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Archive September 2016 XVII, No. 9

Pain Control: Dedicated Teamwork Makes Patients the Winners

The staff at Capital Region Medical Center work hand in hand to achieve excellent pain management.

Jim Burger

Jim Burger, Senior Editor


Nicolette Wise, DO AROUND THE BLOCK Nicolette Wise, DO, performs a supraclavicular nerve block before surgery, assisted by Dr. Tiona Langton, DO.

When surgical patients at Capital Region Medical Center in Jefferson City, Mo., marvel at how little pain they've had to endure, despite having been given few, if any, opioids, they may want to express their gratitude. But whom should they thank? Depends whom you ask.

"Our excellent pain management is largely attributable to our excellent pre-operative and post-operative nursing staff," says Tiona Langton, DO, the hospital's chief of anesthesiology. "They're very attentive to each patient and always in communication with us for their needs."

Ah, but Dr. Langton is being typically modest, says Beth Rackers, RN, CNOR, the clinical educator for surgical services at the hospital. The dozen anesthesiologists and CRNAs who take a personal interest in every patient are the ones who deserve most of the credit, she says. "They do a phenomenal job. When I think about how I'd want to feel in respect to pain after having surgery, I think about the anesthesia staff we have at Capital Region."

The nurses? The anesthesia providers? The staff as a whole? Credit — and gratitude — should be given to everyone. What's propelled Capital Region to such impressive heights and earned the hospital this year's OR Excellence Award for Pain Management is teamwork. Teamwork makes winners, and the ultimate winners in this story are the patients who, even in the aftermath of major procedures, are likely to feel remarkably comfortable without having to worry about the undesirable — and potentially dangerous — side effects associated with opioids.

Holistic Approach Boosts Satisfaction

After incorporating what it calls holistic modalities to help manage post-surgical pain, the Ambulatory Surgery Center at St. Joseph's Regional Medical Center in Paterson, N.J., saw its patient satisfaction scores rise from 78% to 88%. The center uses guided imagery, hand massage, holistic music therapy and mandala meditations (a therapeutic form of drawing) to alleviate anxiety and pain. The approach is based on the philosophy of patient empowerment and the center's data shows statistically significant results in reducing post-op pain.

Proponents of regional
"All of our efforts are done to minimize the patient's narcotic requirements throughout the perioperative period," says Dr. Langton. "We have a multimodal analgesic approach to all of our cases."

Whenever possible, the planning starts several days in advance. The facility's anesthesia providers try to interview every patient and discuss their experiences, their preferences and their co-morbidities. Then they tailor their approach accordingly. "One of the biggest factors in their success is their willingness to step up and take initiative," says Ms. Rackers. "They're genuinely friendly folks and they work great together with the rest of the staff."

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