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Pain Resource Manual


NEWLY REVISED FOR 2018! The Pain Resource Manual is an expanded interdisciplinary Clinical Practice Guideline containing resources for pain assessment and management in a variety of populations and modalities. [Contacts Steve Morton, Page Dunbar, Joy Miller, Kate Bidwell Horton, Nancy Farish, Anne Stadelmaier]

Chapter 01 : Adult Pain Resources

Section 00 : Policies, Protocols, and Procedures

01 Medical Center Policy 0239: Pain Assessment and Management (Adult & Pediatric Patients)

02 Medical Center Policy 0299: Controlled Substances

03 Medical Center Policy 0153: Procedural Sedation by Non-Anesthesiology Providers

04 Medical Center Policy 0312: Same Day Discharge of Outpatients Who Have Received Sedation or Anesthesia

05 Nursing Policy: Palliative Care, End of Life & Postmortem Care

06 Nursing Policy: Epidural Continous Infusions and/or Boluses

07 Emergency Dept P-2: Severe Pain Stabilization Procedure

08 Emergency Dept O-1: Outpatient Prescribing of Opioids in the Emergency Department

09 Standard Work: Comfort Rounding

Section 01 : Adult - General Guidelines

01 : Pain Assessment and Management (Adult Patients)

02 : Treating Pain in the Older Adult

03 : Treating Pain in Adult Patients with Substance Abuse Disorders

04 : Sedation for Diagnostic and Therapeutic Purposes - Adult & Geriatric

05 : Pain, Agitation (Sedation), Delirium Treatment Guidelines - Adult Critical Care

06 : Palliative Sedation Guidelines (3 East)

07 : RETIRED Subpleural catheter insertion and continous Paravertebral Nerve Block for pain from VATS

08 : Alcohol Withdrawal Screening, Assessment and Treatment Guidelines

09 : Intravenous Medication Administration Guidelines - Adult Acute Care

10 : Intravenous Medications Administration Supplement: Adult Intermediate Care Units

Section 02 : Adult - Consultation Services

01 : Inpatient Consultation Services (Adult)

Section 03 : Adult - Pain and Sedation Assessment Tools

01 : UVA Adult Pain Scale

02 : Assume Pain Present - Assessment for Nonverbal or Cognitively Impaired Patients

03 : Critical Care Pain Observation Tool (CPOT)

04 : Assess for Opioid Oversedation Using Modified POSS

04a : Modified Pasero Opioid Sedation Scale (POSS)

05 : Pain Assessment in Advanced Dementia Scale (PAINAD) - Continuum Home Health Use Only

Section 04 : Adult - Opioid Sparing Modalities and Non-Opioid Analgesia

01 : Complementary Modalities

03 : Non-Opioid Analgesia Recommendations (Adults)

04 : Continous Low-Dose Lidocaine Infusion Guidelines (Adult)

04a : Lipid Emulsion Rescue for Lidocaine Toxicity (Adults)

Enhanced Recovery After Surgery (ERAS) Protocols and Pathways

Nitrous Oxide for Intrapartum and Immediate Postpartum Period

Section 05 : Adult - Controlled Substances

01 : Opioid Analgesia Dosing and Recommendations (Adult)

02 : Opioid Equianalgesic Chart

03 : Opioid-Induced Adverse Drug Reaction Management Guidelines

04 : PCA - Patient Controlled Analgesia Guidelines

05 : [RETIRED] PCA Titration Decision-making Guidelines - Adults

06 : Methadone Maintenance Treatment Guidelines (MMT)

**Many STANDARD WORK - Initiation, Waste, Transfer & Inventory, Discrepancy

Ambulatory Contract - Contract Medication Screenings in Primary Care Clinics

Ambulatory Contract - Standard Work: Collecting Chain of Custody Urine Specimens for Contract Med Screening

Ambulatory Contract - Standard Work: Placing Patient on Controlled Substance Contract

Ambulatory Contract - Standard Work: Processing Controlled Substance Refills and Pick Up with No Nurse Visit

Discharge Planning for Outpatients Who Will Receive Sedation or Anesthesia

Handover - Standard Work: Continuous Infusion Transfer for the Interfacility Admission

Handover - Standard Work: Bedside Handover of Care at Shift Change - Inpatient Nursing Staff

Handover - Standard Work: Controlled Substance Chain of Custody for Infusions

Handover - Standard Work: Medication Infusions between ICU RN & Anesthesia

Handover - Standard Work: Nursing Handover of Infusion Pump Interoperability

Handover - Standard Work: OR / INR to NNICU Post Anesthesia

Handover - Standard Work: Patients Going to SAS from Acute, IMU, and ED with PCA Pumps

Ketamine - Guideline 2.152: Ketamine Infusion - Adult ICU, IMU, PACU, Palliative Care, 5 Central

Ketamine - Protocol 1.080: Ketamine Continuous Infusion Protocol - ERAS Thoracic Acute & TIMU

Ketamine - Protocol 1.124: Pain Management (Ketamine) - Burn Hydrotherapy & Wound Care

Section 06 : Adult - Epidural and Intrathecal Analgesia

01 : Anticoagulation Management for Neuraxial or Peripheral Nerve Procedure

02 : Epidural Infusion Management

03 : Intrathecal Analgesia Insertion and Care

Nursing Policy on Epidural Continous Infusions and/or Boluses

Women's Services Epidural Guidelines & Checklists

Section 07 : Adult - Patient Education Links

3 Steps to Safely Manage Your Opioid / Pain Prescriptions

Opioid - 15032 English - Opioid Safety & How To Use Naloxone (Narcan)

