Randomized Controlled Trial Summary

The paragraphs below describe the predominant clinical practice gaps in current management of chronic pain. As NPs increase their knowledge and competence in these areas, it is anticipated that changes in clinical practice will

Recognizing that the prevention of chronic disease and promoting population health is the key to controlling health care expenditure, the inclusion of pain management is a positive aspect of the legislation. While chronic pain is not in the top leading chronic diseases, the cost to the health care system is higher than heart disease and diabetes combined.2 This paper will discuss Title IV - Prevention of Chronic Disease and Improving Public Health. Subsection D - Support for Prevention and Public Health Innovation of the PPACA, including the funding of the United States Department of Health and Humans Services (HHS) for research in public health services and the examination of best prevention practices. One focus of this part of this provision is research and evaluation of pain management, the assessment, and treatment standards through an Institute of Medicine Conference on Pain Care.3

The leading cause of death for people in the majority of the ethnicities in the United States is heart disease, this includes Hispanics, whites and African American. Heart disease is second to cancer in the cause of death of Native Americans, Alaskan Natives and Pacific Islanders. The Center for Disease Control and Prevention (CDC) estimates that 610,000 deaths are recorded from heart disease in the United States annually – which translates to one in every four deaths. Furthermore, heart disease takes the lead in the cause of death of both men and women. The most common type of heart disease is coronary heart disease, being the prime culprit in the death of over 370,000 individuals yearly. On average, 735,000 Americans suffer a heart attack yearly, 525,000 of these are first time sufferers while 210,000 people are individuals who had suffered a heart attack in the past (CDC, 2015). The above alarming statistics on heart disease is a cause for concern and requires a strategic action to fight this public health problem. One of the ways to treat, prevent and reduce the number of heart disease cases is a good and effective patient education. This paper discusses the competencies that make a nurse a good, effective and expert patient educator in patient with coronary heart disease and how to become one.

The program evaluation model will be implemented in various stages. The stages include evaluation planning, data collection, analysis/interpretation, and reporting/dissemination. The setting is a college campus’s counseling unit of their wellness center. The assessment will also focus on students that only utilize one-on-one, face-to-face counseling services.

One of the many ways technology is improving PA and nursing is that it makes promoting patient education much easier. Patient education is when health professionals give information about how to alter your lifestyle to stay healthy. The traditional way of doing this was seeing your PA or nurse through doctor appointments, but now through technology there is a much faster and effective way of doing this.

As a Northwestern University professor of Anesthesiology, Honorio T. Benzon, defines chronic pain is “a demoralizing state that confronts individuals not only with the distress created by the symptoms but also with many other ongoing difficulties that compromise all aspects of their lives” (Benzon). Therefore, chronic pain is rooted in a variety of neurologic functions, integrated from the brain that affects the individual internally and externally. According to David B. Reuben MD, a professor at the David Geffen School of Medicine,

A rigorous evaluation typically involves either an experimental design (like that used in randomized controlled trials) or a quasi-experimental design. In an experimental design, people are randomly assigned to either a treatment group, which participants in the program, or the control group, which does not. After the program is completed, the outcomes of these two (2) groups are compared. This type of research design helps ensure that any observed differences in outcomes between the two (2) groups are the result of the program and not other factors. Given that randomization is not always possible, a quasi-experimental design is sometimes used. In evaluations using this design, the program participants are compared to a group of people similar in many ways to the program participants. However, because a quasi-experimental design does not randomly assign participants to program and non-program groups, it is not as strong a design as the experimental approach. Because there may be unobserved differences between the two (2) groups of people who are being compared, this design does not allow program evaluators to conclude with the same certainty that the program itself was responsible for the impacts observed. Therefore, it would be conducive to try and conduct an experimental design if at all possible (Cooney, Huser, Small, & O’Connor,

