Implementing Non-Pharmacologic Pain Management After Lower Extremity Injury: The Role of the Child Life Specialist
Keywords:Non-pharmacologic pain management
Lower extremity trauma
Child life specialist
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Prescription drug overdoses in Ohio are climbing (Scholl, Seth, Wilson, & Baldwin, 2019). The opioid crisis in Ohio has led to restrictions on prescribing opioid pain medications for children with post-operative pain (Ohio Board of Pharmacy, 2017). Peri-operative anxiety increases post-operative pain and increases the risk for complications in hospitalized children (Chieng, Chan, Klainin-Yobas, & He, 2014; Chng et al., 2015; He, Zhu, Chan, Klainin-Yobas, & Wang, 2015; Kain, Mayes, Caldwell-Andrews, Karas, & McCain, 2006). Non-pharmacologic pain resources provided by Certified Child Life Specialists (CCLS) are a viable adjunct for pain management and can minimize opioid use (Ali, Drendel, Kircher, & Beno, 2010). A routine CCLS consult was implemented in the fall of 2018 for patients admitted to the Orthopaedic service with lower extremity injuries. A retrospective chart review was conducted and compared to patients who received a routine CCLS consult on admission. Average daily pain rating scores, amount of pain medications given (both opioid and non-opioid) during the admission, number of physical therapy (PT) attempts, length of stay (LOS), and demographics were collected for both the retrospective and prospective group. Pain rating scores and pain medication had a decrease in the prospective group; there was no statistical significance, however a positive trend could be seen in the data. The recommendations are to adopt a routine CCLS consult for children with unplanned admissions due to trauma in order to reduce the number of opioids used, provide children with pain and anxiety management resources, and promote coping skills that may be used in the future.
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