Opioid - 15032 Spanish - Opioid Safety & How To Use Naloxone (Narcan)

Opioid - 15034 English - Taking Pain Medicines Safely

Opioid - 15034 Spanish - Taking Pain Medicines Safely

PCA - 15026 English - Patient Information Guide to Patient Controlled Analgesia

PCA - 15026 Spanish - Patient Information Guide to Patient Controlled Analgesia

Surgery - 93004 English - Pain Control for Surgery

Surgery - 93004 Spanish - Pain Control for Surgery

Section 08 : Adult - Appendix

01 : Glossary of Pain-related Terms

02 : Routes of Administration - Pain Management Medications

Chapter 02 : Pediatric Pain Resources

Section 00 : Policies, Protocols, and Procedures

01 Medical Center Policy 0239: Pain Assessment and Management (Adult & Pediatric Patients)

02 Medical Center Policy 0299: Controlled Substances

03 Medical Center Policy 0153: Procedural Sedation by Non-Anesthesiology Providers

04 Medical Center Policy 0312: Same Day Discharge of Outpatients Who Have Received Sedation or Anesthesia

05 Nursing Policy: Palliative Care, End of Life & Postmortem Care

06 Nursing Policy: Epidural Continous Infusions and/or Boluses

07 Emergency Dept P-2: Severe Pain Stabilization Procedure

08 Emergency Dept O-1: Outpatient Prescribing of Opioids in the Emergency Department

09 Standard Work: Comfort Rounding

Section 01 : Pediatric - General Guidelines

01 : Pediatric Pain Assessment and Management Guidelines

02 : Special Considerations - Infants & Children

05 : Neonatal & Pediatric Critical Care Pain, Agitation, and Delirium Management

03 : Sedation for Diagnostic and Therapeutic Purposes – Pediatric

04 : Monitoring and Treatment of Neonates at Risk for Neonatal Abstinence

Neonatal IV Medication Administration Guidelines

Pediatric IV Medication Administration Guideline

Section 02 : Pediatric - Consultation Resources

01 : Pediatric Pain Consultation Resources

Section 03 : Pediatric - Pain and Sedation Assessment Tools

01 : UVA Pediatric Pain Scale

02 : Pediatric FLACC Observation Tool

03 : Neonatal NPASS Scale

03a : Neonatal and Pediatric Pain and Sedation Guideline, Using N-PASS Scale

04 : Neonatal and Pediatric Sedation and Withdrawal Guideline using the Withdrawal Assessment Tool (WAT-1) and State Behavioral Scale (SBS)

05 : Sedation guideline for Mechanically Ventilated Patients in the PICU / Sedation Comfort Documentation Tool

06 : Critical Care Pain Observation Tool (CPOT) - temporarily sedated, mechanically ventilated, pediatric patients

07 : Modified Pasero Opioid Sedation Scale (POSS)

07a : Assess for Opioid Oversedation Using Modified POSS - Pediatric Acute Care

08 : Assume Pain Present - Assessment for Nonverbal or Cognitively Impaired Patients

Section 04 : Pediatric - Opioid Sparing Modalities

01 : Complementary Modalities for Pain Management

02 : Low Dose Continuous Lidocaine Infusion for Pain Control in the Pediatric Patient

03 : Oral Sucrose Analgesia Guidelines for the Preterm Infant and Neonate

04 : Non-Nutritive Suck and Cue-Based Feeding in the NICU

05 : Non-Opioid Analgesia Recommendations (Patients >40kg)

Section 05 : Pediatric - Controlled Substances

01 : Opioid and Non-Opioid Analgesia Recommendations for Infants and Children <40kg

02 : Opioid Equianalgesic Chart

03 : Opioid Analgesia Dosing and Recommendations (Patients >40kg)

04 : Opioid-Induced Adverse Drug Reaction Management Guidelines (Patients >40kg)

**Many STANDARD WORK - Initiation, Waste, Transfer & Inventory, Discrepancy

Handover - Standard Work: Bedside Handover of Care at Shift Change - Inpatient Nursing Staff

Handover - Standard Work: Controlled Substance Chain of Custody for Infusions

Handover - Standard Work: Medication Infusions between ICU RN & Anesthesia

Handover - Standard Work: Nursing Handover of Infusion Pump Interoperability

Handover - Standard Work: Patients Going to SAS from Acute, IMU, and ED with PCA Pumps

Section 06 : Pediatric - Patient Education Links

3 Steps to Safely Manage Your Opioid / Pain Prescriptions

Opioid - 15032 English - Opioid Safety & How To Use Naloxone (Narcan)

Opioid - 15032 Spanish - Opioid Safety & How To Use Naloxone (Narcan)

Opioid - 15034 English - Taking Pain Medicines Safely

Opioid - 15034 Spanish - Taking Pain Medicines Safely

PCA - 15026 English - Patient Information Guide to Patient Controlled Analgesia

PCA - 15026 Spanish - Patient Information Guide to Patient Controlled Analgesia

Surgery - 93004 English - Pain Control for Surgery

Surgery - 93004 Spanish - Pain Control for Surgery

Section 07 : Pediatric - Appendix

00 : References

01: Glossary of Pain-related Terms

02: Routes of Administration - Pain Management Medications

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