In a study done by Emadedin et al. in 2012, they injected MSC from each respective patients bone marrow, into six female volunteers with evidence of knee OA that was severe enough to require joint replacement surgery. The authors described a detailed, meticulous procedure in how they obtained the MSC from the patient’s bone marrow, and made it into the cells they needed for the procedure. They injected the patient’s affected knee joints with the stem cells and followed up with them in one year. At the one year mark, Emadedin et al. (2012) found that overall, the study was successful in decreasing pain and increasing the patients walking distance for the first 6 months. However, they discovered that 3 of the

Murray J. McAllister created this website because he had concerns for how chronic pain was being understood and managed in the current healthcare system. There is no uniform or consistency in how chronic pain is being treated among healthcare providers. Many providers also correlate chronic pain to a previous orthopedic injury and not from a nervous system related condition. This poses many concerns

Being able to identify the number of common factors and obstacles that may need to be overcome in order to carry out an effective patient engagement and strategies would need to be researched. Once the results of the data could be analyzed, we could then indicate the information to the patients and their characteristics and proclivities and others to those of providers. For patients to engage effectively in shared decision making, they must have a certain degree of health literacy. Suppose that all patients are at risk of not understanding their health conditions or how to deal with them. Health care organizations adopting this model would work to increase health literacy and patient engagement over the entire care span. If health care organizations

Comparing a Brief Self-as-Context Exercise to Control-Based and Attention Placebo Protocols for Coping with Induced Pain are two analogue studies that were conducted on college students.This study was conducted due to the large amounts of research that is dedicated to understanding commitment therapy and diagnostic approach based on a unified model of human functioning that promotes psychological flexibility. (ACT; Hayes et al. 2012).It examines the relative impact of a brief exercise for enhancing the contextual self on pain tolerance by comparing it to control-based and attention-placebo protocols. It

Evidence-based nursing practice is a result of research studies or randomized controlled trials (RCT). However, from these trials, a compilation of the evidence is gathered that determines the direction of future trials. Often, the results or findings of the research article will indicate if further studies are warranted and indicated why these studies would be beneficial. Also, the possibility of any sampling error, or selection bias that may have of skewed results of the RCT. Wong and Myers (2015) place the responsibility in the hands of the managers, educators, and clinical nurse specialists to stay abreast of recommended changes, educate and evaluate their clinicians(p. 18). However, the weight of their due diligence begins with gaining

Chronic pain is prevalent problem with significant cost to individuals, their significant others, and to society. In one survey they found that the 12 month prevalence or chronic pain was 37% in developed countries and 41% in developing countries. Before the 1960s chronic pain was viewed as a medical issue that required treatment such as medications and

Much of the literature and research related to the use of cognitive-behavioral therapy in the treatment of chronic pain is rather new. Overall, upon reviewing the available literature, it appears as though research is focused on determining what particular chronic pain populations experience the most success with CBT-based treatments.

constraints and the lack of adequate reimbursement for spending additional time with patients in educational sessions. (Larme, Pugh, 2011). Although every member of the medical team should be actively involved in providing diabetes education to patients, physicians often lack the time necessary to provide preventative services and spend the least amount of their time in educating patients (Yarnall, et al, 2003). Certified Diabetes Educators are an excellent liaison to facilitate physicians’ time and they have been shown to lower patients’ A1C levels by educating them on diabetes self-management, especially in rural areas where physician availability is sparse. (Siminerio et al, 2005). Nurses, Nurse Practitioners and Physician Assistants are also an excellent resource to utilize in these instances because their broad skill set, advanced medical knowledge as well as the trend of spending more time with patients gives them the ability to facilitate diabetic education for patients. (Macdonald, et al, 2013). Multiple studies have shown that nurse-led diabetes education was effective in lowering HbA1c levels in diabetic patients, as well as the risk of CV disease. (Tshiananga, et al, 2011). However, the amount of information imparted on patients must be carefully considered and divided in multiple visits and educational sessions, as to avoid overwhelming patients with information overload, which often leads to confusion and misunderstanding or lack of