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| 1 | Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination显示文摘AIM To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.METHODS Specific intervention strategies(i.e.,comfort positioning,nonnutritive sucking and sucrose analgesia,distraction) were identified,selected and introduced in three waves,using a Plan-Do-Study-Act framework.System-wide change was measured from baseline to post-intervention by:(1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and(2) caregiver satisfaction ratings following the visit.Additionally,self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.RESULTS Significant improvements were noted post-intervention.Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received.Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [t(143) = 2.50,P ≤ 0.05],as well as greater agreement that the pain prevention strategies used helped their children's pain [t(180) = 2.17,P ≤ 0.05] and that they would be willing to use the same strategy again in the future [t(179) = 3.26,P ≤ 0.001] as compared to baseline.Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention.Specifically,staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t(70) =-2.11,P ≤ 0.05],less agreement that pain from vaccinations is 'just part of the process' [3.94 vs 3.23; t(70) = 2.61,P ≤ 0.05],and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t(69) = 2.24,P ≤ 0.05].Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas,including safety,cost,time,and effectiveness,as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t(557) = 6.38,P ≤ 0.001],less need for additional pain prevention strategies [3.33 vs 2.81; t(476) = 4.51,P ≤ 0.001],and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t(433) =-2.39,P ≤ 0.05].CONCLUSION Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children. | Jennifer Verrill Schurman Amanda D Deacy Rebecca J Johnson Jolynn Parker Kristi Williams Dustin Wallace Mark Connelly Lynn Anson Kevin Mroczka | 2017 | World Journal of Clinical Pediatrics2017，6，1： | 3 |
| 2 | Postural sway biofeed back:its effect on reestablishing stance stability in hemiplegic patients 显示文摘 | Shumway-Cook A Anson D Hailer S | 1988 | Arch Phys Med Rehabil1988，69，6： | 1 |
| 3 | Postural sway biofeedback:its effect on re-establishing stance stability in hemiplegic patients显示文摘 | Shumway-Cook A Anson D Haller S | 1988 | Arch Phys Med Rehabil1988，69，： | 1 |
| 4 | Postural sway biofeedback:its effect on reestablishing stance stability in hemiplegic patients显示文摘 | Shumway-Cook A Anson D Haller S | 1988 | Arch Phys Med Rehabil1988，69，： | 1 |
| 5 | Develop- ment of calorie restriction mimetics as a prolongevity strategy 显示文摘 | INGRAM D K ANSON R M DE CABO R | 2004 | Ann N Y Acad Sci2004，1019，： | 1 |
| 6 | Single-channel analysis of an NMDA receptor possessing a mutation in the region of the glutamate binding site显示文摘 | Anson LC Schoepfer R Colquhoun D | 2000 | J Physiol2000，527，： | 1 |
| 7 | High level expres- sion nf the phenylalanine ammonia lyase encoding gene from Rho- dosporicium toruloides in Saccharomyces cerevisiae and Escherichia coli using a bifunctional expression system 显示文摘 | Faulkner J D B Anson J G Tuite M F | 1994 | Gene1994，143，1： | 1 |
| 8 | Some aspects of anion-induced adsorption of white metal cations on mercury显示文摘 | Barclay D J Anson F C | 1970 | J Electroanal Chem1970，28，： | 1 |
| 9 | Catalysis of the electroreduction of O2 by cobalt 5,10,15,20-tetraPhenylPorphyrin dissolved in thin layers of benzonitrile on graphite electrodes显示文摘 | CHUNG T D FRED C ANSON F C | | 0，，01： | 1 |
| 10 | Postural sway bio- feedback= Its effect on reestablishing stance stability in hemiplegic patients 显示文摘 | Shumway-Cook A Anson D Hailer S | 1988 | Arch Phys Med Rehabil1988，69，6： | 1 |
| 11 | The effects of shading on morphometric and meristic characteristics of wild celery,Vallisneria americana,transplants from Lake Okeechobee,Florida显示文摘 | Havens K E Sharfstein B Steinman A Anson D East T Maki R P Rodusky A Jin K R | 2002 | Arch Hydrobiol2002，155，： | 1 |
| 12 | High-inten- sity cycle interval training improves cycling and running per- formance in triathletes显示文摘 | ETXEBARRIA N ANSON J M PYNE D B | 2013 | Eur J Sport Sci2013，14，6： | 1 |
| 13 | Novel therapies in acute and chronic heart failure显示文摘 | Anson D Krum H | 2012 | Pharmacol Ther2012，135，1： | 1 |
| 14 | Robust audio watermarking using perceptual masking显示文摘 | Zhu B Tewfik A H | 1998 | Signal Processing1998，66，： | 1 |
| 15 | Hydrotreatment of bitumen from the whiterocks oil sand deposit显示文摘 | Longst Aff D C Deo M D H Anson F V | | 0，，09： | 1 |
| 16 | Molecular and functional characterization of common polymorphisms in HERG ( KCNH2 ) potassium channels 显示文摘 | Anson BD Ackerman M J Tester D J | 2004 | Am J Physiol Heart Circ Physiol2004，286，： | 1 |
| 17 | Postural sway biofeed-back : its effet on reestablishing stance stability in hemiplegic patients显示文摘 | Shumway CA Anson D Hailer S | 1988 | Arch Phys Med Rehabil1988，69，6： | 1 |
| 18 | High level expression of the phenylalanine ammonia lyase encoding gene from Rhodosporicium toruloides in Saccharomyces cerevisiae and Escherichia coli using a bifunctional expression system显示文摘 | FAULKNER J D B ANSON J G TUIIE M F | 1994 | Gene1994，143，1： | 1 |
| 19 | Calcium sulfate:a 4-year observation of its use as a resorbable barrier in guided tissue regeneration of periodontal defects显示文摘 | Anson D | 1996 | Compend Contin Educ Dent (Compendium of continuing education in dentistry (Jamesburg NJ:1995)1996，17，9： | 1 |
| 20 | Hydrothermal synthesis,crystal structure,spectroscopy,electrochemistry and antimycobacterial evaluation of the copper(Ⅱ) ciprofloxacin complex:[Cu(cf) 2(BF4) 2]6H2O显示文摘 | Saha D K Padhye S Anson C E | | 0，，05： | 1 |
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