is available concerning inpatient falls following patients going on surgery, falls among hospitalized patients have been extensively studies. Falls is one of the major causes of morbidity like lacerations,
Quality of Life Among Tawau Hospital Staff With Osteoarthritis (knees) Been Treated in Physiotherapy Unit
Quality of life among Tawau hospital staff with osteoarthritis (knees) being treated in physiotherapy unit
Knowledge about OA before physiotherapy
Severity of disease before and after rehabilitation
Degree of difficulty as a result of knee OA
Effect on work performance
Effect on emotional status and social activities
Opinion on self-management
Impact of physiotherapy on their knowledge and understanding of the disease
Quality of Life Among Tawau Hospital Sufering From
Knee Osteoarthritis With Physiotherapy
Qualitative study of How Quality of Life of Tawau Hospital Staff
Suffering from Knee Osteoarthritis have been improved at Physiotherapy Unit.
To investigate how the Quality of Life among Tawau Hospital staff suffering from Osteoarthritis (knees) have been improved using Physiotherapy intervention.
The study employs qualitative techniques to collect data. The sample population is selected from people and Tawau Hospital staff visiting the