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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 | Measurement of fracture kyphosis with the Oxford Cobbometer:intra-and interobserver reliabilities and comparison with other techniques显示文摘 | Seel EH Verrill CL Mehta RL | 2005 | Spine2005，30，8： | 1 |
| 3 | Alcohol - related cirrhosis: Early abstinence is a key factor in prognosis, even in the most severe cases 显示文摘 | Verrill C Markham H Templeton A | 2009 | Addiction2009，104，5： | 1 |
| 4 | Persistent recognition of autologous virus by high-avidity CD8 T cells in chronic, progressive human immunodeficiency virus type 1 infection 显示文摘 | Draenert R Verrill C L Tang Y | 2004 | J Virol2004，78，： | 1 |
| 5 | The effect of short-term and long-term pulmonary rehabilitation on functional capacity, perceived dyspnea and quality of life显示文摘 | Verrill D Barton C Beasley W | 2005 | Chest2005，128，2： | 1 |
| 6 | The effects of short-term and long-term pulmonary rehabilitation on functional capacity, perceived dyspnea, and quality of life显示文摘 | Verrill D Barton C Beasley W | 2005 | Chest2005，128，2： | 1 |
| 7 | Interventions in chronic low back pain显示文摘 | Verrills P Vivian D | 2004 | Aust Fam Physician2004，33，6： | 1 |
| 8 | Measurement of fracture kyphosis with the Oxford Cobbometer:intra- and interobserver reliabilities and comparison with other techniques 显示文摘 | Seel EH Verrill CL Mehta RL | 2005 | Spine2005，30，8： | 1 |
| 9 | Measurements of human breast cancer using magnetic resonance spectroscopy:a review of clinical measurements and a report of localized ^31p measurements of response to treatment显示文摘 | Leach M O Verrill M Glahoim J Smith T A Coliins D J Payne G S | 1998 | NMR Biomed1998，11，： | 1 |
| 10 | E - portfolios : dyocumenting student progress 显示文摘 | GARTHWAIT A VERRILL | 2003 | Science and Chil- dren2003，，8： | 1 |
| 11 | Vacuum-pressure soak plus ovendry as an accelerated-aging test for wood-based panel products显示文摘 | Karlsson P O A Mcnatt J D Verrill S P | 1996 | Forest Products Journal1996，46，9： | 1 |
| 12 | Adeno-asso- ciated virus interactions with B23/Nucleophosmin: identifica- tion of sub-nucleolar virion regions显示文摘 | Bevington JM Needham PG Verrill KC | 2007 | Virology2007，357，1： | 1 |
| 13 | Interventions in chronic low back pain显示文摘 | Verrills P Vivian D | 2004 | Aust Fam Physician2004，33，： | 1 |
| 14 | Histopathological as- sessment of lymph nodes in eolorectal carcinoma:docs triple levelling detect significantly more metastases 显示文摘 | Verrill C Carr NJ Wilkinson-Smith E | 2004 | Journal of Clinical Patholo- gy2004，57，11： | 1 |
| 15 | Interventions in chronic low back pain显示文摘 | Verrills P Vivian D | | 0，，： | 1 |
| 16 | The effects of short-term and long-term pulmonary rehabilitation on functional capacity,perceived dyspnea and quality of life显示文摘 | Verrill D Barton C Beasley W | | 0，，： | 1 |
| 17 | Development and evaluation of alow-temperature gasification process for chemical recovery fromkraft black liquor显示文摘 | DickinsonJ Verrill C Kitto J | 1998 | International Chemical Recovery Conference1998，3，： | 1 |
| 18 | Acohol-related cirrhosis-early abstinence is a key factor in prognosis,even in the most severe cases显示文摘 | VERRILL C MARKHAM H TEMPLETON A | 2009 | Addiction2009，104，4： | 1 |
| 19 | The effects of short term and long- term pulmonary rehabilitation on functional capacity,perceived dyspnea,and quality of life显示文摘 | Verrill D Barton C Beasley W | 2005 | Chest2005，128，2： | 1 |
| 20 | Subproteomics based upon protein cellular location and relative solubities in conjunction with composite two-dimensional eletrophoresis gels 显示文摘 | Cordwell SJ Nouwens AS Verrills NM | 2000 | Electrophoresis2000，21，6： | 1 |
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