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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 | 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 |
| 3 | 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 |
| 4 | Interventions in chronic low back pain显示文摘 | Verrills P Vivian D | 2004 | Aust Fam Physician2004,33,6: | 1 |
| 5 | 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 |
| 6 | 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 |
| 7 | Interventions in chronic low back pain显示文摘 | Verrills P Vivian D | 2004 | Aust Fam Physician2004,33,: | 1 |
| 8 | Interventions in chronic low back pain显示文摘 | Verrills P Vivian D | | 0,,: | 1 |
| 9 | 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 |
| 10 | 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 |
| 11 | Quality of life measures and gender comparisons in North Carolina cardiac rehabilitation programs显示文摘 | Verrill D Barton C Beasley W | 2001 | Journal of Cardiopulmonary Rehabilitation2001,21,1: | 1 |
| 12 | Quality oflife meas- ures and gender comparisons in North Car0Iina cardiac re- habilita - tion pmgrams 显示文摘 | Verrill D Barton C Beasley W | 2001 | Journal of cardiopulmonary Re- hablit2001,21,1: | 1 |
| 13 | 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 |
| 14 | The stability of free and bound prostate specific antigen显示文摘 | Cartledge JJ Thompson D Verril H | 1999 | BJU Int1999,84,: | 1 |
| 15 | 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 |
| 16 | The effects of short-term and longterm 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 |
| 17 | A case-control study of smoking and bladder cancer risk:emergent patterns over time显示文摘 | Baris D Karagas MR Verrill C | 2009 | J Natl Cancer Inst2009,101,22: | 1 |
| 18 | The effects of shortterm 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 |
| 19 | The stability of free and boundprostate-specific antigen显示文摘 | Cartledge JJ Thompson D Verril H | 1999 | BJU Int1999,84,: | 1 |
| 20 | 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 |